Does New Hampshire Medicaid Cover Home Birth? 2026 Coverage for the NH Certified Midwife and CNM Credentials
Yes for both credential types, with homework. New Hampshire Medicaid covers Certified Nurse-Midwife services in any setting where a CNM is licensed to practice, including home birth, as a federal mandatory benefit. [1] It also has a dedicated Medicaid benefit for New Hampshire Certified Midwives (NHCMs), the state's non-nurse home birth credential: administrative rule He-W 538 sets out certified midwife services, and it requires the midwife to be an enrolled NH Title XIX provider certified under RSA 326-D. [3] Your job is confirming that the specific midwife you want is enrolled and taking Medicaid clients. Confirm with NH DHHS and your plan before committing.
New Hampshire is one of the states where Medicaid pays non-nurse midwives, and it has been set up that way in state rule, not just in national policy summaries. The state certifies its own credential, the New Hampshire Certified Midwife, through the Midwifery Council under RSA 326-D, [2] and NH Medicaid's certified midwife benefit lives in administrative rule He-W 538. [3] CNM coverage runs on the federal mandate. [1] The practical work is provider-level: not every certified midwife is enrolled with NH Medicaid or has room for Medicaid clients. This guide walks through both credentials and the confirmation calls worth making.
On this page
Sources cited (5)
- Social Security Act § 1905(a)(17)
- NH RSA 326-D (Midwifery)
- N.H. Admin. Code He-W 538 (Certified Midwife Services)
- NASHP, Medicaid Financing of Midwifery Services (2023)
- NH DHHS, Medicaid Care Management
Does New Hampshire Medicaid cover home birth?
Yes, for both midwife credentials the state recognizes. New Hampshire Medicaid covers Certified Nurse-Midwife services in any setting where a CNM is licensed to practice, including planned home birth, as a federal Medicaid mandatory benefit. [1]
For New Hampshire Certified Midwives, coverage is written into the state's own Medicaid rules. Administrative rule He-W 538, titled Certified Midwife Services, defines an NHCM as a person certified to practice midwifery under RSA 326-D:6 and requires participating providers to be enrolled New Hampshire Title XIX (Medicaid) providers. [3] The rule also lists what is not covered, such as operative obstetrics, cesarean sections, and anesthesia, which sit outside the midwifery scope anyway. NHCMs practice in homes and birth centers, the settings the credential was built for. [2]
Coverage on paper is not the same as an available midwife. Individual NHCMs choose whether to enroll with NH Medicaid and whether to keep taking Medicaid clients. For families on New Hampshire Medicaid considering an NHCM-attended home birth, confirm enrollment directly with NH DHHS Medicaid, your specific plan, and the midwife before committing.
Which midwife credentials does New Hampshire Medicaid cover?
New Hampshire recognizes two midwifery credentials.
Certified Nurse-Midwives (CNMs) are licensed by the New Hampshire Board of Nursing as advanced practice registered nurses. CNM services are a federal Medicaid mandatory benefit under § 1905(a)(17) and are reimbursable in any setting where the CNM is licensed to practice. [1]
New Hampshire Certified Midwives (NHCMs) are certified by the New Hampshire Midwifery Council, which sits under the Office of Professional Licensure and Certification. RSA 326-D protects the certified midwife title, sets certification requirements, and states the legislature's intent to preserve the right to deliver at home and remove obstacles to safe out-of-hospital birth. [2] NHCMs typically hold the NARM Certified Professional Midwife credential plus the NH certification. On the Medicaid side, He-W 538 makes NHCM services a defined benefit when the midwife is an enrolled Title XIX provider. [3]
If you want an NHCM-attended home birth on Medicaid, ask each midwife you call: "Are you currently enrolled with NH Medicaid as a billing provider, and have you billed Medicaid for home birth services in 2025 or 2026?"
| CREDENTIAL | NH MEDICAID COVERAGE | PRACTICE SETTING |
|---|---|---|
| Certified Nurse-Midwife (CNM) | Yes (federal mandate) [1] | Hospital, birth center, home |
| NH Certified Midwife (NHCM) | Yes, when enrolled as Title XIX provider [3] | Birth center or home |
| NARM CPM credential | Required for most NHCMs [2] | Bundled with state license |
How does New Hampshire Medicaid reimburse home birth midwives?
