Doula Services
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
Per State Plan Amendment (SPA) 22-0002, doula services are provided as preventive services pursuant to Title 42 Code of Federal Regulations (CFR) Section 440.130(c).
The Department of Health Care Services (DHCS) issued a statewide standing recommendation that all Medi-Cal members who are pregnant or were pregnant within the past year would benefit from receiving doula services from a Medi-Cal enrolled doula provider. The recommendation fulfills the federal requirement for a physician or other licensed practitioner of the health arts acting within their scope of practice to provide a written recommendation for preventive services. Doulas provide person-centered, culturally competent care that supports the racial, ethnic, linguistic, and cultural diversity of members while adhering to evidence-based best practices.
Doula services are aimed at preventing perinatal complications and improving health outcomes for birthing parents and infants.
This section contains general information on doula services. Doula services are aimed at preventing perinatal complications and improving health outcomes for birthing parents and infants.
- Doulas are birth workers who provide health education, advocacy, and physical, emotional, and non-medical support for pregnant and postpartum persons before, during, and after childbirth, including support during miscarriage, stillbirth, and abortion.
- Doulas also offer various types of support, including health navigation; lactation support; development of a birth plan; and linkages to community-based resources.
- Doulas are not licensed, and they do not require supervision. Doulas do not diagnose medical conditions, provide medical advice, or clinical assessment, exam, or procedure.
Eligibility requirements
The member must be active and enrolled in the Medi-Cal Plan.
- Doulas must verify eligibility for the month of service by contacting the Plan or looking the member up in the provider portal.
- The member must be pregnant or have been pregnant within the past year and would benefit from doula services.
Documentation requirements
Additional visits during the postpartum period require a recommendation from a licensed practitioner of the healing arts. Up to nine postpartum visits can be added.
Initial Set of Services:
Members can receive doula services virtually or in-person in any setting, such as home, office, hospital, or an alternative birthing center. All visits are limited to one per day, per member.
The initial recommendation authorizes the following:
- One initial visit.
- Additional visits – up to eight given in any combination of prenatal and postpartum visits.
- Labor and delivery support – including labor and delivery resulting in miscarriage, stillbirth and abortion.
- Postpartum – up to two extended three-hour visits. These visits do not require the member to meet any criteria or receive a separate recommendation.
Assistive services during visits
Doulas can also give assistive or supportive services during an in-home prenatal or postpartum visit. This support provides face-to-face interaction while helping with emotional or educational support, such as folding laundry or drying dishes with the pregnant member. An assistive or supportive activity with the member cannot be billed to the member.
Note: If a doula teaches classes, the classes can be offered at no cost to a member receiving services from the doula.
Coordinating services
Doulas should work with the member’s primary care physician (PCP) or contact the Plan if the member needs additional support.
Non-covered doula services
The following are not covered under doula services:
- Belly binding (traditional/ceremonial)
- Birthing ceremonies (i.e., sealing, closing the bones, etc.)
- Group classes on babywearing
- Massage (maternal or infant)
- Photography
- Placenta encapsulation
- Shopping
- Vaginal steams
- Yoga