Part of the Medi-Cal Doula Toolkit includes a Medi-Cal provider-focused section that includes additional information about Medi-Cal coverage and billing policy, Medi-Cal provider enrollment, Medi-Cal managed care plan (MCP) credentialing and contracting processes, and answers to frequently asked questions (FAQs).  

Fact Sheets 

Medi-Cal Provider Rights 

Medi-Cal providers, whether participating in Medi-Cal fee-for-service, managed care, or both, have certain rights relative to their Medi-Cal provider enrollment and Medi-Cal managed care plan contracts. The following Fact Sheets provide additional information: 

• Medi-Cal Provider Rights  

Complaints & Grievances  

Medi-Cal doula providers, whether participating in Medi-Cal fee-for-service, managed care, or both, may file a complaint or grievance, or appeal if they have concerns with the care they received or the quality of that care, care they were denied, a provider interaction, and more. The following Fact Sheets provide additional information: 

• Medi-Cal Fee-for-Service and Managed Care 
  • How to File a Complaint or Grievance

Medi-Cal Coverage Policy 

Medi-Cal Provider Manual 

The most current Medi-Cal coverage and billing policy is available on DHCS’ Provider Manual | Medi-Cal Providers website, and outlined in the Doula Services section of the Medi-Cal Provider Manual.  

Medi-Cal doula providers are expected to read and adhere to the requirements outlined in the Doula Services section of the Medi-Cal Provider Manual, which provides important information on the following: 

• Key policy definitions 

• Medi-Cal member eligibility criteria 

• Covered and non-covered services 

• Doula minimum qualifications, including descriptions of the two allowable pathways—the “Training Pathway” or “Experience Pathway” 

• Billing codes, including procedure and diagnosis codes 

• Delivery of doula services using telehealth (videoconferencing or telephone) modalities 

• Documentation requirements 

• Recommended trainings 

Medi-Cal Subscription Service  

DHCS may make periodic updates to its coverage and billing policies, so we encourage you to check back periodically. You may also sign up for the Medi-Cal Subscription Services (MCSS), which a free service that keeps Medi-Cal providers up-to-date on the latest Medi-Cal news. Medi-Cal providers who subscribe will receive subject-specific emails for urgent announcements and other updates shortly after they post to DHCS’ website. 

How to Become a Medi-Cal Doula Provider 

Doulas can enroll in Medi-Cal as either an individual (Individual Billing Provider Doula Application) or as part of a doula group (Fee-For-Service Enrollment for Doula Group Providers).  

Doulas who meet the qualifications listed in the Doula Services section of the Medi-Cal Provider Manual may submit a provider enrollment application through DHCS’ Provider Application and Validation for Enrollment (PAVE) portal.  

To assist doulas with Medi-Cal provider enrollment, DHCS has created or linked to additional resources, including the following: 

• Doula Application Information: In accordance with State law (Welfare & Institutions Code Section 14043.75(b)), DHCS established specific application and enrollment requirements for doula providers who apply for enrollment in the Medi-Cal program to be reimbursed for the covered services they provide to Medi-Cal beneficiaries.
  • For more information, please see the regulatory provider bulletin titled, “Medi-Cal Enrollment Requirements and Procedures for Doulas.” Please also refer to the Doula Questions and Answers for additional information regarding doula provider enrollment. 

• PAVE portal : This is a link directly to DHCS’ provider enrollment (PAVE) portal. When accessing PAVE for the first time, you will need to “Sign Up” to create a unique username (email address) and password. DHCS has also created additional resources, as follows: 
  • National Plan and Provider Enumeration System (NPPES): A National Provider Identifier (NPI) is required for Medi-Cal enrollment. You can obtain one from the federal government by visiting the NPPES website.  When obtaining an NPI, you will need to create an account.  DHCS also created a National Provider Identifier (NPI) Application document, which is a step-by-step guide for obtaining an NPI. 
  • Medi-Cal Doula Provider Enrollment Checklist: This checklist can help doulas determine what documents are required to upload as part of their Medi-Cal provider enrollment application through PAVE, depending on how you are enrolling and what counties you will provide services. It also includes information on potential additional documentation that may be required. 
  • PAVE Demonstration for Doulas (Part one): This is the first video in a two-part demonstration series hosted by DHCS to assist doulas with understanding the PAVE portal, electronic submission process, and Medi-Cal provider enrollment requirements.  
  • PAVE Demonstration for Doulas (Part two): This is the second video in a two-part demonstration series hosted by DHCS to assist doulas with better understanding the PAVE portal, electronic submission process, and Medi-Cal provider enrollment requirements.  
  • FAQ: Enrolling as a Doula (updated March 1, 2025): This helpful FAQ providers information on Medi-Cal provider enrollment through PAVE. 
  • Ordering, Referring, Prescribing (ORP) Enrollment for Doula Providers (December 2022): This presentation outlines Medi-Cal provider enrollment requirements to ensure compliance with State and federal ORP enrollment requirements and how this impacts doula providers.  
  • Doula Rendering Provider Application (December 2022): This presentation outlines Medi-Cal provider enrollment requirements for doulas who are rendering providers, which means they are the ones delivering services but not necessarily directly billing. 

