Washington State is leading the way in supporting community-based birth workers. As of January 1, 2025, Apple Health (Washington State Medicaid) now fully covers birth doula services for eligible individuals, making doula care more accessible while compensating doulas at some of the highest rates in the nation—up to $3,500 per birth.
Whether you're a practicing doula or looking to become one, this guide explains how to enroll as a provider, what services are covered, and how to get paid for your work through Medicaid.
What Does Apple Health Cover for Doulas?
Apple Health recognizes birth doulas as key members of the maternity care team. As of 2025, the following services are reimbursable:
- One prenatal intake visit
- Continuous in-person labor and birth support
- Up to 20 hours of additional prenatal and postpartum visits, including one comprehensive postpartum visit
These services are outlined in Washington State’s official billing guide.
Step-by-Step: How to Become a Medicaid-Enrolled Doula in Washington
To get paid through Apple Health, doulas must be certified, obtain an NPI number, and register in Washington’s ProviderOne system. Here's how:
1. Apply for Voluntary Birth Doula Certification
All Medicaid-billing doulas must hold a voluntary certification issued by the Washington State Department of Health.
Washington-based doulas can apply through the DOH.
Out-of-state doulas, such as those certified in Oregon, may be eligible to apply for an out-of-state endorsement.
2. Obtain Your NPI Number
A National Provider Identifier (NPI) is required to bill Medicaid. You can apply online through the National Plan and Provider Enumeration System.
3. Enroll in the ProviderOne System
ProviderOne is the billing and payment platform used by Washington Medicaid. Doulas must create a provider account, link their NPI, and follow the state’s instructions to complete the application process.
Once enrolled, you can submit claims for covered doula services and receive direct payment from the state.
Medicaid Reimbursement Rates for Doulas
Washington State now offers the highest Medicaid reimbursement in the nation for birth doula services. The current rate as of 2025 is:
💵 Up to $3,500 per client, which includes:
- Labor support
- Prenatal visits
- Postpartum visits
This investment not only values the role of doulas but also addresses maternal health equity and outcomes across the state.
2025 Updates to Billing Policies
Washington’s Health Care Authority released new billing guidelines in early 2025, including:
- Telehealth support (including audio-only) is now eligible for reimbursement
- Clarification on how to bill when clients have other health insurance coverage
Doulas should review the updated billing guide to ensure compliance with current policy.
Helpful Resources and Ongoing Updates
To stay informed, doulas are encouraged to:
- Join the official HCA mailing list
- Regularly visit the Doula Services page from Washington State’s Health Care Authority
- Review official updates to the Birth Doula Billing Guide as they’re released
Final Thoughts
With streamlined certification, clear billing guidelines, and industry-leading Medicaid reimbursement rates, Washington is setting a new standard for doula care in the U.S. If you’re a doula, now is the time to get certified, enroll in ProviderOne, and begin offering services to Medicaid families through Apple Health.
