Massachusetts denied-claim help
Perinatal payment cap exceeded
Perinatal visit payments exceed $800 per perinatal period per member.
Denial guidance uses state billing sources.
Next actions avoid reimbursement guarantees.
Source trail remains visible for review.
Start here
Short answer
Perinatal visit payments exceed $800 per perinatal period per member.
Next step
Find the rule for your stateStart with the state where the client has Medicaid coverage.Choose a stateCheck what is neededUse the checklist to sort setup, visit notes, codes, and payer details.Open checklistKeep client work privateUse planning tools without client identifiers. Keep private details in approved records.Open worksheet
Perinatal payment cap exceeded
Perinatal visit payments exceed $800 per perinatal period per member.
Next action
Confirm prior payments or obtain prior authorization before billing.
Back to Massachusetts rulesWhy this page exists
Denial pages use the same checked state sources as the app.
101 CMR 319.00 - Rates for Doula ServicesMassachusetts Executive Office of Health and Human Services · Effective December 8, 2023; 99600 $100, 99600 TF $150, 99199 $900; $800 perinatal-period cap · checked 2026-06-15MassHealth Doula Services Program - Information for DoulasMassHealth (MA EOHHS) · Program coverage and provider information · checked 2026-06-15