Getting started with tricare
Congratulations! If you've decided to become a TRICARE-authorized doula provider, you're taking an exciting step toward serving military families.
Working with insurance can feel overwhelming at first. Since the Childbirth and Breastfeeding Support Demonstration (CBSD) launched in 2021, many doulas have learned the billing process through trial and error. The program has continued to evolve, and if you handle your own billing, you know there can be a steep learning curve.
This guide is designed to simplify the process, help you understand the requirements, and answer some of the most common questions new providers have.
Do You Qualify?
To become a TRICARE-authorized certified labor doula, you must:
Be at least 18 years old.
Be certified with one of the certifying bodies OR check if your state
Complete one or more breastfeeding education courses.
Complete one or more childbirth education courses.
Hold a state or local license if your jurisdiction requires one.
Maintain a current CPR certification.
Obtain a National Provider Identifier (NPI).
Step 1: Verify Your Certifying Organization
TRICARE currently recognizes certification from the following organizations:
CAPPA
DONA International
ICEA
ToLabor
BirthWorks International
National Black Doulas Association
Exception: If your state's Medicaid program recognizes doulas certified through another organization, TRICARE may also accept that certification. This exception is based on state policy, so be sure to verify whether your state qualifies before beginning the application process.
Step 2: Determine Your TRICARE Region
Your enrollment process depends on where you will be providing services. Once you've identified your region, begin the provider enrollment process through the appropriate regional contractor.
TRICARE West:TriWest Healthcare Alliance
TRICARE East:Humana Military
Overseas:International SOS
If you plan to work overseas, note that additional certifying organizations may be accepted depending on the host country's requirements and TRICARE policies.
Once you complete the process it may take a bit to get familiar with billing. I suggest familiarizing yourself with the Tricare Manual, also look to joining the CBSD FaceBook Page for Providers
Frequently Asked Questions
Are doula services covered if my client delivers at a Military Treatment Facility (MTF)?
No. Certified labor doula services provided to beneficiaries who give birth at a military hospital or clinic are currently excluded from the demonstration.
Are virtual doula visits covered?
No. Virtual doula sessions are not reimbursable under the demonstration.
Can I bill for group prenatal or educational sessions?
No. Group sessions facilitated by doulas are not covered services.
Can postpartum doulas enroll as TRICARE providers?
No. At this time, the demonstration only recognizes qualified certified labor doulas. Postpartum doula certification alone does not meet the provider qualifications.
A Final Note
TRICARE policies and procedures continue to evolve. While this guide is intended to help you navigate the enrollment process, it should not replace official guidance from TRICARE or its regional contractors. Always refer to the most current government resources and provider manuals for the latest requirements and policies.
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