Does DC Medicaid Cover Home Birth? 2026 Guide: 100% CNM Parity Plus CPM and CM Coverage Under DC Law
Yes, more broadly than most states. DC law requires Medicaid to cover services from Certified Professional Midwives and Certified Midwives within their scope of practice regardless of the location where care is provided, which reaches planned home birth. [2] Certified Nurse-Midwives are a federal mandatory benefit, [5] paid at 100 percent of the physician rate with full independent practice authority. [1] The practical step is finding a midwife enrolled with DC Medicaid and your specific managed care plan, so confirm enrollment before you commit.
The District of Columbia runs one of the broadest Medicaid midwifery frameworks in the country. The Certified Professional Midwife Amendment Act of 2020 requires Medicaid coverage for CPM and CM services regardless of setting, [2] and NASHP's 50-state tracking lists DC Medicaid as reimbursing both credentials. [3] CNMs are paid at 100 percent of the physician rate and practice independently. [1] Roughly 18 states plus DC now pay midwives without nursing degrees through Medicaid, and DC is on that list. [3] Coverage on paper still depends on provider enrollment in practice, so this guide covers both.
On this page
Sources cited (6)
- NASHP, State CNM Medicaid Coverage
- D.C. Code § 3-1206.71 (Law 23-97)
- NASHP Midwife Medicaid Tracker (2023)
- ACNM CNM-CM-CPM Comparison (2024)
- Social Security Act § 1905(a)(17)
- KFF 2021 Survey; DHCF Doula SPA (2022)
Does DC Medicaid cover home birth?
Yes, across more midwife types than almost anywhere else. Start with Certified Nurse-Midwives: CNM services are a federal Medicaid mandatory benefit, [5] and DC reimburses CNMs at 100 percent of the physician rate for delivery. [1] DC CNMs also hold full independent practice authority, meaning no physician supervision or collaborative agreement requirements stand between a CNM and a planned home birth. [1]
The bigger story is the direct-entry side. D.C. Law 23-97, the Certified Professional Midwife Amendment Act of 2020, wrote a coverage mandate into the code: health coverage provided through Medicaid must cover services rendered by a certified professional midwife or a certified midwife within their scope, "regardless of the location where such services are provided," and with no higher cost sharing than comparable benefits. [2] DC licenses CPMs, and NASHP's 50-state analysis lists DC Medicaid as reimbursing both CPMs and CMs. [3]
One honest caveat: in a 2021 national survey, filed while CPM licensure was still rolling out, DC reported that it did not cover home births. [6] The statute on the books today points the other way, but it pays through enrolled providers. Before you commit to a midwife, ask her which DC Medicaid plans she bills and confirm with your plan that a planned home birth with that provider is payable.
Which midwife credentials does DC Medicaid cover?
The District of Columbia recognizes three midwifery credentials for Medicaid purposes, the widest slate in the region.
Certified Nurse-Midwives (CNMs) are licensed by the DC Board of Nursing as Advanced Practice Registered Nurses. CNM services are a federal Medicaid mandatory benefit. [5] DC reimburses CNMs at 100 percent of the physician rate, with full independent practice authority, and CNMs can serve as primary care providers in DC Medicaid. [1]
Certified Midwives (CMs) hold graduate-level midwifery training without a nursing degree, credentialed by the American Midwifery Certification Board. DC is one of the few jurisdictions that licenses CMs and covers them under Medicaid. [3, 4]
Certified Professional Midwives (CPMs) hold the NARM credential and are licensed by DC Health with oversight from an advisory committee on certified professional midwives. [3] Under D.C. Code § 3-1206.71, Medicaid coverage extends to CPM services in any setting, including home birth, with no extra cost sharing. [2]
| CREDENTIAL | DC MEDICAID COVERAGE | PRACTICE AUTHORITY |
|---|---|---|
| Certified Nurse-Midwife (CNM) | Yes (federal mandate + 100% parity) [1,5] | Full independent practice [1] |
| Certified Midwife (CM) | Yes [2,3] | Graduate-level non-nurse midwife (AMCB) |
| Certified Professional Midwife (CPM) | Yes: DC law requires coverage in any setting [2,3] | Licensed by DC Health; NARM credential |
How do you find a DC Medicaid-accepting midwife?
