How to enroll as a Medicaid doula in South Dakota
South Dakota Medicaid (DSS) · coverage since January 1, 2025 · last checked July 25, 2026
South Dakota Medicaid has covered doula services since January 1, 2025. Prenatal, postpartum, care-coordination, and birth-attendance payments share a $1,800 limit per pregnancy unless the state approves more. South Dakota has no Medicaid managed care, so doulas enroll once and bill the state. Certification must come from one of the eight organizations in the current billing manual, and each client needs a qualifying practitioner referral.
What Medicaid pays
$1,800 per-pregnancy limit, with additional services available by prior authorization
- T1032 covers eligible prenatal, postpartum, and care-coordination time in 15-minute units. T1033 is the flat birth-attendance payment, which was $600 at launch. Both count toward the $1,800 per-pregnancy limit
- South Dakota applied a 1.4% provider rate increase on July 1, 2026. Use the interactive DSS fee schedule for the current T1032 and T1033 amounts rather than relying on an older saved rate
- Services above the $1,800 per-pregnancy limit require prior authorization
No fixed visit count. The $1,800 per-pregnancy limit governs unless DSS authorizes more. Prenatal, care-coordination, and postpartum services through 365 days after pregnancy ends may be in person or by telemedicine; labor and delivery requires physical presence. Home-birth support is covered only when the pregnancy is low risk and the attending provider meets the manual's conditions.
Who can apply
- Current certification from one of eight listed programs: Birthing Advocacy Doula Training–Full Spectrum, BirthWorks, CAPPA, Childbirth Professionals International, DONA International, Doula Trainings International, ICEA's dual birth-and-postpartum certification, or MaternityWise's labor or full-spectrum certification. ToLabor is not on the current list
- Standard Medicaid provider screening and enrollment; no experience-only qualification pathway
- Client-side: a referral from a physician, PA, CNP, or CNM seen within the last 90 days (retroactive up to 60 days)
How to enroll
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Step 1
Check your certification against the current list
South Dakota's billing manual names eight accepted programs and specific credentials for ICEA and MaternityWise. Verify the exact credential before applying.
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Step 2
Get your free Type 1 NPI
NPPES, taxonomy 374J00000X. If you're incorporated, you'll also affiliate a Type 2 entity NPI; tribal and IHS facilities can enroll doulas as a group.
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Step 3
Enroll in the SD Medicaid Online Provider Enrollment Portal
Upload your certificate, disclosure form, and provider agreement. Make sure the addresses on your W-9 and NPPES record match the enrollment application.
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Step 4
Bill the state directly
No managed care in South Dakota Medicaid. Fee-for-service claims to DSS, with telemedicine allowed for everything except the birth itself.
How you get paid
South Dakota Medicaid has no managed care plans. After state enrollment, doulas submit fee-for-service claims directly to DSS. No additional plan contracts are required.
What to plan for
The $1,800 limit includes all covered services for the pregnancy. Check the exact certification credential, obtain the practitioner referral tied to a visit within the prior 90 days, and request prior authorization before exceeding the limit.
Where to get help
- SD DSS doula billing manual & fee schedules (the authoritative billing and rate reference)
- South Dakota Doulas (the advocacy organization behind the benefit; enrollment and reimbursement walkthroughs)
- South Dakota Birth Matters (birth-worker directory by region, including tribal communities)
Sources and last checked
We checked these details on July 25, 2026.
- SD Medicaid Doula Services billing manual
- South Dakota Medicaid fee schedules
- South Dakota Medicaid SFY27 rate increase notice
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.