The NYS Medicaid Doula Services team has created a shareable one-page flyer to provide information about the doula services benefit. Please distribute this flyer widely with your networks in order to increase awareness, education, and the impact of the Medicaid doula services benefit.
Click Flyer to download PDF.
The NYS enacted 2023-24 Executive Budget includes expanded Medicaid coverage of preventative care, including Statewide Medicaid coverage and higher reimbursement for doulas. The NYS Office of Health Insurance Programs will continue to engage doula stakeholders to implement the Medicaid doula services benefit.
* Additional sessions have been added to support provider enrollment. See table below.
* Videos on YouTube can be viewed with captions in other languages. First, click the "CC" button to turn on subtitles/closed captions. Next, click the "Settings" button and select "Subtitles/CC English (auto-translated)". Finally, click "Auto-translate" and select your language.
*Videos on YouTube can be viewed with captions in other languages. First, click the "CC" button to turn on subtitles/closed captions. Next, click the "Settings" button and select "Subtitles/CC English (auto-translated)". Finally, click "Auto-translate" and select your language.
Enrollment Information
Doula services are a permanent Medicaid benefit. Doulas are able to enroll as NYS Medicaid doula services providers on an ongoing basis. There is no deadline to apply.
Visit eMedNY to enroll.
Short Enrollment Videos
Videos have been created to support provider enrollment.
All videos are 5-15 minutes in length.
Videos are available anytime for user convenience.
*Videos on YouTube can be viewed with captions in other languages. First, click the "CC" button to turn on subtitles/closed captions. Next, click the "Settings" button and select "Subtitles/CC English (auto-translated)". Finally, click "Auto-translate" and select your language.
* Past Provider Enrollment Support slide decks and recordings can be viewed in the Archive below.
Preparing for NYS Medicaid Enrollment and Billing
Review Doula Services Provider Enrollment Information on eMedNY.org:
* Attendance at informational and support sessions are voluntary.
*Videos on YouTube can be viewed with captions in other languages. First, click the "CC" button to turn on subtitles/closed captions. Next, click the "Settings" button and select "Subtitles/CC English (auto-translated)". Finally, click "Auto-translate" and select your language.
* Past Provider Enrollment Support slide decks and recordings can be viewed in the Archive below.
* Attendance at informational and support sessions are voluntary.
*Videos on YouTube can be viewed with captions in other languages. First, click the "CC" button to turn on subtitles/closed captions. Next, click the "Settings" button and select "Subtitles/CC English (auto-translated)". Finally, click "Auto-translate" and select your language.
For further billing support and questions, please contact the eMedNY call center at 1-800-343-9000 or submit a contact form.
NYS Medicaid Fee-for-Service Doula Directory
Doulas will be added to the doula directory once their enrollment is approved.
Doulas are responsible for ensuring the information in the doula directory is accurate. If doulas need to update their responses, please submit a new response. The link can be found in the yellow box on eMedNY.
Medicaid Managed Care
Doula services will be carved out of the MMC plan benefit packages from March 1, 2024, through March 31, 2025.
All Medicaid Members who are enrolled in FFS or MMC plans are eligible for Medicaid coverage of doula services during and after the MMC carve out.
Doulas must first enroll with FFS in Medicaid before they can contract with MMC Plans
Each MMC Plan will have their own contracting process for doulas.
More guidance about the Carve-Out can be found in the Provider Manual (external link)
To see which Medicaid Managed Care Plans operate in each NYS county, visit the Medicaid Managed Care Enrollment Reports webpage and view the report for the current year and month.
The Medicaid Office has compiled a list of points of contact at each MMC plan for doulas. Please see the table in the dropdown tab below.
*Videos on YouTube can be viewed with captions in other languages. First, click the "CC" button to turn on subtitles/closed captions. Next, click the "Settings" button and select "Subtitles/CC English (auto-translated)". Finally, click "Auto-translate" and select your language.
Standing Order for Doula Services
The State Health Commissioner Dr. James McDonald issued a statewide standing order that all New Yorkers who are pregnant, birthing, or postpartum would benefit from receiving doula services. This order is another step in expanding access to doula care and fulfills the requirement for a provider recommendation for services to be covered by Medicaid. The standing order will allow doulas to provide physical, emotional, educational, and non-medical support for pregnant and postpartum individuals before, during, and after childbirth or at the end of pregnancy through 12 months postpartum.
This order fulfills the federal requirements in section 440.130(c) of title 42 of the Code of Federal Regulations for a physician or other licensed practitioner of the healing arts acting within their scope of practice to provide a written order for preventive services.
Statewide Benefit Updates
The State Plan Amendment (SPA) for NYS Medicaid Doula Services was submitted for federal approval on December 28, 2023, and approved March 25, 2024. There are two ways to view the SPA:
The Federal Public Notice (FPN) for doula services was published in the NYS Register as of December 13, 2023. The FPN allows for formal public comment on the proposed NYS Medicaid doula services benefit from the FPN publication date, December 13, 2023, until federal approval. The public comment period is now closed. There are three ways to view the FPN:
Link to the Dec 13, 2023, NYS Register (page 79 of the document, page 85 of the PDF).
The doula services FPN can be found in the issue labeled "December 13, 2023/Vol. XLV, Issue 50.".
To review issues, scroll down to the bottom of the State Register website and use the search function.
View the PDF of the Dec 13, 2023, NYS Register (page 79 of the document, page 85 of the PDF).
Doula Pilot Program
On April 23, 2018, New York State announced a comprehensive initiative to target maternal mortality and reduce racial disparities in health outcomes. This initiative included a pilot program to provide Medicaid coverage for doula services to pregnant and postpartum people. A doula, also known as a birth companion, birth coach, or post-birth supporter, is a non-medical person who provides physical, emotional, and informational support to pregnant people before, during, and after delivery. Doulas receive training from either a national organization or a community-based organization, and these trainings vary in content, requirements, and duration. There are no universally accepted standards for doula certification and doulas are not licensed. Doulas do not prescribe treatment, complete a physical or behavioral health assessment, or provide medical care or advice.
Starting on March 1, 2019, pregnant people who were enrolled in Medicaid and living in Erie County were eligible to enroll in the New York State Doula Pilot Program. The pilot was initially established for a two-year period and was extended. Reimbursement for doula services continued through February 29, 2024, and doulas were able to enroll in the pilot through February 28, 2023.
All doulas who are currently enrolled in New York State Medicaid via the Doula Services Pilot will remain enrolled through February 28, 2025. To revalidate on or before February 28, 2025, doulas who are currently enrolled in New York State Medicaid via the Doula Services Pilot will need to follow updated revalidation requirements according to statewide guidelines.
As of April 9, 2024, 1,117 people enrolled in one of six different Medicaid Managed Care Plans or Medicaid Fee-for-Service participated in the pilot program.The pilot covered up to four visits with the doula before delivery, up to four visits with the doula after delivery, and doula support during labor and delivery. To date, approximately 81% of claims were for prenatal visits, 6% were for labor and delivery support, and 13% were for postpartum visits.
Participating people were all sent a survey to assess satisfaction and experience with the pilot. To date, 94% of respondents said having a doula improved or somewhat improved their childbirth experience and 92% of respondents rated their doula as good or excellent.
