Frequently Asked Questions

In 2021 interested parties gathered to discuss the future of the Doula profession.   Overtime leaders emerged to direct the conversation, complete research adn present options to the Commonwealth of Pennsylvania, Doulas, and other interested Parties. Gerria Coffee, Aleta Heard, Theresa Pettaway & Laurent Pietrowski began to organize and form the Non-profit Organization, the Pennsylvania Doula Commission. 

The Certified Perinatal Doula Credential is necessary to create a standard for the PA Department of Human services and CMS to recognize Doulas as a provider type. Being recognized as a provider is an important step in your services being reimbursable when providing Doula support to  families who are enrolled in Medicaid.

in 2021 nearly 90 people who are doulas midwives, and public health experts met regularly to collaborate on a scope of work that allowed us to develop a credential without over regulating the work. Our goal as a team was to create a standard that we can work with. 

That is great!! We could use the support. Complete the application to join one of our committees and the Committee Chair will contact you. 

DONA is a respected brand no doubt, but this credential is designed specifically to the needs of our community and families placed in the margin. the CPD credential applies to birth, postpartum and loss support. It is an entirely new scope. 

 Malpractice insurance for doulas protects personal assets and covers legal expenses in the event a malpractice or professional liability lawsuit is brought against a birthing doula. Doula personal liability insurance is necessary so doulas can tend to mothers/birthing people and families without fear of litigation. As doula services become more popular, the demand for liability insurance for doulas also is increasing.  You can purchase insurance through the Pa Doula Commission Here

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You can apply for the CPD credential here https://www.pacertboard.org/doula There are both paper and online application options. 

Training that meets the minimum 24 Hour requirement and learning measurement.

PADC is happy to cover the cost of the CPD application, which is $50 dollars for applicants in Pennsylvania. Apply Here

You can find the most current listing of Doulas with the state credential in our website navigation under Updated CPD List or by clicking here

You will need an NPI number for your Medicaid provider enrollment application. Training slides are available Here

Enrollment training slides are available Here.

Response was provided at the Doulas and Medicaid Managed Care Organizations training on January 25, 2024.

Yes, you may register for an organizational NPI as well as an individual NPI in the National Plan & Provider Enumeration System (NPPES) NPPES (hhs.gov).

 You are not required to be or have an LLC to enroll as a doula. However, you may wish to speak to an attorney or an accountant regarding how you may structure your practice/business.  

 Doulas may choose which Medicaid Managed Care Organizations (MCOs) they want to contract with for payment. In order to be paid by a Medicaid MCO, the doula must have a contract with the Medicaid MCO. If a doula serves a beneficiary that is covered by a Medicaid MCO, in order to be paid for those services to that beneficiary, the doula will need to be contracted with that beneficiary’s Medicaid MCO. 

 Medicaid MCOs are to negotiate rates with doulas. The Department of Human Services (DHS) will not set a rate that Medicaid MCOs need to pay. You will negotiate your rate directly with the Medicaid MCO. 

All Medicaid MCOs offer onboarding training for new providers to explain their unique billing processes. You will want to contact the appropriate MCO for information about their onboarding training. 

 Medicaid MCOs are required to inform beneficiaries of covered services in their member handbooks 

 Medicaid MCOs will list doulas on their provider directories if they are in the Medicaid MCO’s provider network.  This will allow beneficiaries to reach you directly. 

Doulas may work independently or in partnership with such agencies, or other entities such as birthing hospitals.

 Medicaid MCOs are to negotiate rates with doulas. DHS will not set a rate that Medicaid MCOs need to pay. You will negotiate your rate directly with the Medicaid MCO. 

[No set rate will be decided for all doulas until there is a State Plan Amendment, which only possible when there are enough doulas ready to support each county in PA]

Certification from the Pennsylvania Certification Board as a Certified Perinatal Doula is required for doulas to enroll in the Medical Assistance (MA) Program. 

Doulas will need to get a National Provider Identifier, also referred to as an NPI number, before completing the MA provider application. Doulas can apply for an NPI number at: NPPES (hhs.gov).

Once a Doula has their NPI number and certification, they can complete the MA provider enrollment application.

 In 2024, doulas are eligible for payment by the Medicaid MCOs. You will contract with the Medicaid MCO for payment and will negotiate your rate directly with the Medicaid MCO. You will need to learn and follow the Medicaid MCO’s billing processes in order to be paid by them. Which Medicaid MCO you will bill is determined by which Medicaid MCO covers the beneficiary you are serving. The Medicaid MCO is essentially the beneficiary’s insurance company. 

 DHS has not developed a checklist for the enrollment process. For information how to enroll, please refer to the DHS Provider Enrollment Documents webpage: Provider Enrollment Docs (pa.gov). The DHS webpage includes information on the Doula Provider Type 13 (Non-Traditional Provider), the application, the doula provider enrollment training presentation, and a recording of the doula provider enrollment training. 

 This Perinatal Doula Certification was developed by approximately 90 doula midwives and public health experts across the state with input from DHS and guidance from the Pennsylvania Certification Board to ensure the scope of doula services and requirements of the certification are appropriate to the specific needs of Pennsylvania communities and families. 

: The next step you will need to do is get a National Provider Identifier (NPI) through the NPPES. Once you have your NPI, you can enroll in PA Medicaid. Once you are enrolled in PA Medicaid, you will need to reach out to the Medicaid MCOs to be credentialed. 

General guidance was provided at the Doulas and Medicaid Managed Care Organizations training on January 25, 2024. DHS provided another training on March 14, 2024 on Billing Practices for Doulas. Medicaid MCO-specific guidance will be provided as you are onboarded as a network provider with each Medicaid MCO after contracting.

You may begin billing Medicaid MCOs after you have enrolled in the MA Program and contracted with one or more of the Medicaid MCOs, beginning 2/1/2024.