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ENROLLMENT FORM

Category(s) of Service: 0464

If you are ALREADY ENROLLED and need to change your address, click here.

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Provider Index > DOULA (Pilot Program)

Provider Enrollment & Maintenance



Instructions for doulas enrolling as a provider in the New York State (NYS) Medicaid Doula Pilot Program:
  • The Department of Health announces the launch of a pilot expansion of the State's Medicaid program to cover doula services for Medicaid fee-for-service and Medicaid Managed Care enrollees. The Medicaid pilot program will be implemented through a phased-in approach in order to ensure access to this new benefit. Phase 1 of the pilot launches in Erie County on March 1, 2019. The Department continues to work with doulas in Kings County to enroll as Medicaid providers and Phase 2 of the pilot will launch in Kings County when provider capacity is reached. The doula pilot is a part of the State's multi-pronged initiative to target maternal mortality and reduce racial disparities in health outcomes. A doula is a non-medical birth coach who assists a woman during the prenatal period, labor, delivery, and post childbirth.
  • Only doulas serving NYS Medicaid eligible clients residing in Erie County and all zip codes in Kings County except 11207, 11212, 11233 will be able to apply for enrollment in the NYS Medicaid Doula Pilot Program.
  • Once enrolled as a NYS Medicaid provider, doulas will be able to bill NYS Medicaid for up to four prenatal visits, support during labor and delivery, and up to four postpartum visits provided to Medicaid eligible clients residing in the above-mentioned areas.
  • To become a doula provider for NYS Medicaid Managed Care clients, a doula must first enroll with the NYS Medicaid Program.
  • Once enrolled as a NYS Medicaid provider, a doula can then reach out to the Managed Care Organizations (MCO) that are participating in the Doula Pilot Program to apply to join the MCO's doula provider network.

For more information about the NYS Doula Pilot Program please visit: https://www.health.ny.gov/health_care/medicaid/redesign/doulapilot/

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Complete this Enrollment Form if you are:
  1. Applying for initial ENROLLMENT or ALREADY ENROLLED and enrolling another NPI, or
  2. Responding to a letter instructing you to REVALIDATE your enrollment, or
  3. Seeking REINSTATEMENT or REACTIVATION of your previous enrollment

PRACTITIONER Enrollment Form

Last Updated: 11/2018


Supplemental Information

If you have any questions or concerns, please contact the eMedNY Call Center at 1-800-343-9000 or click here to send us an email.