Arizona billing rules 2026.06.15-current

Arizona Medicaid doula billing rules

Arizona Medicaid doula billing uses per-visit rates starting at $15.26.

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Denial pages use the same state billing sources.

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Short answer

Arizona Medicaid doula billing uses per-visit rates starting at $15.26.

Next step

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Arizona Medicaid doula billing rules

Arizona Medicaid doula billing uses per-visit rates starting at $15.26.

Per-visit model

Doula services (per 15 minutes), up to eight units per day: $15.26

Doula services per diem (labor and delivery), once per 9-month period: $488.40

What to check before billing

Hold ADHS doula certification and register with AHCCCS via APEP with a separate NPI.
Obtain an eligible provider referral (COS-01); an ICD-10 diagnosis is required on every claim.
Bill T1032 in 15-minute units, up to eight units per day; T1033 per diem is billable once within a 9-month period.
Labor and delivery (T1033) is in-person; no prior authorization.
AHCCCS is the payer of last resort; coverage extends to one year postpartum.

This page is built from checked state billing sources.

Public tools are for general checks. Keep client details in your own records.

Launch status and setup

Arizona is marked active. Check setup before claim work.

Launch status

active

Active: state tools are ready for general planning.

Billing portal

AHCCCS (APEP); FFS and MCO pathways

Confirm AHCCCS (APEP); FFS and MCO pathways access and provider enrollment before packet work.
Keep AHCCCS provider ID / NPI in private records only.
Never enter AHCCCS member ID, names, dates of birth, or visit notes into public tools.

Free state tools

Pick the tool that matches the question you have now.

Provider setup

Enrollment and billing profile checklist.

Packet worksheet

Plan the packet.

Claim checker

Packet review checklist.

Rate calculator

Payment model explainer.

Visit note checklist

Visit note checklist.

Denial pages

State-specific denial reasons.

Denied claim help

Review common denial reasons and the next step to check.

Read the Arizona denial reasons guide

Missing provider referral

Obtain and document the referral before billing.

Missing ICD-10 diagnosis

Add the diagnosis code before submission.

Daily unit cap exceeded

Recount timed units for the date of service.

Per-diem cap exceeded

Confirm prior T1033 usage before billing.

Common questions

Plain answers about Arizona Medicaid doula billing.

Does Arizona Medicaid cover doula services?

Yes. AHCCCS doula services covers doula services. Coverage still depends on the client's active eligibility, the service date, provider setup, and documentation.

How much does Arizona Medicaid pay doulas?

Arizona pays per visit — Doula services (per 15 minutes), up to eight units per day: $15.26; Doula services per diem (labor and delivery), once per 9-month period: $488.40. Use the Arizona rate calculator to check current amounts against official sources.

What documentation does Arizona require for doula claims?

Arizona expects 5 visit-note items before a packet is ready, including: Hold ADHS doula certification and register with AHCCCS via APEP with a separate NPI. See the Arizona visit-note checklist for the full list.

Why do Arizona doula Medicaid claims get denied?

Common reasons include missing provider referral; missing icd-10 diagnosis; daily unit cap exceeded. The Arizona denied-claim guide lists the next step for each.