Minnesota billing rules 2026.06.13-current
Minnesota Medicaid doula billing rules
Check Minnesota rates, codes, setup steps, visit-note basics, and denial risks before claim entry.
Quick path
Start with the step you need.
- 1Find the rule for your stateStart with the state where the client has Medicaid coverage.Choose your state
- 2Check what is missingReview setup, visit notes, codes, and payer steps before billing.Use the checklist
- 3Save the checklistDownload the checklist, then keep client details in your own secure records.Open checklist
Minnesota Medicaid doula billing rules
Minnesota uses per-visit service lines such as Prenatal, postpartum, or non-labor doula session at $100, with modifiers, caps, and documentation checks to confirm before claim entry.
Recently updated
Updated Jun 13, 2026Official fee scheduleRates are backed by official published fee-schedule or rate evidence in the source packet.
- Checked Minnesota Department of Human Services: Minnesota Health Care Programs Provider Manual.
- Checked Minnesota Office of the Revisor of Statutes: Minnesota Statutes 256B.758 Payment for Doula Services.
Paid by visit
Prenatal, postpartum, or non-labor doula session: $100
Labor and delivery doula session: $1,400 with modifier U4
Prior authorization is needed after 18 sessions.
What to check before billing
- Document the member's name, visit date, length of time, what was done, discussed, and recommended, important concerns or follow-up advice, and the doula signature.
- Use T1033 without a modifier for non-labor and non-delivery sessions.
- Use T1033 with U4 for labor and delivery sessions, including emergency Cesarean delivery when the doula attended the labor.
- Request prior authorization before providing more than 18 sessions.
- For telehealth labor and delivery billing, keep the signed DHS telehealth assurance statement and document that the doula was available throughout labor.
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
MN-ITS
- Confirm MN-ITS access and provider enrollment before first-claim work.
- Keep MHCP provider ID in your own secure records.
- Keep Medical Assistance member ID, names, dates of birth, and visit notes out of public pages.
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 Minnesota services before claim entry. Do not enter client names, IDs, dates of birth, or visit notes here.
Estimated total
$1,500.00
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.
Missing Medical Assistance member ID
Verify eligibility and add the Medical Assistance member ID before claim entry.
More than 18 sessions need prior authorization
Count prior sessions and attach prior authorization support before billing additional sessions.
Wrong T1033 modifier
Confirm the visit type and correct the modifier before payer entry.
Visit note does not support the service
Complete the visit note before marking the packet ready.
Telehealth assurance missing
Confirm the signed DHS-6806 is on file before telehealth claim entry.
Common questions
Plain answers about Minnesota Medicaid doula billing.
Does Minnesota Medicaid cover doula services?
Yes. Minnesota Medical Assistance doula services covers doula services. Coverage still depends on active eligibility, the service date, provider setup, and visit notes.
How much does Minnesota Medicaid pay doulas?
Minnesota pays per visit — Prenatal, postpartum, or non-labor doula session: $100; Labor and delivery doula session: $1,400. Use the Minnesota rate reference to check current amounts against official sources.
What should my Minnesota visit note include?
Minnesota lists 5 visit-note checks to review before claim entry, starting with: Document the member's name, visit date, length of time, what was done, discussed, and recommended, important concerns or follow-up advice, and the doula signature.. See the Minnesota visit-note checklist for the full list.
Why do Minnesota doula Medicaid claims get denied?
Common reasons include missing medical assistance member id; more than 18 sessions need prior authorization; wrong t1033 modifier. The Minnesota denied-claim guide lists the next step for each.
Rule change alerts
Get a no-PHI email when Minnesota 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 currentMinnesota 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.
Need a PDF copy?
PDF export is in the paid tools, where saved state guides and checklist downloads stay with your account.