How much does Medi-Cal pay doulas for their services?
| Service | Reimbursement |
|---|---|
| Initial 90 min prenatal visit: | $197.98 |
| Prenatal visit: | $162.11 |
| Postpartum visit: | $162.11 |
| Extended postpartum support (for a three-hour visit): | $486.36 |
| Support during vaginal delivery: | $685.07 |
| Support during cesarean section: | $795.73 |
| Support during or after miscarriage: | $250.85 |
| Support during or after abortion: | $250.48 |
Initial Visit
90 minute initial visit with your client at the start of the contract
Additional Visits
With the initial standing recommendation you can meet with your client up to eight more times. It's up to you to decide how to divide them - prenatal, postpartum, a little of both...
Support During Labor & Delivery
Your initial recommendation includes support during labor and delivery, abortion or miscarriage (including labor and delivery resulting in a stillbirth) - in this example our client has a vaginal birth so you would be reimbursed $685.07 for support during birth
Extended Postpartum Visits
You also meet with your client twice after the end of pregnancy for three hours each time.
Total
The total amount you could be reimbursed from Medi-Cal for these 12 interactions is $3,152.65
Additional Recommendation
With an additional recommendation you can add up to 9 more postpartum visits!
Grand Total
The total reimbursement for this contract is now $4,611.64 - the hightest reiumbursement rate in the country for doula Medicaid services!
Practical Examples
If you are a Birth Doula consider:
$197.98 - 1 (in-person, 90min) extended initial prenatal visit
$324.22 - 2 (in-person) prenatal visits
$810.55 - 5 (virtual) prenatal visits- 30min calls & zooms for check ins and Q&A
$162.11 - 1 (in-person or virtual) early labor support, billed as a prenatal visit
$795.73 - Birth Support (surgical/Cesarean)
$486.36 - 1 (in-person, 3 hours) extended postpartum visit, at bedside, directly after the birth
$486.36 - 1 (in-person, 3 hours) extended postpartum visit, at client’s home
Total Reimbursement: $3,263.31
If you are a Postpartum Doula consider:
- The DHCS Medi-Cal Doula Benefit covers 8 prenatal/postpartum visits, and 2 extended postpartum visits. As such, it is recommended that you are aware if the client has received prenatal visits from another doula, before starting your postpartum services.
- Client’s can secure a second recommendation (from an approved provider) for 9 additional postpartum visits
- DHCS did not create a reimbursement model to compensate for overnight visits
$972.72 - 2 (in-person, 3 hours) extended postpartum visit, at client’s home ($486.36 each visit).
$1,458.99 - 9 (in-person) postpartum visits ($162.11 each visit).
Total Reimbursement: $2,431.71
If you are an Abortion Doula consider:
$197.98 - 1 (in-person, 90min) extended initial prenatal visit
$324.22 - 2 (in-person) prenatal visits
$810.55 - 5 (virtual) prenatal visits- 15-30min calls & zooms for check ins and Q&A
$162.11 - 1 (in-person or virtual) early labor support, billed as a prenatal visit
$250.48 - Abortion Support
$486.36 - 1 (in-person, 3 hours) extended postpartum visit, at bedside, directly after the birth
$486.36 - 1 (in-person, 3 hours) extended postpartum visit, at client’s home
Total Reimbursement: $2,718.06
Examples cited from a presentation created by Khefri Riley and Dr. Sayida Peprah-Wilson.
Reimbursement rates can be found on page 10 of the Doula Stakeholder Meeting PowerPoint from October 2022.
