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Updated September 2026

Illinois Medicaid began covering doula services on February 1, 2024. Coverage is available through:

• Illinois Medicaid fee-for-service
• HealthChoice Illinois managed care organizations

Covered services include prenatal education, labor and birth support, postpartum education and advocacy, attendance at certain postpartum and newborn medical visits, and support during or after miscarriage or abortion.

The benefit is intended to expand access to nonmedical physical, emotional and informational support throughout the perinatal period.

The standing recommendation for doula services

Because doula services are covered as preventive services, federal Medicaid rules require the services to be recommended by a licensed healthcare provider.

Illinois addresses this requirement through a statewide Standing Recommendation for Doula Services. Doulas may also work under an individual recommendation from an eligible licensed physician, physician assistant or advanced practice registered nurse.

For every covered service, the doula must document whether the service was provided under:

1. The Illinois standing recommendation; or
2. A recommendation from a specific eligible licensed provider.

This information belongs in the doula’s service documentation for audit purposes. It is not entered on the Medicaid claim.

Illinois Medicaid-Certified Doula requirements

Before enrolling with Illinois Medicaid as a doula, an applicant must first obtain certification through the Illinois Medicaid-Certified Doula Program, administered by the Southern Illinois University School of Medicine.

SIU provides two certification options:

• Training Program Pathway
• Legacy Pathway

The Training Program Pathway is generally intended for newer doulas who have completed their education through an approved doula training organization.

Requirements under the Training Program Pathway

Applicants using the Training Program Pathway must generally:

• Be at least 18 years old
• Complete three perinatal doula experiences within the previous 12 months
• Complete Labor and Birth Doula training through an approved organization
• Complete Postpartum Doula training through an approved organization
• Complete Cultural Competency/Bias Training
• Complete HIPAA training
• Complete Trauma-Informed Care training
• Complete CPR or Basic Life Support training
• Submit all required application materials to SIU
• Receive approval and an Illinois Medicaid-Certified Doula certificate

Applicants should review the current SIU Pathways and Requirements before applying.

Is Newmom.me Academy approved in Illinois?

Yes. Newmom.me Academy is listed by SIU School of Medicine as an approved doula training organization for Illinois’s Training Program Pathway.

Because Illinois requires training in both areas, applicants pursuing this pathway should complete:

• Newmom.me Academy Labor and Birth Doula Training
• Newmom.me Academy Postpartum Doula Training

Newmom.me Academy also provides the following required supplemental courses to its students at no additional cost:

• HIPAA Training
• Cultural Competency and Bias Training
• Trauma-Informed Care Training

CPR or Basic Life Support must be completed separately through an acceptable provider.

Students should retain their certificates, course records and documentation of their three perinatal doula experiences for their SIU application.

View the current SIU list of approved doula training organizations and learn more about Newmom.me Academy’s Medicaid-eligible programs.

Training approval does not automatically provide Medicaid certification

Completing an approved Newmom.me Academy program does not automatically make a graduate an Illinois Medicaid-Certified Doula or an enrolled Medicaid provider.

Graduates must still:

1. Complete all applicable SIU requirements.
2. Apply to the Illinois Medicaid-Certified Doula Program.
3. Receive an SIU-issued certificate.
4. Obtain an individual National Provider Identifier.
5. Enroll through the Illinois Medicaid IMPACT system.
6. Complete any applicable managed-care contracting or credentialing requirements.

The SIU certificate includes a unique certification number, effective date and expiration date. It is valid for three years. Doulas must recertify through SIU and submit proof of recertification to Illinois HFS when required.

Enrolling as an Illinois Medicaid provider

After receiving the SIU certificate, a doula can apply through the Illinois Medicaid Program Advanced Cloud Technology system, known as IMPACT.

Doulas need an individual National Provider Identifier to enroll.

The provider type and specialty are:

• Provider type: Health Support Professional
• Specialty: Doula
• Taxonomy code: 374J00000X

Illinois identifies two principal enrollment structures for doulas.

Rendering or Servicing Provider

A rendering doula provides services to Medicaid members but does not submit claims directly to the state.

The doula must be associated in IMPACT with an enrolled billing provider, such as a group practice, facility, agency or organization.

Regular Individual or Sole Proprietor

A sole proprietor may receive Medicaid payments directly and bill independently.

A sole proprietor may also associate with a billing provider or billing agent and allow that organization to submit claims on the doula’s behalf.

Doulas should select the enrollment structure that accurately reflects how they operate and how their claims will be billed.

Illinois Medicaid doula reimbursement rates

Illinois’s current doula fee schedule is effective May 1, 2026, and was updated May 5, 2026.

Prenatal education and support

S9445 — Non-physician prenatal patient education

• $15 per 15-minute unit
• Maximum of eight units or two hours per day
• Maximum individual reimbursement of $120 per day

S9445-HQ — Group prenatal education

• $5 per 15-minute unit per Medicaid member
• Maximum of eight units or two hours per day
• Maximum reimbursement of $40 per member per day

Labor and birth support

The following labor-support codes are reimbursed at $720, with one eligible labor-support payment per pregnancy:

• 59409: Vaginal delivery
• 59514: Cesarean delivery
• 59612: Vaginal delivery after a previous Cesarean birth
• 59620: Cesarean delivery following an attempted vaginal birth after Cesarean

The appearance of obstetric procedure descriptions does not mean the doula is performing the delivery. These codes are used to bill for the doula’s nonmedical labor and birth support.

