{"name":"DoulaPaid Midwifery Medicaid Billing Verified Source Dataset","version":"2026","billingStatus":"partially verified","license":"https://creativecommons.org/licenses/by/4.0/","requiredAttribution":"DoulaPaid, \"Midwifery Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-midwifery-medicaid-reimbursement-2026","canonicalReport":"https://doulapaid.com/state-of-midwifery-medicaid-reimbursement-2026","distributions":{"csv":"https://doulapaid.com/midwifery-medicaid-reimbursement-dataset.csv","json":"https://doulapaid.com/midwifery-medicaid-reimbursement-dataset.json"},"rows":[{"vertical":"midwifery","state_code":"WA","state_name":"Washington","billing_status":"verified","source_checked_at":"2026-06-30","coverage_summary":"Washington publishes a 2026 HCA billing guide and fee schedule for planned home births and births in birth centers. The listed global OB, prenatal, delivery, postpartum, transfer, facility, newborn, and home-supply billing details are verified.","billing_question":"Which Washington planned home birth or birth-center setting, credential track, global/unbundled code, transfer condition, and supply/facility rule applies before selecting the claim line?","credential_question":"Which Washington licensed midwife, nurse-midwife, HCA-approved planned home birth provider, birth-center provider, attestation, and low-risk documentation must be retained?","official_source_label":"Washington HCA Planned Home Births and Births in Birth Centers Billing Guide","official_source_url":"https://www.hca.wa.gov/assets/billers-and-providers/planned-home-births-bg-20260101.pdf","official_source_publisher":"Washington State Health Care Authority","canonical_page_url":"https://doulapaid.com/midwifery/washington","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Midwifery Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-midwifery-medicaid-reimbursement-2026"},{"vertical":"midwifery","state_code":"FL","state_name":"Florida","billing_status":"verified","source_checked_at":"2026-06-30","coverage_summary":"Florida publishes a 2026 licensed midwife fee schedule and AHCA coverage page for low-medical-risk birth center and midwife services. The listed delivery, home-delivery, transfer, prenatal, postpartum, newborn, risk-screening, and supply billing details are verified.","billing_question":"Which Florida licensed-midwife setting, TH modifier path, transfer context, prenatal or postpartum row, newborn row, and unpriced drug exclusion applies before selecting the claim line?","credential_question":"Which Florida licensed midwife or licensed birth center provider, low-medical-risk pregnancy documentation, and transfer support must be retained before billing?","official_source_label":"Florida AHCA Licensed Midwife Fee Schedule","official_source_url":"https://ahca.myflorida.com/content/download/28122/file/2026%20Licensed%20Midwife%20Fee%20Schedule.pdf","official_source_publisher":"Florida Agency for Health Care Administration","canonical_page_url":"https://doulapaid.com/midwifery/florida","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Midwifery Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-midwifery-medicaid-reimbursement-2026"},{"vertical":"midwifery","state_code":"MT","state_name":"Montana","billing_status":"verified","source_checked_at":"2026-06-30","coverage_summary":"Montana publishes a 2026 direct-entry midwife fee schedule with global, delivery, prenatal, postpartum, E/M, G2211, and J3430 services. The listed billing details are verified. Confirm current home-birth requirements with Montana DPHHS.","billing_question":"Which Montana direct-entry midwife service, office or facility rate, global or unbundled code, and home-birth requirement apply?","credential_question":"Which Montana licensed direct-entry midwife credential, Medicaid enrollment path, place of service, and pregnancy/delivery documentation must be retained before billing?","official_source_label":"Montana Healthcare Programs Direct Entry Midwife Services Fee Schedule","official_source_url":"https://medicaidprovider.mt.gov/docs/feeschedules/2026/January2026DirectEntryMidWifeServicesFeeSchedule.pdf","official_source_publisher":"Montana Healthcare Programs","canonical_page_url":"https://doulapaid.com/midwifery/montana","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Midwifery Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-midwifery-medicaid-reimbursement-2026"},{"vertical":"midwifery","state_code":"MN","state_name":"Minnesota","billing_status":"unverified","source_checked_at":"2026-06-30","coverage_summary":"Minnesota SPA 25-0025 and the MHCP manual document midwifery professional parity and home-birth or free-standing birth-center services. Rates and billing instructions are unavailable until exact codes, rates, and birth-setting rules are confirmed.","billing_question":"Which Minnesota CNM, certified midwife, traditional midwife, home-birth, birth-center facility, transfer, or supply lane applies before rate calculation?","credential_question":"Which Minnesota credential, low-risk birth criteria, enrollment, and facility or provider documents are required before billing?","official_source_label":"Minnesota