South Dakota denied-claim help
Missing licensed-practitioner referral
South Dakota Medicaid requires a physician, PA, CNP, or CNM referral (face-to-face or telemedicine within 90 days) before doula services are billable.
Read the payer denial reason first.
Check the matching source before correcting or appealing.
Keep claim numbers and client details in private records.
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
Missing licensed-practitioner referral
South Dakota Medicaid requires a physician, PA, CNP, or CNM referral (face-to-face or telemedicine within 90 days) before doula services are billable.
Next action
Obtain and retain the referral (or care management program referral) before billing; it may be retroactive up to 60 days.
Sources for this denial
Denial pages use the same checked state sources as the app.
SD Medicaid Doula Services Billing and Policy ManualSouth Dakota Department of Social Services / SD Medicaid · Updated December 2025; doula benefit effective January 1, 2025; T1032 timed unit, T1033 labor/delivery, $1,800 per-pregnancy cap, referral within 90 days · checked 2026-06-19SD Medicaid Doula Services Fee ScheduleSouth Dakota Department of Social Services / SD Medicaid · Doula Services fee schedule (Current SFY): T1032 $16.87 per 15-minute unit, T1033 $600 per delivery · checked 2026-06-19