Beginning April 1, 2025 (delayed from Oct. 1. 2024), EmblemHealth will cover doula services in hospital, clinic, and community settings for Medicaid, Health and Recovery Plan (HARP), and Essential Plan members who are pregnant, birthing, and postpartum (for up to 12 months after the delivery date).
In preparation for this new benefit, EmblemHealth is now inviting doulas to join our provider networks. If you are interested in partnering with EmblemHealth, please contact medicaidproduct@emblemhealth.com.
Members may be covered for a maximum of eight prenatal doula visits and/or postpartum doula visits and one labor and delivery support visit (vaginal, vaginal birth after cesarean, cesarean birth, and stillbirth). Doulas must be enrolled as New York State Medicaid fee-for-service providers to receive reimbursement according to the following rate structure:
| Service | Visit Allowance |
Per Visit Reimbursement | Percentage of Total Reimbursement | Amount of Total Reimbursement |
|---|---|---|---|---|
Perinatal Service: Prenatal or postpartum doula support |
Up to eight (8) visits | New York City: $93.75 Rest of state: $84.37 |
50% | New York City: Rest of state: |
Labor and Delivery: In-person doula support during labor and birth |
One (1) encounter | New York City: $750 Rest of state: $675 |
50% | New York City: $750 Rest of state: $675 |
For more information, see New York State doula services benefit.
JP 65350 7/2024