MedicaidCoverageMedium impact
Doula Certification, Enrollment, and Billing per Public Act 102-0004 Effective February 1, 2024
Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine·Provider Notice
Effective date
Feb 1, 2024
We identified it
Jun 20, 2026
Summary
Illinois Medicaid now covers doula services effective February 1, 2024, with specific certification, enrollment, and billing requirements. Doulas must obtain Illinois Medicaid certification through SIU School of Medicine and enroll as providers in the IMPACT system to bill for eight new procedure codes including prenatal education, labor support, and postpartum services.
Action Required
Immediately: Billing teams at practices with doulas must ensure doulas obtain Illinois Medicaid certification through SIU School of Medicine and enroll in the IMPACT provider system with NPIs. Update billing software to include new doula procedure codes S9445, 59409, 59514, 59612, 59620, S9444, 59430, 99381, and T1032 with taxonomy code 374J00000X. Configure system to require documentation of standing recommendation or physician/PA/APRN recommendation for audit purposes. Set up telehealth billing capability for codes S9444, S9445, and T1032 with modifiers GT or 93.