Does Arkansas Medicaid Cover Home Birth?2026 Coverage and the Arkansas Licensed Lay Midwife Credential
Yes for CNMs. Arkansas Medicaid covers Certified Nurse-Midwife services as a federal mandatory benefit, [1] including home birth where the CNM is licensed to practice. Arkansas has a unique state credential called Licensed Lay Midwife (LLM) regulated by the Arkansas Department of Health, [2] but LLMs are not Medicaid-eligible providers. CPMs are also not in the 14-state Medicaid CPM coverage list. [3] LLM-attended home birth is paid out of pocket only.
Arkansas has an unusual midwifery licensure structure. Alongside Certified Nurse-Midwives (regulated by the Board of Nursing), the state recognizes a Licensed Lay Midwife (LLM) credential through the Arkansas Department of Health. [2] LLMs must hold either a NARM CPM credential, an AMCB CNM/CM credential, or an equivalent. [2] But LLMs are not Medicaid-eligible providers in Arkansas, and CPMs are not in the 14-state Medicaid CPM coverage list. [3] CNM-attended home birth is the only Medicaid-covered home birth path in Arkansas.
On this page
Sources cited (5)
- Social Security Act § 1905(a)(17)
- Arkansas DOH Licensed Lay Midwifery
- NACPM Medicaid Reimbursement Rates (2025)
- Arkansas DHS CNM Provider Manual
- Arkansas LLM Listing (Apr 2025)
Does Arkansas Medicaid cover home birth?
Yes when attended by a CNM. Arkansas Medicaid covers Certified Nurse-Midwife services as a federal Medicaid mandatory benefit, [1] including home birth where the CNM is licensed to practice. The Arkansas Department of Human Services maintains a Certified Nurse-Midwife provider manual detailing the billing workflow. [4]
For home birth attended by other midwifery credentials, Arkansas Medicaid coverage does not exist. Arkansas has a unique Licensed Lay Midwife (LLM) credential regulated by the Arkansas Department of Health under the Rules Governing the Practice of Licensed Lay Midwifery in Arkansas. [2] LLMs must hold a NARM CPM credential, an AMCB CNM/CM credential, or an equivalent state-approved certification. [2] The state has not extended Medicaid billing privileges to LLMs.
Certified Professional Midwives are also not Medicaid-eligible in Arkansas. [3] As of 2025, Arkansas is not among the 14 states with Medicaid CPM coverage. The result: CPM-attended or LLM-attended home birth in Arkansas requires out-of-pocket payment, with Medicaid covering prenatal labs, ultrasounds, and any hospital transfer when ordered through Medicaid-enrolled providers.
Which midwife credentials does Arkansas Medicaid cover?
Arkansas recognizes three midwifery credential pathways, but only one is Medicaid-eligible.
Certified Nurse-Midwives (CNMs) are licensed by the Arkansas State Board of Nursing as Advanced Practice Registered Nurses. CNM services are a federal Medicaid mandatory benefit under § 1905(a)(17), [1] and Arkansas Medicaid reimburses CNMs through the Provider Type CNM billing structure detailed in the Arkansas DHS provider manual. [4]
Licensed Lay Midwives (LLMs) are credentialed by the Arkansas Department of Health under the state's lay midwifery rules. [2] LLMs must hold either a current NARM CPM, AMCB CNM/CM, or other equivalent state-approved certification. The state maintains a public listing of Licensed Lay Midwives. [5] LLMs are not Medicaid-eligible providers despite their state licensure.
Certified Professional Midwives (CPMs) holding the NARM credential alone are not licensed in Arkansas unless they also hold the LLM credential. CPMs cannot bill Arkansas Medicaid regardless. [3]
| CREDENTIAL | AR MEDICAID COVERAGE | PRACTICE SETTING |
|---|---|---|
| Certified Nurse-Midwife (CNM) | Yes (federal mandate) [1,4] | Hospital, birth center, home |
| Licensed Lay Midwife (LLM) | Not Medicaid-eligible [2] | Home or out-of-pocket only |
| NARM CPM credential alone | Not Medicaid-eligible [3] | Requires LLM licensure |
How does Arkansas Medicaid reimburse CNM home birth?
