Modifications to the Reimbursement of Childbirth Support Services Under the TRICARE Childbirth and Breastfeeding Support Demonstration
Published Date: 1/29/2026
Notice
Summary
Starting March 1, 2026, TRICARE is changing how it pays certified labor doulas who help with childbirth. These updates aim to make payments steadier and fairer for military families using these support services. If you’re a military member or family using doula care, expect smoother reimbursement with these new rules.
Analyzed Economic Effects
3 provisions identified: 2 benefits, 1 costs, 0 mixed.
Stable doula pay: baseline + MEI index
If you are a military member or family using certified labor doula (CLD) services, TRICARE will treat the rate approved for March 1, 2025 as a baseline and increase it each year by the Medicare Economic Index (MEI), with local adjustments using the Medicare Geographic Adjustment Factor (GAF). This change takes effect for rates beginning March 1, 2026 and is intended to prevent year-to-year decreases in CLD reimbursement.
Method change: won't cut below Medicaid
TRICARE changed the calculation steps so the Medicaid-to-Medicare Fee Index is capped at one (so a state's Medicare-like rate will not be lower than that state's Medicaid rate) and added a step to remove significant outliers when establishing a national baseline. DHA will only establish a new baseline if it produces a rate higher than the previous year's rate multiplied by the MEI.
Annual cost to TRICARE budget
The modification to the reimbursement methodology for childbirth support services will result in annual incremental costs of about $280,000.00 to the Defense Health Agency.
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