New Hampshire Medicaid is delivered through both fee-for-service Medicaid and Medicaid Care Management plans (NH Healthy Families, WellSense Health Plan, AmeriHealth Caritas New Hampshire). [5] Each plan administers Medicaid for its members within NH DHHS guidelines.
For CNM services (CPT 59400 global maternity care), reimbursement falls within the NH Medicaid fee schedule. Nationally, NASHP's 50-state analysis found roughly 18 states plus DC reimburse midwives who do not hold a nursing degree, and New Hampshire sits in that group. [4]
For NHCMs, He-W 538 defines the covered benefit at the state level, [3] but each managed care plan processes its own claims. Individual practices report varying experience with billing, so ask each midwife about her recent experience with your specific plan. Confirm before you sign a care agreement, not after.
How do you find a Medicaid-accepting midwife in New Hampshire?
New Hampshire's home birth midwifery community is concentrated in the southeast (Portsmouth, Manchester, Concord) and around the Lakes Region. The NH Midwives Association is a useful starting point.
Identify your Medicaid plan
Are you on NH Medicaid fee-for-service or one of the Medicaid Care Management plans? Your enrollment confirmation lists yours.
Search for licensed midwives by region
Home Birth Partners and the NH Midwives Association both maintain provider directories. Most NHCMs and home-birth-attending CNMs serve the southeastern New Hampshire corridor.
Ask specifically about Medicaid billing experience
Ask each midwife: "Are you an enrolled NH Medicaid provider, and have you billed [my Medicaid plan] for home birth services in 2025 or 2026? What was the outcome?" A midwife who bills your plan regularly saves you weeks of claims friction.
Confirm enrollment with NH DHHS or your plan
Call NH DHHS Medicaid Member Services or your plan and ask: "Is [midwife name] an enrolled provider, and is planned home birth with a New Hampshire Certified Midwife a covered service on my plan?" Document the answer with date and reference number.
What if no enrolled NHCM has room in your area?
If the NHCMs near you aren't enrolled with NH Medicaid or their panels are full, three options exist:
Find a CNM offering planned home birth. New Hampshire CNMs who attend home births exist but are fewer than NHCMs. Cross-reference the NH ACNM Affiliate with the NH Midwives Association to find them.
Use a freestanding birth center. Several New Hampshire and Massachusetts border-region birth centers staff CNMs and accept NH Medicaid. Confirm the specific center is in network with your plan; birth-center delivery carries the same Medicaid eligibility as hospital delivery.
Hire an NHCM out of pocket plus Medicaid for prenatal labs and hospital backup. Some NH families pay private-pay for the NHCM's home-birth attendance while keeping Medicaid for prenatal labs, ultrasounds, and any hospital transfer.
For a full guide to home birth midwives in New Hampshire, including licensing, costs by region, and what to ask before hiring, see our New Hampshire home birth midwife guide.
Bottom line: New Hampshire Medicaid covers CNM-attended home birth as a federal mandatory benefit, [1] and it defines a certified midwife benefit for NHCMs in administrative rule He-W 538 when the midwife is an enrolled Title XIX provider. [3] The state-level coverage question is settled; the provider-level questions are not automatic. If you're on NH Medicaid and want an NHCM-attended home birth, confirm enrollment and panel status in writing with NH DHHS, your plan, and each midwife you call. CNM-staffed hospital and birth-center care are covered fallbacks.
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. View source
- New Hampshire Revised Statutes Annotated. Chapter 326-D: Midwifery. View source
- New Hampshire Code of Administrative Rules. He-W 538: Certified Midwife Services. Chapter He-W 500, Medical Assistance. View source
- National Academy for State Health Policy. Medicaid Financing of Midwifery Services: A 50-State Analysis. May 2023, updated April 2026. View source
- New Hampshire Department of Health and Human Services. Medicaid Care Management. 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.
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.
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