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Pennsylvania referral requirements
How to refer a Medicaid member to covered doula care in Pennsylvania
Use Pennsylvania Medical Assistance doula services sources to help a Medicaid member find and confirm doula support. Keep private member intake in your compliant system.
Confirm eligibility and plan in your own compliant system.
Use official program or directory links.
Do not send client details through public forms.
What to tell the member
Share program and referral requirements. Add member details only inside your organization's approved system.
Program requirements
- Program: Pennsylvania Medical Assistance doula services
- Referral or recommendation: Keep the Doula Services Recommendation Form on file; T1032 must carry a U7/U8/U9 pricing modifier. No prior authorization.
- Registry or provider setup: Certified perinatal doula; Medical Assistance enrollment as provider type 13, specialty 130.
- Payer path: PROMISe (FFS); MA MCO pathways
Client privacy reminder
Do not put member names, Medicaid IDs, dates of birth, service dates, claim numbers, visit notes, or diagnoses in public forms, screenshots, or shared links.