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Medicaid doula billing guide
Washington Medicaid doula billing
Check Washington Medicaid doula rates, setup, notes, denials, and first-claim steps.
Short billing answer
What to check before a Washington doula claim
Washington Apple Health bills birth doula services through ProviderOne: 59899 U1 prenatal intake is $750, T1033 labor and delivery is $750, and T1032 additional prenatal/postpartum time is $25 per 15-minute unit up to 80 units / $3,500 per client.
First-claim check: Confirm ProviderOne access, Apple Health eligibility, visit-note duration, and whether the service is covered before entering the claim.
Sources: Washington HCA Birth Doula Services Fee Schedule, Washington HCA Provider Billing Guides and Fee Schedules.
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Washington Medicaid doula billing guide
Share the resource. Keep client names, Medicaid IDs, claim numbers, service dates, and visit notes out of public links.
Get a provider-readiness review
Receive a written Washington setup and claim-readiness plan with official sources. Do not submit patient or claim details.
Get a provider setup review before you bill.
Choose your billing route, provider setup status, service, and code. Keep names, IDs, screenshots, visit notes, and private messages in your own records.
Washington Medicaid doula billing rules
Washington uses 15-minute billing units at $25, with a 80-unit / $3,500 cap and service-line rules to check before claim entry.
Can doulas bill Medicaid in Washington?
Yes, when Apple Health birth doula services rules, eligibility, setup, and notes support the service.
How does payment work?
$25 per 15-minute unit, up to 80 units / $3,500 per client.
First thing to check?
Confirm ProviderOne access and payer routing.
Biggest risk?
Missing Apple Health client ID: Verify eligibility and enter the Apple Health client ID before submission.
Save free State Watch for Washington
Watch HCA guide and fee-schedule changes that could affect ProviderOne setup, $25 units, the 80-unit cap, telemedicine exclusions, or the 365-day filing window.
State Watch alerts and saved changes are free. Written reviews are sold separately. State Watch does not guarantee payment. Tracked source: Washington HCA Birth Doula Services Fee Schedule.
Billing availability
Billing guide and tools available.
How payment works
Verified Jun 29, 2026$25 per 15-minute unit, with a limit of 80 units and $3,500 per client.
Check before billing
- Track the 80-unit / $3,500 cap before claim entry.
- Confirm fee-for-service vs managed care routing before billing or follow-up.
- Remove noncovered services or document a covered doula service instead.
Recently updated
Updated Jun 29, 2026Official fee scheduleRates come from an official fee schedule or public rate source.
- Checked Washington State Health Care Authority: Washington HCA Provider Billing Guides and Fee Schedules.
- Checked Washington State Health Care Authority: Washington HCA Birth Doula Services Billing Guide.
- Checked Washington State Health Care Authority: Washington HCA Birth Doula Services Billing Guide.
Rule change alerts
Get an email when Washington doula billing rules change or a new official source is reviewed.
We store your email, selected state, email preferences, and consent dates. Do not send client details.
Official sources are linked with each billing rule.
Notes before billing
Check these in groups so you can spot the missing piece faster.
Open notes before billingProvider setup
Confirm provider setup and payer requirements before the first claim.
Open provider setupWashington training details
Review Washington rates, exclusions, and an example claim.
Open Washington training detailsPayout estimator
Model common claim totals from verified published rates. Keep client-specific details in your own secure records.
Open payout estimatorFirst-claim checks
Complete these four checks before opening the payer portal.
Open first-claim checksState-specific denial reasons
Review common denial reasons for this state and the next step to check.
Open state-specific denial reasonsGet a written denial-code review.
The paid review uses a denial category and public sources. Do not enter a claim, EOB, or payer message.
Check first-claim readiness
Choose the state, service category, codes, modifiers, units, and place of service. Do not enter a claim or patient record.
Included task: Set follow-up
What stays outside DoulaPaid
- Claim submission stays with the payer, portal, group, or biller.
- Client names, Medicaid IDs, claim numbers, and visit notes stay in your secure records.
- Payment is never guaranteed.
- DoulaPaid stores only the provider setup choices you select.
Common questions
Short answers about Washington Medicaid doula billing.
Does Washington Medicaid cover doula services?
Yes. Apple Health birth doula services covers doula services. Coverage still depends on active eligibility, the service date, provider setup, and visit notes.
How much does Washington Medicaid pay doulas?
Washington pays by time block: $25 per 15-minute unit, up to 80 units ($3,500) per client. Check current amounts against the official sources in the Washington rate reference.
What should my Washington visit note include?
Washington lists 5 visit-note checks to review before claim entry, starting with: Document the date, duration, nature of care, coordination with medical or community resources, and referrals.. See the Washington visit-note checklist for the full list.
Why do Washington doula Medicaid claims get denied?
Common reasons include missing apple health client id; units exceed state limit; visit note does not support service. The Washington denied-claim guide lists the next step for each.
Can a Washington doula bill for phone calls, texts, or emails?
No. WAC 182-533-0665 lists phone calls, text messages, and emails as noncovered birth doula services.
Can a Washington doula bill for travel time or mileage?
No. WAC 182-533-0665 excludes travel time and mileage. Only covered doula service time should be used for billing decisions.
Can a Washington doula bill for note-writing time?
No. WAC 182-533-0665 excludes note-writing time. Keep visit notes complete, but do not count that time as a covered doula service.
Does Washington pay fee-for-service for managed care clients?
Yes. WAC 182-533-0670 says Apple Health pays covered birth doula services through fee-for-service using the agency fee schedule for eligible managed care and fee-for-service clients.
Can Washington birth doula services be provided by telemedicine?
Some services can be audio-visual telemedicine only after the in-person prerequisites in WAC 182-533-0680 are met. Prenatal intake, labor and delivery support, and specified first visits are not payable by telemedicine.
What happens if a Washington claim exceeds the unit cap?
If units are over the published limit, pause and check whether authorization or an exception path applies before billing. Track cumulative units before claim entry.
Can Washington doulas bill group services?
No. WAC 182-533-0665 lists group services as noncovered for birth doulas.
What should each Washington doula visit note include?
Document the service date, duration, nature of care, coordination with medical or community resources, and referrals. Keep client-specific notes in your own secure records.
Doula wellbeing
Birth work is heavy. Free, anonymous wellbeing resources are available when you need support.
Save Washington updates
Get reviewed source updates or order a written provider-readiness review.