Guide for California doulas

How to become a Medi-Cal doula: enrollment, step by step

Medi-Cal has covered doula care since 2023, but getting from “trained doula” to “paid by Medi-Cal” takes several separate approvals. Here they are in order, with what each one needs.

1.Check that you qualify

You must be at least 18, hold adult and infant CPR certification, and have completed basic HIPAA training. Then meet one of two pathways:

  • Training pathway: at least 16 hours of training (lactation support, childbirth education, anatomy of pregnancy and childbirth, nonmedical comfort measures and labor support, and building a community resource list), plus support at three or more births.
  • Experience pathway: at least five years of doula work in the last seven, and three letters (client testimonials or professional recommendations) from the last seven years, at least one from a licensed provider, a community-based organization or an enrolled doula.

Keep proof of your training. After you enroll, you need three hours of continuing education every three years.

2.Get your NPI

Apply for a National Provider Identifier on the CMS NPPES site. Choose a Type 1 NPI as an individual. If you’ll bill through an LLC, corporation or doula group, that entity needs a Type 2 NPI as well. Online applications usually come back in under 10 business days; paper takes about 20.

3.Sort out your business paperwork

DHCS asks you to meet local business requirements and to upload proof with your application:

  • A business license, if your city or county requires one. The name and address must match your application.
  • A Fictitious Business Name Statement (DBA), if your practice name doesn’t include your last name (for example “Golden Hour Doula Care” rather than “Rosa Delgado Doula Services”).

4.Apply in PAVE, as an individual or a group

Enrollment happens in DHCS’s online portal, PAVE (Provider Application and Validation for Enrollment). Use DHCS’s doula Provider Enrollment Checklist to see which documents to upload for your situation.

  • Solo doula: one application for yourself.
  • Doula group or community organization: one application for the group, plus a separate application for each doula who will provide services.

Review can take anywhere from weeks to a few months, and errors restart the clock, so double-check names and addresses. Questions about an application go to DHCS’s PAVE team.

5.Contract with the Medi-Cal plans in your area

DHCS approval lets you bill fee-for-service Medi-Cal directly. But most Medi-Cal members belong to a managed care plan (such as L.A. Care, Alameda Alliance, Inland Empire Health Plan or Partnership HealthPlan), and to be paid for their members you need a contract with each plan. Plans can have their own credentialing steps. Contact the provider or network team of each plan that covers your county. You can contract with as many as you like.

6.Contract with Kaiser, if you serve Kaiser members

Kaiser Permanente covers doula care for its Medi-Cal members and, since January 2025, its commercial members in California. Since January 2026, members must use a Kaiser-contracted doula. You’ll need your NPI and a tax ID. Kaiser’s contracting teams are reached at medi-cal-state-program@kp.org (Northern California) and kp-scal-professional-contracting@kp.org (Southern California), and Kaiser publishes a claims guide for doula services.

7.Get recommendations and bill your first claim

Every Medi-Cal doula client needs a written recommendation from a licensed provider. It can be a note in their record, a standing order from their plan or provider group, or the signed DHCS recommendation form they bring you. The first recommendation covers an initial visit, up to eight more visits, labor and delivery support and two extended postpartum visits; more postpartum visits need a second recommendation.

Claims use specific codes, diagnosis codes and the XP modifier on every line. Our Medi-Cal doula billing cheat sheet has all of them on one page.

Common questions

Do I need an NPI to become a Medi-Cal doula?

Yes. Every Medi-Cal doula needs a National Provider Identifier from CMS: a Type 1 NPI as an individual, and a Type 2 NPI if you bill through an LLC, corporation or doula group. An online application usually takes under 10 business days.

Can I bill Medi-Cal while my PAVE application is pending?

For fee-for-service members, once your application is approved you can bill retroactively to the date you submitted it. For members in a Medi-Cal managed care plan, you can only be paid once you are contracted with that plan.

Do I need a contract with every Medi-Cal managed care plan?

You need a contract (or another arrangement) with each plan whose members you serve. Most Medi-Cal members are in a managed care plan, so contracting with the main plans in your county is where most doula income comes from. You can contract with several plans.

How do I get paid by Kaiser as a doula?

Kaiser pays doulas who are contracted with Kaiser, for its Medi-Cal members and, since January 2025, its commercial members in California. You need an NPI and a tax ID; Kaiser’s Northern and Southern California contracting teams start the process.

How much does Medi-Cal pay doulas?

DHCS publishes fee-for-service rates for each doula code, and California raised them in 2024. Managed care plans negotiate their own rates with doulas. Check the current Medi-Cal fee schedule and each plan’s contract offer.