← Back to list
2025.14 - Provider Bulletin - New Coverage of Certified Doulas
Effective date
Jan 1, 2025
Identified
Jun 20, 2026
Summary
Connecticut Medicaid (CMAP/HUSKY Health) is adding fee-for-service coverage for certified doula services that are not part of the Maternity Bundle, for dates of service retroactive to January 1, 2025. Perinatal visits are reimbursed at $100.00 under procedure code T1033, and in-person attendance during labor and delivery is reimbursed as a flat fee of $800.00 under T1033-HD. Services are not eligible for reimbursement until the doula is certified by the Department of Public Health and fully enrolled and approved by CMAP, and doula services must be recommended, referred or ordered by a licensed and enrolled CMAP practitioner.
Get alerts when payers change rules like this one
We check Connecticut Medicaid (HUSKY Health) and other payers every day and email you when a change matches your specialty and state.
Get Connecticut Medicaid (HUSKY Health) alertsPolicy Monitoring is free. No card required.
What to do
Action · 11 steps
01Already effective 2025-01-01: Doula services are eligible for reimbursement only after the doula is certified by DPH and fully enrolled and approved by CMAP.
02Providers: the doula's services must be recommended, referred or ordered by a licensed and enrolled Medicaid practitioner (physicians, advanced practice registered nurses, physician assistants, or certified nurse-midwives); a handwritten or electronic recommendation is acceptable.
03Billing team: bill T1033 for each perinatal visit at $100.00; members are eligible for up to four antepartum or postpartum visits and one labor and delivery visit.
04Doulas must request prior authorization for medically necessary perinatal visits beyond the four visits, and CHNCT will review the PA request.
05Billing team: for in-person attendance during labor and delivery, the claim must include procedure code T1033 with modifier HD (parenting/pregnant women's program) for a flat fee of $800.00; claims without the HD modifier will either deny or be reimbursed at the $100.00 perinatal visit rate, and providers are responsible for recouping and resubmitting the claim correctly.
06Telemedicine: bill the place of service that reflects where the service would have been provided in person (for example POS 11), because CMAP does not recognize POS 10 or 2; append modifier 95 or GT; no more than half of visits may be via telemedicine, and telemedicine is not permitted for labor and delivery attendance.
07Outpatient hospitals: hospitals cannot bill directly for doula services, and the doula must be enrolled and bill for services directly.
08FQHCs: doula services cannot be billed as an encounter and none of the doula procedure codes can be reported with HCPCS code T1015; an FQHC can establish a separate office enrolled as a doula or doula group, and claims must include the certified doula as the rendering provider.
09Doula services conducted as group visits and travel and mileage are not covered.
10Fee schedule: Provider > Provider Fee Schedule Download on www.ctdssmap.com, then the Doula fee schedule.
11Questions go to the Provider Assistance Center at 1-800-842-8440, Monday through Friday, 8:00 a.m. to 5:00 p.m.
Codes mentioned
T1033HDT1015
Original notice
2025.14 - Provider Bulletin - New Coverage of Certified Doulas
ctdssmap.com · Always check the source before changing claims.
Related changes
See all Connecticut Medicaid (HUSKY Health) changes →2026.44 - Provider Bulletin - Maternity Care Service Billing Guidance: Antepartum CareHighEffective Sep 1, 2026 · Provider Bulletin2026.36 - Provider Bulletin - Behavioral Health Integration - Psychiatric Collaborative Care Model (CoCM)MediumEffective Jul 1, 2026 · Provider Bulletin2024.83 - Provider Bulletin - Changes for Billing Long-Acting Reversible Contraceptive Devices in the Medical FQHC SettingHighEffective Jan 1, 2025 · Provider Bulletin2025.33 - Provider Bulletin - New Coding & Reimbursement for SBIRT ServicesHighEffective Jul 1, 2025 · CodingBrowse every Connecticut Medicaid (HUSKY Health) change in the policy list