MedicaidBilling CodesHigh impact
Claim Resubmission and Billing Clarification for Doula Services
Maryland Medicaid·MD · OB-GYN·Doulas
Effective date
Jun 11, 2026
We identified it
Jul 17, 2026
Summary
Maryland Medicaid has established a claim resubmission opportunity for doula services rendered between May 1, 2024 and May 1, 2026, allowing providers to correct previously underbilled claims by requesting void of initial claims and resubmitting with accurate 4-unit billing for 60-minute visits. The policy also clarifies the 8:1 reimbursement model, fee schedule effective July 1, 2023, and eligible place-of-service codes for prenatal (T1032), postpartum (T1032 U9), and labor/delivery (T1033) services.
Action Required
By May 1, 2026 (resubmission window deadline): Billing team must identify and correct all underbilled doula claims for services rendered between May 1, 2024 and May 1, 2026. For each affected claim: (1) Contact the MCO to request claim void, (2) Verify that 60-minute doula visits were billed as exactly 4 units at the correct rate per Table 1 ($16.62 per unit for prenatal T1032; $19.62 per unit for postpartum T1032 U9; $800 flat for delivery T1033), (3) Resubmit corrected claims with accurate unit counts. Update billing system edits to enforce 4-unit requirement for all future prenatal and postpartum doula visits billed after June 11, 2026. Ensure telehealth claims include appropriate GT modifier and valid place-of-service codes (prenatal: 04, 11, 12, 22, 50, 99; postpartum: 02, 04, 11, 12, 99; delivery in-person only: 21, 25). MCOs must prepare systems to process resubmitted claims and void originals upon provider request. Failure to correct claims by May 1, 2026 will forfeit reimbursement opportunity for the identified lookback period.