Medicaid SPA 25-0025","official_source_url":"https://www.medicaid.gov/medicaid/spa/downloads/MN-25-0025.pdf","official_source_publisher":"Centers for Medicare & Medicaid Services / Minnesota Department of Human Services","canonical_page_url":"https://doulapaid.com/midwifery/minnesota","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Midwifery Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-midwifery-medicaid-reimbursement-2026"},{"vertical":"midwifery","state_code":"NM","state_name":"New Mexico","billing_status":"unverified","source_checked_at":"2026-06-30","coverage_summary":"New Mexico SPA 26-0001 pays licensed midwives at 100 percent of the physician fee schedule for global delivery codes. Exact fees and Birthing Options requirements are unavailable.","billing_question":"Which New Mexico global delivery code, managed-care or fee-for-service route, credential, and current physician fee apply?","credential_question":"Which New Mexico licensed midwife, lay midwife, CNM, or birth-center enrollment requirements must be captured before the state can be treated as billable?","official_source_label":"New Mexico Medicaid SPA 26-0001","official_source_url":"https://www.medicaid.gov/medicaid/spa/downloads/NM-26-0001.pdf","official_source_publisher":"Centers for Medicare & Medicaid Services / New Mexico Health Care Authority","canonical_page_url":"https://doulapaid.com/midwifery/new-mexico","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Midwifery Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-midwifery-medicaid-reimbursement-2026"},{"vertical":"midwifery","state_code":"TX","state_name":"Texas","billing_status":"unverified","source_checked_at":"2026-06-30","coverage_summary":"Texas publishes licensed-midwife guidance and fees for selected services. Billing instructions are unavailable because the manual requires U1, U2, or U3 delivery modifiers, while the fee table lists 59409 without modifier-specific rates.","billing_question":"Which Texas licensed-midwife birthing-center service, delivery modifier, 59410 exclusion, and modifier-specific fee apply?","credential_question":"Which Texas licensed midwife setting, birthing-center requirement, and home-delivery noncoverage rule must be captured before billing?","official_source_label":"Texas Medicaid Provider Procedures Manual: Gynecological, Obstetrics, and Family Planning","official_source_url":"https://www.tmhp.com/sites/default/files/file-library/resources/provider-manuals/tmppm/pdf-chapters/2026/2026-03-march/2_07_gyne_and_repro_health_srvs.pdf","official_source_publisher":"Texas Health and Human Services / TMHP","canonical_page_url":"https://doulapaid.com/midwifery/texas","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Midwifery Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-midwifery-medicaid-reimbursement-2026"},{"vertical":"midwifery","state_code":"ID","state_name":"Idaho","billing_status":"unverified","source_checked_at":"2026-06-30","coverage_summary":"Idaho publishes a midwife services provider handbook with global, unbundled, transfer, postpartum, birth-center, and informed-consent rules. Exact public fee-schedule rates are unverified. Do not use these details to bill Idaho midwifery services.","billing_question":"Which current Idaho fee-schedule row applies to global, antepartum, transfer, birth-center, postpartum, or newborn services?","credential_question":"Which Idaho licensed midwife enrollment, informed consent, place of service, and birth-center noncoverage rule must be retained before billing?","official_source_label":"Idaho Medicaid Midwife Services Provider Handbook","official_source_url":"https://www.idmedicaid.com/Provider%20Guidelines/Midwife%20Services.pdf","official_source_publisher":"Idaho Medicaid","canonical_page_url":"https://doulapaid.com/midwifery/idaho","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Midwifery Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-midwifery-medicaid-reimbursement-2026"},{"vertical":"midwifery","state_code":"NY","state_name":"New York","billing_status":"unverified","source_checked_at":"2026-06-30","coverage_summary":"New York publishes eMedNY midwife policy and fees for service dates on or after July 1, 2026. Those fees did not take effect before July 1, 2026.","billing_question":"Which New York effective date, global or unbundled service, facility or nonfacility rate, and MOMS requirement apply to the service date?","credential_question":"Which New York licensed midwife enrollment, written practice agreement, referral/consultation protocol, and six-year record retention requirement must be retained before billing?","official_source_label":"eMedNY Midwife Manual Policy Section","official_source_url":"https://www.emedny.org/ProviderManuals/Midwife/PDFS/Midwife_Manual_Policy_Section.pdf","official_source_publisher":"New York State Department of Health / eMedNY","canonical_page_url":"https://doulapaid.com/midwifery/new-york","dataset_license":"https://creativecommons.org/licenses/by/4.0/","required_attribution":"DoulaPaid, \"Midwifery Medicaid Billing Verified Source Dataset (2026),\" https://doulapaid.com/state-of-midwifery-medicaid-reimbursement-2026"}]}