Postpartum education, advocacy and resources

S9444 — Postpartum parenting education, advocacy and connection to appropriate resources

• $15 per 15-minute unit
• Maximum of 16 units or four hours per day
• Maximum individual reimbursement of $240 per day

S9444-HQ — Group postpartum education

• $5 per 15-minute unit per Medicaid member
• Maximum of eight units or two hours per day
• Maximum reimbursement of $40 per member per day

Attendance at postpartum medical visits

59430 — Attendance at a postpartum practitioner or OB visit

• $50 per eligible visit
• Maximum of two payments per delivery

The doula must accompany the birthing person to the practitioner visit. One payment may be available for a visit occurring within 26 days after delivery, and another may be available for a visit occurring between 27 and 89 days after delivery.

The actual delivery date must be reported in the required field on the claim.

Initial newborn visit

99381 — Facilitation and attendance at the initial newborn medical visit

• $50 per child
• The visit must occur within two weeks after delivery
• The claim must be billed using the newborn’s recipient identification number
• The service may be billed for each child in a multiple birth

Miscarriage or abortion support

T1032 — Doula support during or after miscarriage or abortion

• $15 per 15-minute unit
• Maximum of eight units or two hours per day
• Maximum reimbursement of $120 per day

Review the current Illinois Medicaid Doula Fee Schedule.

Required time documentation

Effective May 1, 2026, Illinois requires Medicaid providers to document the start and end time of each covered doula service or encounter.

Records for timed services should clearly show:

• Date of service
• Service provided
• Start time
• End time
• Total duration
• Applicable recommendation
• Relevant education, advocacy or support provided
• Any referrals or resources discussed
• Doula’s identifying information and signature, when required

Time must be recorded in hours and minutes and must support the number of 15-minute units billed.

Medical records without start and end times may be considered incomplete and may be subject to an audit, payment recoupment or other corrective action. See the Illinois HFS May 2026 Provider Notice.

Telehealth rules

Illinois allows certain doula services to be delivered through telehealth when the service can appropriately meet the required components of an in-person encounter.

Telehealth may be used for:

• S9445 prenatal education
• S9444 postpartum education and advocacy
• T1032 support during or after miscarriage or abortion

Depending on how the service is delivered, the claim may require:

• Modifier GT for audio and video
• Modifier 93 for audio-only services
• Place of service 02 when telehealth is provided outside the member’s home
• Place of service 10 when the member receives telehealth at home

Labor and birth support codes are not listed as telehealth-eligible services.

How Illinois doulas submit Medicaid claims

Illinois Medicaid doula claims are submitted electronically using the 837 Professional transaction. Claims may also be entered directly through the MEDI system.

A basic reimbursement workflow includes:

1. Confirm that the SIU certification is active.
2. Confirm that the doula’s IMPACT enrollment is active.
3. Verify the Medicaid member’s eligibility and health plan.
4. Confirm whether the member is covered through fee-for-service or a managed-care organization.
5. Document the standing recommendation or individual provider recommendation.
6. Deliver and document the covered service.
7. Record start and end times for timed services.
8. Select the appropriate procedure code, modifier, units and place of service.
9. Include the delivery date or newborn information when required.
10. Submit the claim through the correct state or managed-care billing channel.
11. Track acceptance, payment, denial and any required correction or appeal.

Doulas serving HealthChoice Illinois members should also confirm the individual managed-care organization’s contracting, authorization, documentation and claim-submission requirements.

Illinois Medicaid doula checklist

Before providing and billing for Medicaid doula services, confirm that you have:

• Completed both approved Labor and Birth Doula and Postpartum Doula training
• Completed three qualifying perinatal doula experiences
• Completed HIPAA training
• Completed Cultural Competency/Bias Training
• Completed Trauma-Informed Care training
• Completed CPR or Basic Life Support
• Received your Illinois Medicaid-Certified Doula certificate from SIU
• Obtained an NPI
• Enrolled through IMPACT
• Selected the correct enrollment type
• Used taxonomy code 374J00000X
• Confirmed the member’s eligibility and health plan
• Documented the standing or individual recommendation
• Recorded start and end times
• Used the appropriate billing code, units, modifiers and place of service
• Followed all applicable managed-care requirements
• Maintained secure and complete records

Building a professional doula practice in Illinois

Illinois’s Medicaid doula benefit creates a meaningful opportunity to expand access to continuous, culturally responsive support during pregnancy, childbirth and postpartum recovery.

For doulas, success within the program requires more than completing a training course. It also requires certification, enrollment, accurate documentation, familiarity with Medicaid billing and careful attention to each health plan’s requirements.

Newmom.me Academy helps students begin this pathway through approved Labor and Birth Doula and Postpartum Doula education, supplemental training, mentorship and practical business resources.

Learn more about  Newmom.me Academy’s Medicaid-approved doula trainings.

This article is provided for educational purposes and does not constitute legal, billing, medical, financial or tax advice. Medicaid requirements, reimbursement rates and health-plan policies may change. Completing an approved training program does not guarantee SIU certification, Medicaid enrollment, contracting, clients, claim payment or income. Doulas should confirm current requirements directly with SIU, Illinois HFS and the applicable managed-care organization.

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