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Delaware billing rules 2026.06.19-draft

Delaware Medicaid doula billing rules

Check Delaware rates, codes, setup steps, visit-note basics, and denial risks before claim entry.

Updated Jun 19, 2026Sources checked within 90 days
Open claim checkerUse saved tools
21 live state guidesSources checked within 90 daysLast updated Jun 19, 2026
Set up provider details first.
Check rates, visit notes, and claim gaps.
Use denied-claim help when a payer sends a reason code.

Quick path

Start with the step you need.

  1. 1Find the rule for your stateStart with the state where the client has Medicaid coverage.Choose your state
  2. 2Check what is missingReview setup, visit notes, codes, and payer steps before billing.Use the checklist
  3. 3Save the checklistDownload the checklist, then keep client details in your own secure records.Open checklist

Delaware Medicaid doula billing rules

Delaware payer rates and codes are still being checked, so use these sources for planning until the billing details are verified.

Recently updated

Updated Jun 19, 2026
  • Checked AmeriHealth Caritas Delaware (Delaware Medicaid MCO): AmeriHealth Caritas Delaware - Doula Services.
  • Checked Delaware Certification Board: Delaware Certification Board - Doula.
  • Checked Delaware Division of Medicaid and Medical Assistance: Delaware Medical Assistance Program (DMAP) provider enrollment.

Rates still being checked

Delaware delivers the doula benefit through Medicaid MCOs that set their own credentialing and rates; no statewide DMAP fee-schedule rate row has been verified. DoulaPaid keeps this state in planning mode until payer codes and rates are confirmed.

What to check before billing

  • Use Delaware claim tools for planning only until an MCO or DMAP fee-schedule rate source is verified.
  • Doula services are delivered through Delaware Medicaid MCOs; complete MCO-Only DMAP enrollment and contract with each plan before billing.
  • Hold the Delaware Certification Board doula credential and an individual NPI with taxonomy 374J00000X.
  • Benefit covers 1-3 prenatal visits, up to 3 postpartum visits (up to 8 total with the five-visit extension), labor/birth attendance, and 90-minute visits; confirm each MCO's limits before billing.

This state guide will open more tools after payer sources are reviewed.

Use nicknames on public pages.

Keep client names, IDs, claim numbers, and visit notes in your own records.

Provider setup

These state tools are available for planning. Confirm payer requirements before billing.

Launch status

draft

Draft: payer rates and codes are still being checked, so this state stays in planning mode for now.

Billing portal

DMAP enrollment; Medicaid MCO (MCO-only) pathways

  • Confirm DMAP enrollment; Medicaid MCO (MCO-only) pathways access and provider enrollment before first-claim work.
  • Keep NPI / DMAP MCO provider ID in your own secure records.
  • Keep Delaware Medicaid (DMAP) member ID, names, dates of birth, and visit notes out of public pages.
Open Delaware setup checklistFind health plan linksJump to official sources

State tools

Choose the question you need help with now.

Provider setup checklist

Enrollment and provider details checklist.

Claim checklist worksheet

Download a plain text checklist.

Check missing items

Find setup, eligibility, rate, and note gaps.

Rate reference

See how this state pays.

Check visit-note requirements

See what the note must support.

Fix denied claims

State-specific denial reasons.

Denied claim help

Review common denial reasons and the next step to check.

Read the Delaware denial reasons guide

MCO/DMAP rate source pending

Keep the state in draft and re-run source review before enabling service-code rows.

Common questions

Plain answers about Delaware Medicaid doula billing.

Does Delaware Medicaid cover doula services?

Delaware Medicaid doula coverage is still being checked against official payer sources. Use this page for planning until codes and rates are confirmed.

How much does Delaware Medicaid pay doulas?

Rates are still being verified against official Delaware sources, so use this state page for planning only. Use the Delaware rate reference to check current amounts against official sources.

What should my Delaware visit note include?

Delaware lists 4 visit-note checks to review before claim entry, starting with: Use Delaware claim tools for planning only until an MCO or DMAP fee-schedule rate source is verified.. See the Delaware visit-note checklist for the full list.

Why do Delaware doula Medicaid claims get denied?

Common reasons include mco/dmap rate source pending. The Delaware denied-claim guide lists the next step for each.

Official sources

Check these official sources before billing.

Source review

Source review current

Delaware sources on this page were last checked Jun 19, 2026. Use the linked payer sources as the source of truth before billing.

These payer links were checked within the last 90 days.

How we verify these rules

AmeriHealth Caritas Delaware - Doula ServicesAmeriHealth Caritas Delaware (Delaware Medicaid MCO) · Doula benefit effective January 1, 2024; provider requirements and benefit details · checked Jun 19, 2026Delaware Certification Board - DoulaDelaware Certification Board · Doula credentialing requirements for Medicaid reimbursement · checked Jun 19, 2026Delaware Medical Assistance Program (DMAP) provider enrollmentDelaware Division of Medicaid and Medical Assistance · MCO-Only provider enrollment path for doulas · checked Jun 19, 2026

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