How to enroll as a Medicaid doula in Nevada
Nevada Medicaid (Provider Type 90) · coverage since April 1, 2022 · last checked July 25, 2026
Nevada has covered doula services since April 2022. Current rates pay $100 per visit and $900 for delivery, with a 10% rural adjustment, for up to $1,500 in urban areas or $1,650 in rural areas when all six visits are authorized. Enrollment requires Nevada Certification Board certification and an online Provider Type 90 application. Nevada verifies credentials centrally, but you must still contact each managed care plan you intend to bill about contracting.
What Medicaid pays
Up to $1,500 urban / $1,650 rural per pregnancy (6 visits + delivery)
- S9445-U1 prenatal/postpartum visits: $100 each; delivery codes with U1: $900 (urban)
- Rural adjustment: 10% for eligible members, making visits $110 and delivery $990. Since August 25, 2025, Nevada assigns the adjustment from the member's ZIP code; do not add the former TN modifier
- The current rates became effective retroactively to October 2023 after the 2024 state plan amendment approval
4 prenatal/postpartum visits + 1 labor & delivery without prior authorization (13 rolling months, postpartum to 90 days); up to 6 visits total with a healthcare provider's FA-111 certification; PA beyond that.
Who can apply
- Nevada Certification Board birth doula certification ($100 initial; $50 renewal every 2 years with 20 continuing-education hours): approved doula training, 4 hours of trauma-informed education, 6 hours of cultural education, 1 hour of HIPAA training, current adult and infant CPR, and attendance as primary doula at 1 or more births in the past 5 years with the birthing person's recommendation
- Live or work in Nevada at least 50% of the time
- Free Type 1 NPI
How to enroll
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Step 1
Get NCB-certified
nevadacertboard.org lists the approved trainings and competencies, the single certifying body for the state.
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Step 2
Get your free Type 1 NPI
NPPES, taxonomy 374J00000X.
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Step 3
Enroll online as Provider Type 90
Nevada Medicaid's Online Provider Enrollment portal (paper isn't accepted) using the PT 90 checklist; Gainwell is the fiscal agent.
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Step 4
Bill via the provider web portal
Four visits plus delivery are covered without prior authorization. Two more visits require a provider's certification on form FA-111; anything beyond that needs prior authorization. The rural adjustment is now assigned from the member's ZIP code, so do not use the former TN modifier.
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Step 5
Complete managed care contracting
Nevada verifies credentials centrally, but that does not replace a plan contract. After state enrollment and CAQH setup, contact each managed care entity you intend to bill for its current onboarding instructions.
How you get paid
Nevada's centralized credential verification took effect in February 2025, and managed care expanded statewide on January 1, 2026. Central verification does not replace plan contracting. Contact each managed care entity you intend to bill for its current network and claims instructions.
What to plan for
State enrollment and centralized credential verification do not complete the managed care step. Keep each plan's contract and billing instructions, and let Nevada assign any rural adjustment from the member's ZIP code rather than adding the discontinued TN modifier.
Where to get help
- Nevada Certification Board, birth doula (the required certification, approved trainings, and CE rules)
- Nevada Medicaid PT 90 billing guide (billing guidelines (updated Aug 2025), enrollment checklist, and form FA-111)
- DHCFP 'Become an Approved Doula' (the state's enrollment overview for doulas)
Sources and last checked
We checked these details on July 25, 2026.
- Nevada Medicaid PT 90 billing guide
- Nevada Medicaid FA-111 additional visit certification
- Nevada Medicaid rate announcement 3474
- Nevada Medicaid rural adjustment update
- Nevada Certification Board birth doula requirements
This is general educational information, not legal, billing, or enrollment advice. Rules and rates can change between reviews. Confirm the current provider manual, payment schedule, and health-plan contract before you apply or bill. Junie can create a payment receipt labeled as a superbill, but the current output derives its dates and descriptions from payment records and must be checked against the recipient's requirements. A superbill is not a Medicaid claim. Junie does not currently enroll providers in Medicaid or submit Medicaid claims. Found an error? Email hello@junie.app.