Arkansas Medicaid is administered by the Arkansas Department of Human Services through fee-for-service Medicaid and PASSE (Provider-led Arkansas Shared Savings Entity) plans for managed care. The Certified Nurse-Midwife provider manual details billing codes, prior authorization requirements, and reimbursement rates for CNM services. [4]
For CNM services (CPT 59400 global maternity care), Arkansas Medicaid reimburses at the standard fee schedule. The structural barrier in Arkansas is provider availability, not policy: most Arkansas CNMs practice in hospital settings, and the subset attending planned home birth is small. Little Rock and Northwest Arkansas have the largest CNM communities; rural Arkansas has very few practitioners.
"Arkansas's Licensed Lay Midwife credential is one of the most distinctive in the country, requiring CPM, CNM, or equivalent training. The state regulates the credential carefully but has not extended Medicaid billing to LLMs. The structural gap means most home births in Arkansas are private-pay regardless of family Medicaid status.
On the Arkansas LLM-Medicaid gap
How do you find an Arkansas Medicaid-accepting midwife?
Arkansas's home birth midwifery community is small, with most LLMs and CNMs concentrated in Little Rock, Fayetteville, and Bentonville. The Arkansas Department of Health publishes a regularly updated list of Licensed Lay Midwives. [5]
Identify your Arkansas Medicaid plan
Are you on fee-for-service Medicaid or one of the PASSE managed care plans? Your enrollment confirmation lists yours.
Search for CNMs offering planned home birth
Cross-reference your plan's provider directory with the American College of Nurse-Midwives Arkansas Affiliate. Most Arkansas CNMs practice in hospitals; finding one offering planned home birth requires direct outreach.
Use the Arkansas LLM listing for context
The Arkansas Department of Health maintains a public list of Licensed Lay Midwives by location. [5] LLMs are not Medicaid-billable but can be hired privately. The list helps you understand the home birth landscape in your region.
Plan for the credential split
If you're on Arkansas Medicaid and want home birth, the Medicaid path requires a CNM. If you prefer an LLM (which is more common for home birth in Arkansas), expect to pay out of pocket while keeping Medicaid for prenatal labs and any hospital transfer.
What if no Medicaid-accepting home birth CNM is available?
Three options exist:
Hospital-based CNM care. Arkansas Medicaid fully covers hospital-based CNM-attended birth. Several Little Rock and Northwest Arkansas hospitals have CNM-staffed maternity programs.
Pay out of pocket for an LLM. Arkansas LLMs are state-licensed but not Medicaid-billable. [2] Some Arkansas families pay private-pay for an LLM home birth attendance while keeping Arkansas Medicaid for prenatal labs, ultrasounds, and any hospital transfer (when ordered through Medicaid-enrolled providers).
Use a freestanding birth center. Some Arkansas birth centers staff CNMs and accept Arkansas Medicaid. Birth-center delivery is fully covered with the same Medicaid eligibility as hospital delivery.
Bottom line: Arkansas Medicaid covers CNM-attended home birth as a federal mandatory benefit. [1] Arkansas's unique Licensed Lay Midwife credential , which requires CPM, CNM, or equivalent training , is regulated by the state but not Medicaid-eligible. [2] CPMs alone are also not Medicaid-eligible. [3] The practical Medicaid path for home birth in Arkansas requires finding a CNM willing to attend out-of-hospital, and most CNMs practice in hospital settings. Use the LLM listing to understand the home birth landscape, cross-reference with the ACNM Arkansas Affiliate, and consider hospital-based CNM care or birth-center alternatives when needed.
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. View source
- Arkansas Department of Health. Licensed Lay Midwifery. View source
- National Association of Certified Professional Midwives. Medicaid Reimbursement Rates by State. 2025. View source
- Arkansas Department of Human Services. Certified Nurse-Midwife Provider Manual. View source
- Arkansas Department of Health. Arkansas Licensed Lay Midwives. Updated April 2025. View source
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Every guide on Home Birth Partners is researched against primary sources (federal regulations, peer-reviewed clinical literature, and state-level licensing boards) and reviewed by a credentialed midwife before publication.
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