MedicaidCoverageMedium impact
New: Doula Services Coverage
EmblemHealth·OB-GYN, Family Medicine, General Practice·Provider News
Effective date
Apr 1, 2025
We identified it
Jun 20, 2026
Summary
EmblemHealth now covers doula services for pregnant, birthing, and postpartum patients (up to 12 months after delivery) in hospital, clinic, and community settings. This new benefit applies to Medicaid, Health and Recovery Plan (HARP), and Essential Plan members effective April 1, 2025.
Action Required
Immediately: Billing team must verify doula service billing codes and coverage requirements with EmblemHealth. Update billing system to recognize doula services as covered for Medicaid, HARP, and Essential Plan members who are pregnant or postpartum (up to 12 months post-delivery). Train staff to verify member eligibility and service settings (hospital, clinic, community) before billing.