Current through Register 1538, January 3, 2025
Section 463.407 - Covered Services(A) The MassHealth agency pays for medically necessary doula services including perinatal visits and labor and delivery support provided in-person or via telehealth.(B) Doula services must be recommended by a physician or other licensed practitioner of the healing arts acting within the scope of their practice under state law. Such licensed practitioners include the following:(1) certified nurse practitioners, certified nurse midwives, certified registered nurse anesthetists, clinical nurse specialists, psychiatric clinical nurse specialists, physician assistants, clinical social workers, psychologists; and(2) other licensed practitioners as indicated in written guidance from the MassHealth agency.(C)Doula Claims Submissions. Providers eligible to render doula services in accordance with 130 CMR 463.404 may submit claims for doula services when they provide those services directly to MassHealth members. See Subchapter 6 of the Doula Manual for service code descriptions and billing requirements.Adopted by Mass Register Issue 1510, eff. 12/8/2023.Amended by Mass Register Issue 1535, eff. 11/8/2024 (EMERGENCY).Amended by Mass Register Issue 1538, eff. 11/8/2024 (COMPLIANCE).