Billing codes

Medicaid doula billing codes depend on the state and service.

Check code, modifier, billing-unit, and diagnosis-code basics before opening the state rule or claim checklist.

Do not copy a code from one state into another state.

Codes should match the service date, visit note, and payer rule.

Keep real client and claim details in private records.

Official baseline sources

Use CMS code context for HCPCS basics, then use the state guide for the code, modifierModifierA modifier is added to a billing code to describe a specific service, setting, or program rule. Examples include state-specific modifiers for doula visit type or delivery support., unit, and rate that applies.

Healthcare Common Procedure Coding System· Centers for Medicare & Medicaid Services· checked 2026-06-19

Federal baseline sources

These sources explain national Medicaid doula reimbursement context, NPI lookup, and the federal preventive-service rule. State rules still control the billing details.

Medicaid Reimbursement for Doula Services· Centers for Medicare & Medicaid Services· checked 2026-06-19 Doulas in Medicaid case study findings· MACPAC· checked 2026-06-19 NPPES NPI Registry· Centers for Medicare & Medicaid Services· checked 2026-06-19 42 CFR 440.130(c), preventive services· Electronic Code of Federal Regulations· checked 2026-06-19

Codes vary by state and service

Before you look at a code, make sure you know the client state, the service type, and the visit date.

Billing code

The code tells the payer what kind of doula service you are billing, such as a visit, labor support, or postpartum service.

Modifier

A modifier adds detail to a code. It can show a state program, service type, telehealth rule, or special visit type.

Visits or billing units

Units show how many visits or how much time is billed. Some states use one flat unit, and some use 15-minute units.

Diagnosis code

Some payers ask for a diagnosis code on the claim. The right code depends on the state, payer, and service.

Service date

The code and units should match the date, length, and type of support in your private visit note.

State rule

Doula billing codes are not the same everywhere. Always start with the state where the client is covered.

Modifier warning

Do not copy modifiersModifierA modifier is added to a billing code to describe a specific service, setting, or program rule. Examples include state-specific modifiers for doula visit type or delivery support. between states. The same modifier letters can mean different things depending on the payer, state rule, service date, and claim line.

Connecticut

Connecticut uses HD on the in-person labor/delivery doula line; do not assume HD means the same thing in another state.

T1033 HD = Connecticut in-person labor/delivery attendance

Minnesota

Minnesota uses T1033 without a modifier for non-labor sessions and T1033 with U4 for labor and delivery.

T1033 = non-labor session
T1033 U4 = labor/delivery session

Ohio

Ohio doula guidance uses T1032/T1033 without borrowing U7/U8/U9 meanings from Pennsylvania.

Do not use PA's U7/U8/U9 meanings on Ohio claims.

Oklahoma

Oklahoma's verified doula rows use HD with 59899 and delivery service lines; check SoonerCare guidance before copying that modifier elsewhere.

59899 HD = Oklahoma prenatal/postpartum visit
Delivery codes also use HD in verified Oklahoma rows

Pennsylvania

Pennsylvania uses U7, U8, and U9 as state-specific T1032 service-type modifiers.

U7 = prenatal
U8 = postpartum
U9 = other/loss-related support

Washington

Washington uses U1 on the 59899 prenatal intake line, while T1033 labor support has no modifier in the verified fee schedule.

59899 U1 = prenatal intake
T1033 = labor and delivery support

State code examples

These examples come from the state rule records in DoulaPaid. Open the state page before using any code for real billing.

Arizona

per visit

T1032 · Doula services (per 15 minutes), up to eight units per day

Modifier: No modifier listed. Units: 15-minute units. Rate: $16.28 per unit.

T1033 · Doula services per diem (labor and delivery), once per 9-month period

Modifier: No modifier listed. Units: Flat service. Rate: $781.32.

Medicaid doula billing codes depend on the state and service.

Official baseline sources

Codes vary by state and service

Billing code

Modifier

Visits or billing units

Diagnosis code

Service date

State rule

Modifier warning

Connecticut

Minnesota

Ohio

Oklahoma

Pennsylvania

Washington

State code examples

Arizona

California

Connecticut

District of Columbia

Illinois

Kansas

Louisiana

Maryland

Michigan

Minnesota

Missouri

Nevada

New Jersey

New Mexico

New York

Ohio

Oklahoma

Oregon

Pennsylvania

Rhode Island

South Dakota

Utah

Virginia

Washington

Check the rest of the claim

Common questions

What billing codes do Medicaid doulas use?

Are Medicaid doula billing codes the same in every state?

Can DoulaPaid choose the billing code for me?