DoulaPaid

Michigan billing rules 2026.06.13-current

Michigan Medicaid doula billing rules

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

Updated Jun 13, 2026Sources checked within 90 days
Open claim checkerUse saved tools
26 live state guidesSources checked within 90 daysLast updated Jun 21, 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

Michigan Medicaid doula billing rules

Michigan uses per-visit service lines such as Prenatal or postpartum doula visit, 12 total visits before prior authorization at $100, with modifiers, caps, and documentation checks to confirm before claim entry.

Recently updated

Updated Jun 13, 2026Official fee schedule

Rates are backed by official published fee-schedule or rate evidence in the source packet.

  • Checked Michigan Department of Health and Human Services: MDHHS Doula Fee Schedule.
  • Checked Michigan Department of Health and Human Services: MDHHS Doula Billing Guidance.
  • Checked Michigan Department of Health and Human Services: MDHHS Doula Provider FAQ Guidance.

Paid by visit

Prenatal or postpartum doula visit, 12 total visits before prior authorization: $100 with modifier HD

Telemedicine-eligible prenatal or postpartum doula visit: $100 with modifier HD, 95

Attendance at labor and delivery, in-person: $1,500 with modifier HD

Prior authorization is needed after 12 sessions.

What to check before billing

  • Submit fee-for-service claims in CHAMPS and follow Medicaid Health Plan billing instructions for managed-care members.
  • Use S9445 with modifier HD for prenatal and postpartum visits; use diagnosis Z33.1 for prenatal and Z39.2 for postpartum.
  • Use T1033 with modifier HD and diagnosis Z33.1 for in-person labor and delivery attendance.
  • Track the 12 total prenatal/postpartum visit limit before prior authorization; DoulaPaid blocks the prior authorization path until PA fields are added.
  • Keep start and end time, professional service description, recommendation source or statewide standing recommendation basis, and doula record details for at least seven years.
  • For telemedicine S9445 visits, confirm the service followed MDHHS telemedicine policy and include modifier 95.

This page is built from checked state billing sources.

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

active

Active: guide and tools are ready for general planning.

Billing portal

CHAMPS / Medicaid Health Plan pathways

  • Confirm CHAMPS / Medicaid Health Plan pathways access and provider enrollment before first-claim work.
  • Keep CHAMPS Medicaid provider ID / NPI in your own secure records.
  • Keep Michigan Medicaid beneficiary ID, names, dates of birth, and visit notes out of public pages.
Open Michigan setup checklistFind health plan linksJump to official sources

Payout estimator

Model common claim totals from verified published rates. Keep client-specific details in your own secure records.

Planning estimator

Estimate a claim total

Use published rates to model Michigan services before claim entry. Do not enter client names, IDs, dates of birth, or visit notes here.

Estimated total

$1,700.00

Final payment still depends on eligibility, payer edits, documentation, and claim review.

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.

Prior authorization

Check whether approval is needed.

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 Michigan denial reasons guide

Michigan visit limit reached

Check prior billed visits and obtain prior authorization before services beyond 12; do not create those packets in DoulaPaid until PA support is enabled.

Diagnosis code does not match Michigan guidance

Confirm the visit type and use the listed diagnosis code before submission.

Michigan modifier missing or wrong

Use HD for in-person S9445/T1033 lines and HD plus 95 for telemedicine S9445 lines.

Labor and delivery line must be in person

Use an in-person T1033 HD line only when labor and delivery attendance is documented.

Common questions

Plain answers about Michigan Medicaid doula billing.

Does Michigan Medicaid cover doula services?

Yes. Michigan Medicaid doula initiative covers doula services. Coverage still depends on active eligibility, the service date, provider setup, and visit notes.

How much does Michigan Medicaid pay doulas?

Michigan pays per visit — Prenatal or postpartum doula visit, 12 total visits before prior authorization: $100; Telemedicine-eligible prenatal or postpartum doula visit: $100; Attendance at labor and delivery, in-person: $1,500. Use the Michigan rate reference to check current amounts against official sources.

What should my Michigan visit note include?

Michigan lists 6 visit-note checks to review before claim entry, starting with: Submit fee-for-service claims in CHAMPS and follow Medicaid Health Plan billing instructions for managed-care members.. See the Michigan visit-note checklist for the full list.

Why do Michigan doula Medicaid claims get denied?

Common reasons include michigan visit limit reached; diagnosis code does not match michigan guidance; michigan modifier missing or wrong. The Michigan denied-claim guide lists the next step for each.

Rule change alerts

Get a no-PHI email when Michigan doula billing rules change or new verified sources are added.

Do not include client details. This signup stores only the state and email address.

Official sources

Check these official sources before billing.

Source review

Source review current

Michigan sources on this page were last checked Jun 17, 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

MDHHS Doula Fee ScheduleMichigan Department of Health and Human Services · January 2026 fee schedule: S9445 HD $100, T1033 HD $1,500 · checked Jun 13, 2026MDHHS Doula Billing GuidanceMichigan Department of Health and Human Services · CHAMPS billing, diagnosis codes, HD modifier, telemedicine modifier 95, and labor/delivery restrictions · checked Jun 13, 2026MDHHS Doula Provider FAQ GuidanceMichigan Department of Health and Human Services · Registry, CHAMPS enrollment, statewide standing recommendation, documentation, 12 visits plus prior authorization path · checked Jun 13, 2026

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