MedicaidCoverageMedium impact
Supplement 25-01: Billing and Reimbursement for Doula Services
New Mexico Medicaid·NM · OB-GYN, Family Medicine·Claims & Billing
Effective date
Oct 1, 2024
We identified it
Jun 21, 2026
Summary
New Mexico Medicaid now covers doula services as reimbursable preventive care effective October 1, 2024. Billing teams can submit claims using specific T1032 and T1033 codes with required modifiers, and have 90 days from this supplement date to avoid timely filing denials for services provided since October 1, 2024.
Action Required
By April 9, 2025: Billing team must set up new provider type 406 with specialty code 206 for doula services in billing system. Configure T1032 with U1/U2 modifiers for prenatal/postpartum and counseling services (15-minute units, max 8 units/day, 9 visits/year), and T1033 with U3 modifier for labor/delivery (per diem, max 1 unit). Update CMS 1500 forms to include doula agency NPI in block 32a, rendering provider NPI in block 24j, and taxonomy 374J00000X. Submit retroactive claims for services provided October 1, 2024 through present within 90 days to avoid timely filing denials.