Medi-Cal Doula Directory 

Once a Medi-Cal provider application has been approved by DHCS, enrolled Medi-Cal doula providers are strongly encouraged to opt in to be listed on the Medi-Cal Doula Directory. The Doula Directory lists Medi-Cal enrolled doula providers by county who opted to be included in the directory, inclusive of important information such as: specialties, language, ethnicity, contact information, and other information that doulas shared with DHCS for the directory. DHCS updates the directory once each month. 

Delivering Services to Medi-Cal Members 

Once a Medi-Cal provider application has been approved by DHCS, enrolled Medi-Cal doula providers have options in terms of which Medi-Cal members they want to serve, as follows: 

Medi-Cal Fee-for-Service Delivery System  

Enrolled Medi-Cal doula providers may immediately begin providing services to Medi-Cal fee-for-service members and submitting claims directly to DHCS for reimbursement. 

Medi-Cal Managed Care Delivery System 

Enrolled Medi-Cal doula providers interested in serving Medi-Cal managed care members will also need to separately enter into contracts or agreements with Medi-Cal managed care plans (MCPs) before they begin providing services and submitting claims to the Medi-Cal member’s Medi-Cal MCP plan. There are a couple of important pieces of information to highlight here: 

• This is an additional step beyond PAVE enrollment.  

• Enrolled Medi-Cal doula providers must enter contracts with each Medi-Cal MCP in their geographical area in order to serve Medi-Cal members who receive services through each Medi-Cal MCP and to receive reimbursement for doula services provided to Medi-Cal MCP members.  

• Medi-Cal MCPs may have additional and/or different requirements beyond PAVE requirements tied to their credentialing and contracting processes.  

To assist enrolled Medi-Cal doula providers with navigating Medi-Cal MCP credentialing and contracting processes, DHCS hosted a webinar, Doula Services Benefit: Orientation to Managed Care Plans (January 2023) and also created Frequently Asked Questions (FAQ): Managed Care Plans (updated September 10, 2025). Additional resources that may be helpful include the following: 

• All Plan Letter (APL) 22-013 (Provider Credentialing/Re-credentialing and Screening/Enrollment): This APL provides information about Medi-Cal MCP responsibilities related to the screening and enrollment of all Network Providers pursuant to Title 42 of the Code of Federal Regulations (CFR) Part 438 and Part 455 (Subparts B and E). This APL also outlines MCPs’ contractual obligations related to credentialing and re-credentialing as required in Title 42 of the CFR, Section 438.214.  

• FAQ: APL 22-013: Provider Credentialing/Re-Credentialing and Screening/Enrollment: This FAQ provides additional guidance and clarification to Medi-Cal MCPs regarding APL 22-013, which establishes requirements for screening and enrollment of providers who participate in Med-Cal MCP Networks. 

• APL 23-024 (Doula Services): This APL provides Medi-Cal MCPs with guidance regarding the qualifications for providing doula services. 

• Health Plan Directory: This resource can be used to identify Medi-Cal MCPs in each county, which can help enrolled Medi-Cal doulas understand who they need to contact for credentialing and contracting. It also includes website links and phone numbers. 

• MCP Contact List: By County: This quick reference provides a list of each Medi-Cal MCP and the county or counties they operate in which can help enrolled Medi-Cal doulas understand who they need to contact for credentialing and contracting.  

For questions regarding credentialing and contacting with a specific Medi-Cal MCP, please reach out to DHCS via email at DoulaBenefit@dhcs.ca.gov. 

Billing 

Medi-Cal Fee-for-Service 

For enrolled Medi-Cal doula providers serving Medi-Cal fee-for-service members, all claims are submitted directly to DHCS for reimbursement. Doula services are going to be submitted using the CMS-1500 form, which is a hard copy, paper claim form submitted via mail to DHCS, or its electronic equivalent, the 837P claim form, which is submitted to DHCS electronically through the Medi-Cal Provider Portal.  

• CMS-1500 paper claims must be submitted to DHCS via mail at:  
  • California MMIS Fiscal Intermediary 
    P.O. Box 15700 
    Sacramento, CA 95852‑1700 

• Electronic 837P claim forms must be submitted to DHCS through the Medi-Cal Provider Portal. First-time users will need to register, and support is available 8:00 a.m. to 5:00 p.m. PT, Monday through Friday, except holidays.  

