HIPAA compliant fax for doulas: when HIPAA applies, and a BAA from $4.99

A doula working alone pays $4.99 a month for HIPAA fax with a signed BAA at 200 pages on Fax Pigeon Basic, billed annually, against $10.70 at SRFax, $24.99 at iFax and $33.33 at eFax. HIPAA reaches a doula only when she transmits health information electronically in a covered transaction, such as a Medicaid claim.

Do doulas need HIPAA compliant fax?

HIPAA applies to a doula as a covered entity only when she transmits health information electronically in connection with a covered transaction, such as a health care claim submitted to a health plan (45 CFR 160.103). A doula who bills Medicaid electronically meets that test, and a cash-pay doula may not. The obstetric clinicians and pelvic-floor physical therapists a doula refers clients to usually are covered entities. What is a covered entity under HIPAA? sets out the test.

HHS says a covered entity may disclose PHI to another provider for that provider's treatment, whether orally, on paper, by fax or electronically, without patient consent or authorization (45 CFR 164.506(c)(2), in HHS's treatment fact sheet). A doula who wants a BAA signed with her fax service gets one at sign-up on every Fax Pigeon plan, and the agreement is readable at faxpigeon.com/baa before paying.

What does a doula fax, and to whom?

A doula faxes referrals to clinicians and social services, receives a licensed practitioner's recommendation, and exchanges Medicaid enrollment and managed care paperwork with the state and its plans. Virginia requires a doula to keep that recommendation on file for each Medicaid member.

The table pairs each document with the party on the other end.

Two of those clinicians have pages of their own: HIPAA compliant fax for physical therapy clinics and HIPAA fax for pediatric practices.

How does Medicaid pay for doula care?

Medicaid pays for doula care state by state: the federal rule behind the benefit is 42 CFR 440.130(c), which defines preventive services as services recommended by a physician or other licensed practitioner of the healing arts, and CMS approves each state plan amendment that adds the benefit.

Virginia's amendment, SPA 21-0013, was approved on October 28, 2021, effective January 1, 2022. It ties doula services to 42 CFR 440.130(c) and covers up to 8 prenatal and postpartum visits plus support during labor and delivery. A value-based incentive payment applies when the doula performs at least one postpartum visit and the client is seen by an obstetric clinician for a postpartum visit after a labor and delivery claim.

Virginia's community doula program requires a doula to obtain an NPI, enroll with DMAS as a Medicaid provider, sign a provider agreement with each managed care plan she serves and retain a licensed practitioner's recommendation for each member. Virginia says a recommendation for doula care is not the same as a prior authorization. CMS describes the NPI as a unique identification number for covered health care providers.

New Mexico's Supplement 25-01 treats doula services as preventive services that a physician or other licensed practitioner must recommend. New Mexico enrolls doulas under provider type 406, specialty code 206 and taxonomy 374J00000X, has doula services billed as professional services in the CMS 1500/837P claim format and requires no prior authorization.

The Illinois doula fee schedule, effective February 1, 2024 and updated September 22, 2025, names the same taxonomy code, 374J00000X. Illinois pays when the doula attends the postpartum visit with a practitioner and the visit falls within 26 days of delivery or between days 27 and 89. MACPAC lists Florida, Minnesota, New Jersey, Oregon and Rhode Island as states that have implemented the benefit.

What does HIPAA fax cost a doula?

Among the providers in the tables, a doula pays least for HIPAA fax with a BAA on Fax Pigeon: $4.99 a month billed annually for 200 pages on Basic and $9.99 for 500 pages on Standard, for one doula or for three.

The table shows the cheapest plan with a BAA for one person, as a price a month, at 200 and 500 pages sent and received.

Each price is for the cheapest plan that carries a BAA. SRFax provides one on request under its Healthcare plans, eFax prints it on the Business plan card, iFax offers it free to Plus and Pro subscribers, WestFax includes it on every plan, Sfax prints "BAA Available" on its Plus card and Fax.Plus includes it on Enterprise only. Fax Pigeon signs it at sign-up on every plan.

The table shows the cheapest plan with a BAA for 3 people, as a price a month, at 200 and 500 pages sent and received.

At 3 people, WestFax moves from Solo, which is capped at one user, to Team at $39.95 month to month. iFax moves to Pro with 2 team licenses, because choosing two or more team licenses takes Plus off its selector. SRFax, Sfax and Fax.Plus Enterprise include multiple or unlimited users and eFax Business includes 5 users, so their prices stay put. Pages are sent plus received, and an extra Fax Pigeon page costs 10¢ on Basic and 5¢ on Standard.

Can a doula collective share one fax number?

A doula collective shares one fax number on Fax Pigeon because everyone in the practice shares one number, one inbox and one page allowance, and adding people costs nothing. Every plan includes unlimited people and a shared inbox with roles and assignment, so each incoming fax can be assigned to a member of the collective.

Paid plans send and receive from the practice's own number. Transferring an existing number is free on every paid plan: most transfers finish in 5 to 15 business days, and the number keeps working with the current provider until then.

Which doulas should switch, and to what?

Doulas and doula collectives who pay more than $4.99 a month billed annually for a fax plan that carries a BAA should switch to Fax Pigeon Basic, which signs the BAA at sign-up, gives the practice its own number and includes unlimited people. A doula whose provider holds the BAA back for a higher tier should switch too.

Billed annually at 200 pages, a year of Basic is $59.88, against $128.40 at SRFax, $299.88 at iFax and $399.96 at eFax. The lowest-priced option in the tables is Fax Pigeon Basic at $4.99 a month billed annually for 200 pages.

* Prices last verified October 23, 2026, at each provider's own site, except Sfax, whose prices were last verified October 19, 2026. Fax Pigeon is not affiliated with SRFax, eFax, iFax, WestFax, Sfax or Fax.Plus.