ICEA Announces Doula Insurance Reimbursement

The President of the International Childbirth Education Association (ICEA), Jeanette Schwartz, announced October 21, 2009 that the National Uniform Claim Committee has approved a (new) billing code for doulas in the United States. The code will enable certified birth and certified postpartum doulas to obtain an NPI (National Provider Identification) number to submit reimbursement claims to Medicaid and third-party provider insurance companies.

Schwartz commented, “This is an important landmark for ICEA birth doulas and great timing for our new ICEA Postpartum Doula Program."

“The birth or postpartum doula will need to provide her certificate of certification as this is the evidence of
certification credentials necessary to apply for the NPI number,” continued Schwartz. Only certified birth and postpartum doulas will be able to use this code to apply for an NPI number or for reimbursement. Application for an NPI number can be made using the new taxonomy code at the National Plan and Provider Enumerator Systems (NPPES) website. Group practices are able to apply for a number, although the application process is slightly different.

The new taxonomy code is 374J00000X and is called “Doula” under the heading of “Nursing Service Related Providers Type.” While the term Doula is listed under the Nursing heading, RN or LPN licensure are not required to obtain the NPI number. The description includes the services of antepartum, labor doulas, and postpartum doulas. A definition of doula work is included on the National Uniform Claim Committee website: “Doulas work in a variety of settings and have been trained to provide physical, emotional, and information support to a mother before, during, and just after birth and/or provide emotional and practical support to a mother during the postpartum period.”

Schwartz went on to say that standard billing forms are still being developed, with birth doula forms in the final stages of development with postpartum forms coming at a later date. Until forms are finalized, ICEA doulas are encouraged to use the 1500 Universal Claims Form can be used to bill for reimbursement. Forms and a free manual of instructions are available online at websites such as the JustCMS1500Forms website. Software to automatically generate the forms is available also. A sample of the 1500 Universal Claim Form is available in PDF at the National Uniform Claim Committee website. “For now,” Schwartz advised, “doulas should bill clients directly as they have always done, file for reimbursement, and then offer the clients reimbursement when it is received from the insurance companies. We hope to bring you even better news soon, that doulas can bill insurance companies directly.”