CurrentArkansas Blue Cross and Blue ShieldPolicy 32

New Payment Policies for Doula and Lactation Consultant Services

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This document announces reimbursement policies for doula and lactation consultant services when those services are included in a member's benefit plan. It affects eligible and credentialed providers submitting claims to Arkansas Blue Cross and Blue Shield.

Policy Summary

PayerArkansas Blue Cross and Blue Shield

PolicyNew Payment Policies for Doula and Lactation Consultant Services

Policy CodePolicy N/A

Change TypeNew payment policies

Effective DateSeptember 1, 2026

Next Review DateN/A

Key ActionEligible doula and lactation consultant providers must submit a request for application and complete the provider credentialing process before submitting claims.

SourceLink

POLICY UPDATE CHANGES

Arkansas Blue Cross and Blue Shield is implementing new payment policies establishing reimbursement guidance for doula and lactation consultant services.

2New payment policies announced

3Eligible lactation professional types

90 daysCredentialing process duration

Benefit-dependent

OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

CurrentArkansas Blue Cross and Blue ShieldPolicy 32

New Payment Policies for Doula and Lactation Consultant Services

Customize your policy alerts

Sign up for arkansas_blue_cross_blue_shield Policy 32 alerts

Get alerted when Policy 32 changes without checking for updates manually.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Policy Summary

PayerArkansas Blue Cross and Blue Shield

PolicyNew Payment Policies for Doula and Lactation Consultant Services

Policy CodePolicy N/A

Change TypeNew payment policies

Effective DateSeptember 1, 2026

Next Review DateN/A

Key ActionEligible doula and lactation consultant providers must submit a request for application and complete the provider credentialing process before submitting claims.

SourceLink

POLICY UPDATE CHANGES

Arkansas Blue Cross and Blue Shield is implementing new payment policies establishing reimbursement guidance for doula and lactation consultant services.

2New payment policies announced

3Eligible lactation professional types

90 daysCredentialing process duration

Benefit-dependent

General Coverage and Reimbursement Conditions

General coverage and reimbursement conditions

Coverage and reimbursement are subject to the member's specific benefit plan and the applicable payment policy requirements. All of the following conditions must be met:

Coverage conditions

The member's benefit plan includes the applicable doula or lactation consultant service.
The provider meets applicable eligibility and credentialing requirements.
The applicable payment policy requirements for eligible services, coding and billing, service limitations, and reimbursement are satisfied.

Provider Enrollment and Pre-Service Checks

Documentation Required

Complete Provider Application and Credentialing

Eligible doulas and lactation consultants must submit a request for application (RFA), complete the full provider application, sign and submit all required forms and contracts, and satisfy credentialing requirements. Credentialing includes credential verification and credential committee review and may take up to 90 days; additional information is available in the Credentialing Standards.

Submit the RFA at https://hub.veritystream.cloud/app/39307/ApplicationRequest.
After the RFA is accepted, complete the full provider application using the link sent by email.
Wait for approval and the welcome letter with executed contract copies before providing services as a participating provider.

Billing Rule

Verify Participating Provider Status

Confirm that the provider is set up as participating before submitting claims for doula or lactation consultant services.

Verify participating status at https://providersearch.arkbluecross.com/index.html.

Note

Verify Member Eligibility and Benefits

Coverage for doula and lactation consultant services depends on the member's specific benefit plan. Verify member eligibility and benefit coverage before rendering services.

Billing Rule

Review Applicable Payment Policy

Review the applicable payment policy for complete provider requirements, eligible services, coding and billing requirements, service limitations, and reimbursement guidelines before rendering services or submitting claims.

Doula Services Payment Policy #32 covers reimbursement guidance for certified doula services during the prenatal, labor and delivery, and postpartum periods.
Lactation Consultant Services Payment Policy #33 covers lactation support by eligible credentialed professionals, including IBCLCs, CLCs, and CBCs, subject to applicable policy requirements.

Provider and Credentialing Definitions

Eligible doula

ProfessionalCertified professional providing doula services.

Prenatal periodDoula services provided during the prenatal period.

Labor and delivery periodDoula services provided during labor and delivery.

Postpartum periodDoula services provided during the postpartum period.

Eligible lactation consultant

International Board-Certified Lactation ConsultantEligible credentialed lactation professional, including an IBCLC.

Certified Lactation Counselor