CurrentmhnPolicy N/A

Postpartum Doula Services Coverage Criteria

Defines requirements for recommending and documenting postpartum doula services for Medi‑Cal members, including who may provide the recommendation and what attestation is needed.

Policy Summary

Payermhn

PolicyPostpartum Doula Services Coverage Criteria

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionObtain a written recommendation and attestation from a physician or other licensed practitioner that the member would benefit from or has requested postpartum doula services.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

1required attestation statements by recommending provider

2information types on form

Coverage Criteria for Postpartum Doula Services

Eligibility and recommendation requirements

Covered when ALL of the following are met

Recommending provider qualifications: Recommendation must be submitted by a physician or other licensed practitioner of the healing arts acting within their scope of practice.

Recommending provider does not need to be enrolled in Medi‑Cal or be a network provider.

Attestation statements: The recommending provider must attest that they are a physician or other licensed practitioner and that the Medi‑Cal member would benefit from doula services and/or has requested doula services.

Attestation must be included with the written recommendation for additional postpartum doula visits.

Provider Requirements and Documentation

Policy Summary

Payermhn

PolicyPostpartum Doula Services Coverage Criteria

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionObtain a written recommendation and attestation from a physician or other licensed practitioner that the member would benefit from or has requested postpartum doula services.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Documentation Required

Required documentation and attestation

The recommending provider must complete and sign an attestation stating they are a physician or other licensed practitioner of the healing arts and that the Medi‑Cal member would benefit from and/or has requested doula services. Provider contact information and basic member identifiers should be included.

Attestation must include: 1) statement that signer is a physician or licensed practitioner of the healing arts; 2) affirmation that the member would benefit from doula services and/or has requested them.
Provider information to include: name, title, agency name, NPI (or N/A), email, phone, fax.
Member information to include: member first and last name and gender.

Background

Postpartum doula services are non-medical support services provided during the postpartum period and are covered only when supported by a written recommendation from a qualified recommending provider. The recommending provider must be a physician or other licensed practitioner of the healing arts acting within their scope of practice; enrollment in Medi‑Cal or network participation is not required for the recommending provider.

The written recommendation must include an attestation by the recommending provider stating: (1) that they are a physician or other licensed practitioner of the healing arts, and (2) that the Medi‑Cal member would benefit from doula services and/or has requested doula services. The recommendation form captures standard provider contact information and member identifying details to support authorization and coordination of care.

Definitions

Recommending provider

Who may recommend postpartum doula servicesA physician or other licensed practitioner of the healing arts acting within their scope of practice.

Enrollment requirement for recommending providerThe recommending provider does not need to be enrolled in Medi‑Cal or be a network provider.

Required attestation by recommending providerProvider must declare they are a physician or other licensed practitioner and attest that the Medi‑Cal member would benefit from and/or has requested doula services.

Scope limitationRecommendation must be made while the practitioner is acting within their scope of practice.

Form purposeWritten recommendation is required for additional postpartum doula visits during the postpartum period.