How to enroll as a Medicaid doula in Virginia
Virginia Medicaid (DMAS Community Doula Program) · coverage since 2022 (full implementation July 1, 2022) · last checked July 25, 2026
Virginia's Community Doula Program has covered doulas since 2022. The current maximum is $1,078.92: $978.92 for the covered service set and two possible $50 incentives. The benefit includes 4 prenatal visits, birth attendance, and 6 postpartum visits through 12 months. A licensed practitioner must recommend care before services begin. Enrollment requires 60 hours of approved training, a Virginia Certification Board credential, liability insurance, fingerprinting, PRSS enrollment, and separate plan contracts.
What Medicaid pays
Up to $1,078.92 per episode, including two possible $50 incentives
- $978.92 for the base service set: 4 prenatal visits, labor and delivery attendance, and 6 postpartum visits through 12 months
- Two $50 value-based incentives: client attends the postpartum OB visit; newborn attends the pediatric visit
- Virginia uses CPT codes with the HD modifier: 99600 for the initial visit, 59425 for prenatal visits, 59409 for vaginal delivery, 59514 for cesarean delivery, 59430 for postpartum visits, and 99199 for an incentive. Do not use T1032 for this benefit
4 prenatal visits (60 minutes; initial up to 90) + labor & delivery attendance + 6 postpartum visits through 12 months (since July 2025), plus the two incentive payments.
Who can apply
- 60 hours of VDH-approved training from a Virginia Certification Board-accredited entity, then the VCB State-Certified Doula credential ($100 initial / $75 recert every 2 years with 15 CE hours)
- Medical liability insurance at $1M per claim / $3M per year
- Fingerprinting and background check at DMAS enrollment
- A licensed practitioner recommendation completed before doula services begin
How to enroll
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Step 1
Complete the 60-hour training and get VCB-certified
All 60 hours must be VCB-accredited. Urban Baby Beginnings runs a VDH-approved community doula training if you're looking for one.
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Step 2
Get your free Type 1 NPI
NPPES, taxonomy 374J00000X.
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Step 3
Enroll via the PRSS Provider Enrollment Wizard
Virginia's MES portal. Upload the VCB certificate and insurance proof, complete fingerprinting. No published processing timeline.
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Step 4
Sign a provider agreement with each Cardinal Care MCO
Five plans since July 2025: Aetna Better Health, Anthem HealthKeepers Plus, Humana Healthy Horizons, Sentara Health Plans, UnitedHealthcare Community Plan. DMAS enrollment must come first; each plan contracts separately.
How you get paid
After state enrollment, apply separately to each of the five Cardinal Care plans you intend to bill. Virginia does not offer centralized plan credentialing. Confirm the member's plan and your network status before care begins.
What to plan for
The practitioner recommendation, state enrollment, and five possible plan contracts are separate steps. Virginia also uses CPT codes with an HD modifier rather than the T1032 and T1033 codes used by many other states, so follow the current DMAS billing guide.
Where to get help
- DMAS Community Doula Program (program page, enrollment tips & FAQs)
- Virginia Certification Board, State-Certified Doula (the required credential)
- Urban Baby Beginnings (statewide perinatal hubs and VDH-approved community doula training)
Sources and last checked
We checked these details on July 25, 2026.
- DMAS Community Doula Program
- DMAS bulletin: maternal health changes effective July 1, 2025
- DMAS State Plan Amendment 26-006
- DMAS Cardinal Care plans
- KFF Virginia maternal and infant health profile
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.