Doula Services
The Department of Health Care Services (DHCS) added doula services as a covered benefit through State Plan Amendment 22-000, effective January 1, 2023. Doula services are available in both the Medi-Cal fee-for-service (sometimes called “Regular” Medi-Cal) and Medi-Cal managed care delivery system.
- In Medi-Cal fee-for service, Medi-Cal members access covered doula services directly from Medi-Cal enrolled doulas who bill DHCS directly.
- In Medi-Cal managed care, Medi-Cal members access covered doula services through their applicable Medi-Cal managed care plan (MCP).
For general information on Medi-Cal doula services, please refer to DHCS’ Frequently Asked Questions: General (updated August 2026).
Background
Doulas are non-clinical, trained professionals who provide personal support to Medi-Cal members and their families throughout pregnancy and up to one year postpartum. This includes emotional, physical, and informational support provided during pregnancy, labor, birth, and the postpartum period, as well as support for and after miscarriage and abortion. Doulas are also known by other titles, including birth workers.
Doulas can help prevent perinatal complications and improve health outcomes for birthing parents and infants. According to a recent review by Sobczak and colleagues (2023), doula care was associated with positive delivery outcomes including a reduction in caesarean sections, epidural use, length of labor, low-birthweight and premature deliveries. Additionally, the emotional support provided by doulas lowered stress and anxiety during the labor period.
Studies examining the impact of continuous support by doulas report increased empowerment and autonomy during birth, high overall satisfaction with the birthing process, and improved breastfeeding success and duration (Sobczak et al., 2023).
Written Recommendation Requirement
As a preventive benefit, doula services require a written recommendation from a physician or other licensed practitioner of the healing arts.
Core Set of Doula Services
To increase access to services, DHCS Medical Director, Karen Mark, MD, issued a standing recommendation for the initial, core set of doula services (as described below) for any Medi-Cal member who is pregnant or was pregnant within the past year.
Additional Postpartum Visits
To be eligible to receive up to nine (9) additional postpartum visits, an additional recommendation from a physician or other licensed practitioner of the healing arts if required. This recommendation can be noted in the Medi-Cal member’s medical record by the recommending licensed provider, or a member can ask a licensed provider to complete the Medi-Cal Doula Services Recommendation: Additional Postpartum Visits form and give the form to the doula.
Covered Services
Under Medi-Cal, covered doula services include all of the following:
- One initial visit.
- Up to eight (8) additional visits, which may be provided in any combination of prenatal and postpartum visits.
- Support during and after labor and delivery (including labor and delivery resulting in a stillbirth), abortion, or miscarriage.
- Up to two (2) extended three (3)-hour postpartum visits after the end of a pregnancy.
- Up to nine (9) additional postpartum visits.
Please note that the standing recommendation authorizes all of the above services except the nine (9) additional postpartum visits, which require an additional recommendation from a physician or other licensed practitioner of the healing arts acting (as described above).
Medi-Cal Doula Toolkit
The Department of Health Care Services (DHCS) created this “Medi-Cal Doula Toolkit” (Toolkit) to provide additional guidance and clarification to assist Medi-Cal doula providers with navigating and understanding DHCS requirements, including enrollment and coverage and billing, as well as Medi-Cal managed care requirements for contracted Medi-Cal managed care plans (MCPs).
Senate Bill 65 Doula Stakeholder Workgroup
Senate Bill 65 (Skinner, Chapter 449, Statutes of 2021) required DHCS to establish a Doula Implementation Stakeholder Workgroup and publish a report by July 1, 2025. The Doula Benefit Implementation Report is now available and includes quantitative and qualitative data on doula service utilization and recommendations on outreach efforts and reducing barriers to services. Information about previous stakeholder meetings can be found on the Doula Implementation Stakeholder Workgroup webpage.
Spotlights: Doula Impacts
We’re excited to highlight a new Day with a Doula feature from the DHCS Office of Communications. In this video, DHCS Social Media Manager Andie Tovar interviews Amber Bardini of Blooming Families Doula Services to share how doulas play an essential role in supporting parents throughout their breastfeeding journey. This feature is a wonderful way to spread awareness about the benefits available to Medi-Cal members while also illustrating the essential and compassionate care doulas provide to families every day. We encourage you to watch and share the video with your community to help more families and providers understand the true value of doula care.
Resources
DHCS Medi-Cal Doula Benefit Townhall August 7th, 2026
On August 7, 2026, the Department of Health Care Services (DHCS) hosted the Medi-Cal Doula Benefit Townhall—an open, statewide forum designed to share key updates on Medi-Cal doula services and support shared learning among members, doula providers, managed care plans, and community partners. During this Townhall, DHCS presented upcoming policy updates for the doula benefit, shared data on doula provider enrollment, and featured presentations from doula workgroup members and Medi-Cal managed care plans. The event also included space for discussion, shared experiences, and a dedicated question‑and‑answer session
Recording Link: DHCS Med-Cal Doula Benefit Townhall August 7th, 2026
Q&A Document: (Coming soon)
Contact Us
Contact DHCS via email at DoulaBenefit@dhcs.ca.gov for any questions relating to Medi-Cal doula services. If you are emailing us about a Medi-Cal member you are serving, please do not include personal information in your email. If you wish to share this information, please email us first so we can reply with a secure (encrypted) email for you to respond to and share that information.
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