Washington ruleset 2026.04.01-current
Washington Medicaid doula billing rules
Washington Medicaid doula billing uses 15-minute units and state-specific caps.
Washington Medicaid doula billing rules
Washington Medicaid doula billing uses 15-minute units and state-specific caps.
Unit-based model
$25 per 15-minute unit, with a tracked cap of 80 units and $3,500 per client.
Submission safeguards
- Document the date, duration, nature of care, coordination with medical or community resources, and referrals.
- Preserve enough detail to support every billed service line.
- Verify client Apple Health eligibility before packet generation.
- Track the 20-hour / 80-unit prenatal and postpartum visit limit, including 6 units designated for postpartum care.
- Document in-person prerequisites before billing later telemedicine visits; audio-only telemedicine is not covered.
This page is generated from a versioned ruleset, so new state pages can reuse the same structure after source review.
Free state tools
Public tools stay no-PHI and point doulas toward the private workspace only when client details are needed.
Denial decoder
Every state ruleset can publish denial-specific long-tail pages from source-backed data.
Missing Apple Health client ID
Verify eligibility and enter the Apple Health client ID before submission.
Units exceed state limit
Recalculate timed visits and document whether a limitation extension is needed.
Documentation does not support service
Add visit documentation before exporting the packet.
Telemedicine service is not payable
Confirm an in-person qualifying visit is documented or change the service line before submission.
Timely filing window risk
Check service dates and prioritize packets near the 365-day filing limit.
Overnight postpartum support is not covered
Remove noncovered services or document a covered doula service instead.
Source trail
Published rules must stay attached to payer or policy sources.