Medi-Cal Member Recommendation for Postpartum Doula Services
Requires a written recommendation from a physician or other licensed practitioner for additional postpartum doula visits; recommending provider need not be enrolled in Medi‑Cal or a network provider.
No material clinical or coverage changes in this revision.
Coverage Criteria
Coverage condition for additional postpartum doula visits
Covered when ALL of the following are met
Recommending provider need not be enrolled in Medi-Cal or be a network provider.
This policy covers additional postpartum doula visits only when a written recommendation is submitted by a physician or other licensed practitioner of the healing arts acting within their scope of practice and attesting that the Medi‑Cal member would benefit from or has requested doula services. The recommending provider need not be enrolled in Medi‑Cal or be a network provider.
No exclusions or other coverage conditions are specified in the source document. The recommendation must be documented on a form that includes recommender identification (name, title, agency, NPI if available, contact information) and member identification (member first and last name), along with the attestation that the member would benefit from or has requested doula services.
Provider Actions and Documentation Requirements
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