For additional assistance with billing forms, please refer to these sections of the Medi-Cal Provider Manual: 

• CMS-1500 Completion: This section outlines the CMS-1500 claim form fields and how they should be completed. 

• CMS-1500 Tips for Billing: This section describes the CMS-1500 claim form fields that must be completed accurately and completely in order to avoid claim suspense or denial. The tips in this section are designed to supplement instructions in the CMS-1500 Completion section above. 

• Claim Submission and Timeliness Overview: This section includes information about claim forms that providers use to bill services rendered to Medi-Cal members of the programs listed in this manual. In addition, this section includes basic claim form preparation instructions, claim submission deadline information and a brief description of claims processing procedures. 

• Electronic Methods for Eligibility Transactions and Claim Submissions: This section describes the types of Electronic Data Interchange (EDI) options available in the Medi-Cal Provider Portal. Medi-Cal offers a variety of electronic methods (via telephone and computer) that allow providers to verify Medi-Cal member eligibility, perform batch eligibility transactions, and more.  

• Electronic Data Interchange (EDI) 837 Claims Overview: This section provides an overview of 837P electronic claim submission, among other things. 

For additional billing assistance, a free training course is available on the Medi-Cal Learning Portal, as follows: 

• Medi-Cal Learning Portal: Billing for Doula Services Recorded Webinar  

Please note that first time users may need to register in order to access the training course.  

Medi-Cal Managed Care 

For enrolled Medi-Cal doula providers serving Medi-Cal managed care members, all claims are submitted directly to each individual Medi-Cal MCP for reimbursement. Individual Medi-Cal MCPs may have different requirements and processes for claims submission than DHCS, so enrolled Medi-Cal doula providers are strongly encouraged to reach out to their primary Medi-Cal MCP contacts for questions and assistance with claims submission and reimbursement. For information on dispute resolution processes, please refer to DHCS’ Frequently Asked Question: Doula Dispute document. 

Additional Resources 

• Billings Tips for Doula Providers: This quick reference document outlines common billing errors and messages that explain why a claim may have been denied.  

• Doula Billing Codes: This website provides the current Medi-Cal fee-for-service billing codes for doula services, a description of those billing codes, and reimbursement rate information. 

• Frequently Asked Questions (FAQs): Reimbursement (updated September 17, 2025): These helpful FAQs provide information on billing both DHCS directly for Medi-Cal fee-for-service members and individual Medi-Cal MCPs for Medi-Cal managed care members.  

Doula Access in Hospitals 

Enrolled Medi-Cal doula providers regularly interact with other Medi-Cal maternal health care providers and facilities, including but not limited to OB/GYNs, clinics, and hospitals. As a result, it is important other Medi-Cal maternal health care providers are taking proactive steps to foster a doula-friendly environment that respects the important role that doulas serve, as part of a Medi-Cal member’s care team, in the development and implementation of individualized birth plans, and in hospitals leading up to and as part of the labor and delivery process. This includes having clear policies and procedures, robust clinical and non-clinical staff education and training, and interdisciplinary collaboration that recognizes doulas as an important member of Medi-Cal members’ care teams.  

To help reduce barriers and promote access to care for doulas accompanying Medi-Cal members in hospital settings, please refer to the following resources: 

• All Facilities Letter (AFL) #25-13: DHCS, in partnership with the California Department of Public Health, drafted and released this AFL to provide information on the following: overview of doula services for Medi-Cal birthing individuals; the benefits of doula support; a reminder about hospital visitation requirements; and recommendations for hospitals to foster a doula-friendly environment for patients and their families. 

• Doula Access in Hospitals: What the Law Requires (June 6, 2024): The California Hospital Association hosted a webinar to increase awareness of the role of doulas and remind hospitals of what the law requires in this space.   

• Frequently Asked Questions (FAQ): Hospitals: This FAQ describes Medi-Cal members rights to having visitors of their choosing and exceptions, hospital policy and procedure requirements, and what to do if doulas experience difficulty with, or is denied access to, providing support to Medi-Cal members. 

• Doula Guidance for Hospitals (24-746) (October 2024): This document was authored and co-signed by four Medi-Cal MCPs, HealthNet, Molina Healthcare, L.A. Care Health Plan, and Anthem, highlighting doula coverage and stating an expectation for Network Hospitals that doula care will be addressed in their maternity care policies and that respect for the important role that doulas serve will also be reflected in their organization’s practices. 

Other Resources 

• W.H.O Safe Childbirth Checklist Implementation Guide 

Language Access 

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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.