Doula Providers- Enrolling as a Doula

The Department of Health Care Services (DHCS) covers doula services in both managed care and fee-for-service (FFS) delivery systems for pregnant and postpartum Medi-Cal members. Services include nonmedical support for prenatal and postpartum visits, and during labor and delivery, miscarriage, and abortion.

1. What is the process to become a doula?

Doulas may apply for enrollment through the DHCS PAVE – Provider Application and Validation for Enrollment portal. Supporting videos and additional information on how to apply can be found in the “Doula Application Information” webpage.

Doulas can also reference the Medi-Cal Doula Provider Enrollment Checklist to identify what documents they need before they begin their application.

2. What are the qualifications to enroll as a doula with Medi-Cal?

All doulas must be at least 18 years old, possess an adult/infant cardiopulmonary resuscitation (CPR) certification, and have completed basic Health Insurance Portability and Accountability Act (HIPAA) training. In addition, a doula must meet either of the following qualification pathways:

Training Pathway:

• Complete a minimum of 16 hours of training in the following areas:
  • Lactation support
  • Childbirth education
  • Foundations on anatomy of pregnancy and childbirth
  • Nonmedical comfort measures, prenatal support and labor support techniques
  • Developing a community resource list
• Attest that they have provide support as a doula at a minimum of three births

Experience Pathway:

• Or both of the following:
  • At least five years of active doula experience in either a paid or volunteer capacity within the previous seven years.
  • Attestation to skills in prenatal, labor, and postpartum care as demonstrated by three written client testimonial letters or professional letters of recommendation from any of the following: a physician, licensed behavioral health provider, nurse practitioner, nurse midwife, licensed midwife, enrolled doula, or community-based organization. Letters must be written within the last seven years. One letter must be from either a licensed provider, a community-based organization, or an enrolled doula.

3. Does DHCS require doulas to possess a certificate from specific organizations?

No. The certificate does not need to be from a specific organization as long as it covers the requirements listed in the Medi-Cal Provider Manual: Doula Services. Additional information regarding enrollment is available at Doula Application Information webpage.

4. Will experienced doulas have to recertify, if so, will the certification cost?

DHCS does not have a schedule for recertification. If recertification is required in the future, it would be the responsibility of the doula to cover any costs associated with meeting the doula minimum qualifications and training/experience pathway requirements outlined in the Provider Manual.

5. How do I enroll as a Medi-Cal provider?

Doulas can enroll through DHCS’ Provider Application and Validation for Enrollment (PAVE) portal: PAVE page. Additional resources on how to enroll in PAVE can be found on the Doula Application Information webpage and Doula – Training and Medi-Cal Providers webpage.

Doulas will also need to contract separately with each individual Medi-Cal managed care plan (MCP) operating within their service area to provide covered services to Medi-Cal members who receive Medi-Cal through the managed care delivery system. Please see the Medi-Cal Managed Care Plan Contact List for names and contact information for each individual MCP who can assist doulas with contracting with the MCP. Please see the MCP enrollment section for more detailed information.

6.  Are there any additional requirements I need to meet to enroll in Medi-Cal as a doula?

Individuals who enroll in Medi-Cal may also need to meet applicable local (city, county, etc.) or state requirements to operate a business in California. This is particularly important for doula group enrollment. Please see the Medi-Cal Doula Provider Enrollment Checklist to identify what documents you may need to submit as part of your application in the PAVE system.

These requirements are in addition to DHCS’ requirements as identified in the Medi-Cal Provider Manual: Doula Services.

7.  Will I need to acquire an NPI number?

Yes. Doulas will need to register for a National Provider Identifier (NPI) to enroll with DHCS. An NPI is a numeric identifier assigned to a health care provider by the Centers for Medicare & Medicaid Services (CMS). Doulas can apply for an NPI online or by mail through the CMS NPI Application/Update Form page.

8. How long does it usually take to obtain an NPI number?

A provider who submits a properly completed electronic application can receive an NPI in fewer than 10 business days. Paper application reviews take approximately 20 business days. Application errors may delay the process.

9. Do I need a Social Security Number (SSN) to enroll as a doula?

Federal and state laws require that individuals submit their SSN in order to enroll as a Medi-Cal provider. DHCS can only approve doula applications from doulas who have submitted an SSN as part of their enrollment application.  

10. Are doulas required to have their own insurance or will DHCS provide doulas with insurance? 

DHCS does not offer any types of insurance for any providers, including doulas. As part of Medi-Cal provider enrollment requirements, individual doulas are not required to carry any insurance to enroll as a Medi-Cal FFS provider. However, a doula group may have other requirements when enrolling as a Medi-Cal FFS provider, and those will be indicated as part of the application process. Further, individual MCPs may have different insurance requirements, such as professional liability insurance for individual doulas or workers’ compensation insurance for doula groups, and doulas are required to follow those contracting and credentialing processes in order to serve MCP members.

11. Can community-based doula groups, organizations, and agencies enroll as a doula group?

Yes, if they meet the criteria to apply as a doula group. When enrolling as a group provider, one application is submitted for the group itself, and a separate application is submitted for each rendering provider. Please visit the Doula Application Information page.

12. Can a doula be reimbursed for services provided to Medi-Cal members while their PAVE application is being processed?

Once their application is approved, doulas may bill DHCS for services provided to Medi-Cal FFS members retroactively to the date they submitted an application that was approved.

Doulas who wish to provide services to MCP members must enter into contracts or letters of intent/agreement (LOI/LOA) with MCPs to receive reimbursement for doula services provided to MCP members.

13. Is there someone I can contact if I have questions about my application?

Yes. Applicants may email PAVE@dhcs.ca.gov if they have questions or comments about their application or enrollment in PAVE.