Tricare CBSD Resource Guide for providers
The TRICARE Childbirth and Breastfeeding Demonstration is an initiative aimed at enhancing maternal and infant health among military families by providing comprehensive support during and after childbirth. This demonstration focuses on improving access to prenatal, delivery, and postnatal care while emphasizing the importance of breastfeeding. It offers expanded benefits such as personalized lactation consultations and educational resources to support new mothers. By integrating these services, the demonstration seeks to address the unique challenges faced by military families, promote healthier outcomes for mothers/birth parent and babies, and foster a supportive environment for lactation support. By integrating these services, support from doulas and lactation professionals enhance the overall birthing experience but also fosters a more informed and empowered approach to infant feeding, which is crucial for both maternal and infant health.
More recently with healthcare plans covering doula support, doulas have faced significant challenges along the way. For example, lack of formal understanding of the billing processes required doulas to navigate complex and often unfamiliar systems to secure compensation. The initial learning curve involved understanding how to work within existing insurance frameworks, creating detailed service documentation, and advocating for the value of their support within the broader healthcare system. As awareness and recognition of the benefits of doula care have grown, some progress has been made toward reimbursement and integration into healthcare plans, but many doulas still encounter obstacles related to learning the ins and outs of setting up as a provider and learning how to bill. Despite these challenges, providers are navigating the nuances and jumping to the call of supporting our community.
Below is your guide to finding the most recent background and publications regarding the CBSD.
The Tricare Childbirth and Breastfeeding Support Demonstration
In 2021 The Assistant Secretary of Defense for Health Affairs (ASD(HA)) announced the Childbirth and Breastfeeding Support Demonstration (CBSD) in a Federal Register (FR) notice published on October 29, 2021 (86 FR 60006). The CBSD establishes coverage of the services of three new classes of extra-medical TRICARE-authorized providers: certified labor doulas (CLDs), certified lactation consultants, and certified lactation counselors. (The National Defense Authorization Act is any of a series of United States federal laws specifying the annual budget and expenditures of the U.S. Department of Defense.) This is what guides DHA to implement the CBSD Program. The links referencing the Federal Register through reimbursement rates, encompass everyone and can be used as a guide to for questions. Information for doulas and lactation professionals can be found under the designated region. If you are unsure who covers what, learn more here.
· Federal Register Establishing the Tricare CBSD – published by the Department of Defense Office of the Secretary in October 2021
· Federal Register instructing Defense Health Agency to establish the Childbirth and Breastfeeding Demonstration. April 2024 most recent updated version
· Federal Register Modifications for the Overseas Implementation of the CBSD – Updated August 2023
Tricare Manual – Most recent publication with 2024 updates
Doula rates by locality - new rates under Phase 2
Who are the Contractors?
Tricare West (HealthNet Federal Services), Tricare East (Humana Military), and Tricare Overseas (SOS) are the healthcare contractors for the Military. Each contractor was given the information to develop their version under the parameters set forth by the aforementioned. Below are the most current and up-to-date links to each region for convenience.
Tricare West Contractor (Currently HealthNet Federal Services)
· HealthNet CBSD Website – Program questions can be located here to include participation guidelines and enrollment.
· Register for a webinar about the CBSD – West Only
· Directory for In and Out of Network Doulas & Lactation
· Provider News with CBSD Updates
· Point of Contact:
By email: ChildbirthSupport_Providers@hnfs.com
Customer service: 1-844-866-WEST (9378), Monday through Friday, 5 a.m.–9 p.m. PT, excluding holidays. Visit our Customer Service page for additional details.
Website support: 1-800-440-3114, Monday through Friday, 6:30 a.m.–6 p.m. PT
What you need to know:
HNFS CBSD is still open for IN NET contract requests through Oct 1, 2024. This does NOT affect Non-network requests.
Starting January 1, 2025, TriWest will be the new contractor for the West Region
Tricare East Contractor (Humana Military)
· Humana Military CBSD Website
· Directories
Out of Network: Instructions- Search Under Medical Specialist to find the dropdown for DOULA.
· Provider News with CBSD Updates
· Point of Contact:
Customer service representatives are available to assist you Monday - Friday, 8 AM - 6 PM (ET and CT) at (800) 444-5445
Humana Military utilizes local liaisons as points of contact. Location your liaison should be under the User Access List in your portal.
TOP Tricare Overseas (SOS)
· TOP Website - TRICARE Overseas Program (TOP) and is set to operate from January 1, 2025, through December 31, 2026.
Information for the Overseas Program is forthcoming and will be updated accordingly.
Common Topics
Certified labor doula services for beneficiaries who give birth at a military hospital or clinic are excluded from the demonstration.
Virtual doula sessions are not covered.
Doulas facilitating group sessions is not a covered services under the demonstration.