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Effective November 1, 2024, doulas must include Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) diagnosis codes on claims. These diagnosis codes are federally required and used to determine what services were provided.
Claims will be denied if they do not have a diagnosis code or if they have a diagnosis code paired with a billing code incorrectly.
To identify which diagnosis codes may be billed with each code, the Department of Health Care Services (DHCS) created a coding crosswalk.
- Doulas can generally choose between several diagnosis codes for each billing code.
- The diagnosis code can be entered into field 21A on the CMS 1500 form and should not have a decimal point on the form.
Learn more
- Consult the Medi-Cal Provider Manual on Doula services.
- If you have questions, email DHCS or HPSM Provider Services.