Reimbursement Rates

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

Keep in mind

The initial recommendation authorizes the following:

  • One initial visit
  • Up to eight additional visits that may be provided in any combination of prenatal and postpartum visits.
  • Support during labor and delivery (including labor and delivery resulting in a stillbirth), abortion or miscarriage.
  • Up to two extended three-hour postpartum visits after the end of a pregnancy.
  • An additional recommendation from a physician or other licensed practitioner of the healing arts acting within their scope of practice is required for up to nine additional postpartum visits.

For Example:

Let's look at a case study with one client and all the ways you might interact with them and be reimbursed by Medi-Cal. So, let’s say your client had a vaginal birth:

1
1 - initial visit

Initial Visit

90 minute initial visit with your client at the start of the contract

2
2 - additional visits

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...

birth
3 - vaginal birth

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

4
4 - extended postpartum

Extended Postpartum Visits

You also meet with your client twice after the end of pregnancy for three hours each time.

5
5 - first rec total

Total

The total amount you could be reimbursed from Medi-Cal for these 12 interactions is $3,152.65

Add a heading
6 - additional recommendation

Additional Recommendation

With an additional recommendation you can add up to 9 more postpartum visits!

Add a heading (1)
7 - overal total

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

1

If you are a Postpartum Doula consider:

pexels-william-fortunato-6393374
  • 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

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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.