DC's home birth midwifery community is small but tight-knit, and several practices serve the District plus nearby Maryland and Virginia. The Department of Health Care Finance runs DC Medicaid through managed care contracts, so enrollment questions have two layers: DC Medicaid itself, and your specific plan.
Identify your DC Medicaid plan
DC Medicaid managed care is delivered through AmeriHealth Caritas DC, CareFirst Community Health Plan DC, and MedStar Family Choice DC. Wellpoint DC members are being moved to AmeriHealth Caritas DC during 2026. Your enrollment letter lists yours.
Search for CNMs, CMs, and CPMs offering planned home birth
Cross-reference your plan's provider directory with the ACNM DC affiliate and local midwifery listings. All three credentials are Medicaid-coverable in DC, so ask about credential and enrollment together.
Confirm credential and Medicaid panel by phone
Ask each practice: "Which credential do you hold, and which DC Medicaid plans do you currently bill for planned home birth?" Get the billing answer before you sign a care agreement.
Cross-reference with regional resources
Some DC-based midwives serve clients across the metro region in Maryland and Virginia. Local availability extends beyond the District line, but Medicaid billing follows your enrollment, not your address alone.
What if your DC Medicaid plan won't cover home birth?
DC law is on your side, but practical access still depends on which DC Medicaid managed care plan you are enrolled in and whether the specific midwife you want is contracted with that plan. If your plan or your chosen provider is not a fit, you have several real options.
First, ask the midwife directly whether she accepts the specific DC plan you carry. Midwives in DC contract with different plans, and being enrolled with DC Medicaid generally is not the same as being in your specific managed care arrangement.
Second, consider Maryland or Virginia midwives with an eye on the rules. DC's small footprint means families in NW or SE DC often live closer to suburban Maryland or Northern Virginia providers than to DC ones. But Medicaid is state-bound: Maryland HealthChoice and Virginia's Cardinal Care cover CNM services for their own enrollees, and DC residents generally cannot use another state's Medicaid. A cross-border midwife works best when she is enrolled with DC Medicaid as a provider, so ask that exact question.
Third, freestanding birth centers in the DC region, including some in Maryland and Virginia within a short drive, accept DC Medicaid in some circumstances. The midwife-led birth center model preserves much of what families want from home birth; confirm enrollment case by case.
Fourth, doula support paired with hospital midwifery is a covered path when home birth is not the right fit. DC Medicaid has covered doula services since October 2022, with up to 12 visits across pregnancy, birth, and postpartum. [6]
For a complete picture of home birth in DC, including hospitals like MedStar Washington Hospital Center and Sibley Memorial, transfer logistics, and what to ask, see our Washington DC home birth directory.
Bottom line: DC Medicaid covers more midwife types than almost any state program: CNMs at 100 percent of the physician rate with independent practice, [1] plus CPMs and CMs under a DC law that requires coverage in any setting, home birth included. [2] NASHP lists DC among the roughly 18 states plus DC whose Medicaid programs pay midwives without nursing degrees. [3] The work left for you is enrollment math: find a midwife who bills your specific DC Medicaid plan, and confirm the home birth arrangement with the plan before committing. Use your MCO directory plus the ACNM DC affiliate to build the shortlist.
- National Academy for State Health Policy. State Medicaid Coverage of Certified Nurse Midwives. View source
- D.C. Code § 3-1206.71. Reimbursement for certified professional midwives or certified midwives. Certified Professional Midwife Amendment Act of 2020, D.C. Law 23-97, effective June 17, 2020. View source
- National Academy for State Health Policy. Midwife Medicaid Reimbursement Policies by State. Updated 2023. View source
- American College of Nurse-Midwives. CNM-CM-CPM Comparison Chart. October 2024. View source
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. View source
- Kaiser Family Foundation. Medicaid Coverage of Pregnancy-Related Services: Findings from a 2021 State Survey. May 2022; DC Department of Health Care Finance. Doula Services Benefit. Effective October 1, 2022. View source
▶ How we research and review this content Editorial standards
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.
We update articles when source data changes, when state laws are revised, or at minimum every 12 months. The "Last reviewed" date in the byline reflects the most recent review.
If you spot an error or have a primary source we should add, email [email protected].