Medicaid Doula Pilot Program
Date Issued: 1/23/2019
Beginning March 1, 2019, EmblemHealth will participate in the New York State Doula Pilot Program. The pilot program is part of the state’s comprehensive initiative to target maternal mortality and reduce racial disparities in health outcomes.
Pregnant women who live in selected zip codes in Kings* (Brooklyn) County will have access to doula services. A doula, also known as a birth companion, birth coach, or post-birth supporter, is trained to provide physical and emotional support to a mother before, during, and after childbirth.
As of March 1, 2019, EmblemHealth will cover the following doula services for pregnant Medicaid members residing in the selected zip codes in Kings* County:
- Up to and including three prenatal visits
- Support during labor and delivery
- Up to and including four postpartum visits
Doulas in EmblemHealth’s network must submit claims with the following procedure codes for reimbursement:
||Max Number of Billable Visits
|Prenatal Care Visit
|Labor and Delivery
||99600 + UA Modifier
*The Doula Pilot Program does not include the following zip codes in Kings County that are already funded through the New York City Department of Health and Mental Hygiene’s By My Side program: 11207, 11212, and 11233.
For more information, visit: https://www.health.ny.gov/health_care/medicaid/redesign/doulapilot/pilot.htm.