We're now covering certified doula services

Effective Oct. 3, 2024, the Ohio Department of Medicaid (ODM) will require doulas to be certified by the state Board of Nursing before enrolling as a UnitedHealthcare Community Plan of Ohio network provider. Certified doulas will be eligible for reimbursement of services provided for our members.

Coverage overview

The listed doula specialty types are the only care providers eligible to bill for services using the following codes:

Independent doula = PT 09
Doulas affiliated with:
- A professional medical group = PT 21
- A rural health clinic (RHC) = PT 05
- A federally qualified health center (FQHC) = PT 12
- An ambulatory health care clinic = PT 50
- A hospital = PT 02
- A free-standing birth center = PT 1

Note: Under ODM’s doula coverage, members will be eligible to receive care during antepartum, labor and postpartum. The following conditions apply:

During labor – flat rate for birth, regardless of length of time
Antepartum and postpartum – up to 48 fifteen-minute units at any time from first prenatal visit to 12 months postpartum; including consultations and telehealth visits

Resources

For UnitedHealthcare contracting information, visit Join our network. To learn more about the state requirements, see the Ohio Department of Medicaid Doula Initiative.