Does New York Medicaid Cover Home Birth?2026 Coverage, Licensed Midwives, and the New Perinatal Care Standards
Yes. New York Medicaid covers home birth attended by Licensed Midwives. [1] As of February 1, 2026, updated Medicaid Perinatal Care Standards apply to both Medicaid fee-for-service (FFS) and Medicaid Managed Care (MMC) plans. [1] New York Licensed Midwives can be reimbursed directly without a written practice agreement with a physician. [2]
New York's midwifery licensure framework is among the most progressive in the country. The state issues a single Licensed Midwife credential that covers both nurse-midwives and direct-entry pathways, and Licensed Midwives can practice and bill Medicaid independently. [2] In February 2026, New York rolled out updated Medicaid Perinatal Care Standards that further clarified home birth and out-of-hospital coverage. [1] If you're on New York Medicaid, the legal coverage is strong; the work is finding an enrolled provider.
On this page
Sources cited (4)
- NY DOH Medicaid Perinatal Care Standards (2026)
- NYSED Midwifery Q&A
- Social Security Act § 1905(a)(17)
- NASHP, Medicaid Financing of Midwifery Services (2023)
Does New York Medicaid cover home birth?
Yes. The New York State Department of Health Medicaid Perinatal Care Standards, effective February 1, 2026, govern coverage of midwifery services across both Medicaid fee-for-service and Medicaid Managed Care plans. [1] Licensed Midwives are included as eligible providers, and home birth is a covered place of service for low-medical-risk pregnancies.
Unique to New York: Licensed Midwives do not require a written practice agreement with a physician for licensure or for Medicaid reimbursement. [2] Midwives practice independently within their licensed scope, which simplifies the credentialing path compared to states that require collaborative agreements.
Which midwife credentials does New York Medicaid cover?
New York uses a unified Licensed Midwife credential rather than maintaining separate CNM, CPM, and LM credentials.
New York Licensed Midwives are credentialed by the New York State Education Department under Title 8, Article 140 of the New York Education Law. The licensure path requires a master's degree in midwifery and a national certifying exam (typically the AMCB CNM exam, though direct-entry pathways exist). New York Licensed Midwives practice independently and bill Medicaid directly. [2]
All New York Licensed Midwives are Medicaid-eligible providers; the federal § 1905(a)(17) mandate covering nurse-midwifery services applies to those who hold the AMCB credential, and state-specific provisions cover the broader LM category. [3]
New York doesn't separately license CPMs as such , anyone practicing midwifery in New York must hold the New York Licensed Midwife credential.
| CREDENTIAL | NY MEDICAID COVERAGE | WHERE THEY PRACTICE |
|---|---|---|
| NY Licensed Midwife (LM) | Yes (state and federal mandate) [1,3] | Hospital, birth center, home |
| Practice agreement | Not required for LMs [2] | Independent practice |
| CPM (national credential alone) | Not licensed to practice in NY | Must hold NY LM credential |
How does New York Medicaid reimburse home birth midwives?
New York Medicaid reimbursement for midwifery services is administered through both fee-for-service and managed care plans. The 2026 Perinatal Care Standards specify covered services, billing codes, and rate floors. [1]
For global maternity care (CPT 59400), New York Medicaid reimburses CNMs at a state-set fee schedule. According to NASHP's 50-state analysis, New York is among the states that reimburse CNMs at 75 to 98 percent of physician rates rather than full parity. [4]
Newborn care in the immediate postpartum period is included for the first 28 days, and Medicaid covers the routine pediatric exam and any required emergency transfer care.
How do you find a Medicaid-accepting midwife in New York?
New York's Medicaid Managed Care system spans plans like Healthfirst, Fidelis Care, Empire BlueCross BlueShield HealthPlus, and others. Each maintains a provider network. The faster path is to combine plan directories with state midwife associations.
Confirm your plan type
Are you on Medicaid fee-for-service or a Medicaid Managed Care plan? FFS lets you use any Medicaid-enrolled provider. MMC requires in-network.
Pull the plan's midwife provider directory
Search your MMC plan's provider directory online for "midwife." Empire BlueCross BlueShield HealthPlus, for example, publishes a separate Home Birth by CNM coverage policy.
Cross-reference with state midwife directories
The American College of Nurse-Midwives New York Affiliate and the New York Home Birth and Midwifery Association maintain provider directories. Home Birth Partners also lists New York midwives by city.
Verify Medicaid panel status by phone
Call practices directly. New York is large enough that a midwife listed in a directory may have closed her Medicaid panel for your due date. The five-minute phone call saves you weeks of waiting on a referral that won't materialize.
What if your New York Managed Care plan denies a home birth claim?
If a plan denies a Medicaid claim for home birth services, New York provides multiple recourse channels.
Internal plan appeal. File a written appeal with your MMC plan within 60 days. The plan must respond within 30 days for non-urgent appeals.
External appeal through the NYS Department of Financial Services. If the plan's internal appeal is denied, file an external appeal. NY DFS oversees both private and managed Medicaid plans for adverse benefit determinations.
Medicaid Fair Hearing. Medicaid recipients have a separate right to request a Fair Hearing through the New York State Office of Temporary and Disability Assistance. This is the strongest formal recourse. Hearings are scheduled within 30 days and decisions typically come within 90 days.
The 2026 Perinatal Care Standards strengthened beneficiary protections; cite them by name when filing an appeal.
Bottom line: New York Medicaid covers home birth attended by Licensed Midwives across both fee-for-service and Managed Care plans, with updated Perinatal Care Standards taking effect February 2026. [1] LMs practice independently without physician practice agreements, [2] and reimbursement falls in the 75 to 98 percent range of physician rates. [4] The work is finding a Licensed Midwife in your specific Managed Care plan with capacity; access varies sharply between NYC metro and upstate regions.
- New York State Department of Health. Medicaid Perinatal Care Standards. Effective February 1, 2026. View source
- New York State Education Department, Office of the Professions. Midwifery: Questions and Answers. View source
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. View source
- National Academy for State Health Policy. Medicaid Financing of Midwifery Services: A 50-State Analysis. May 2023, updated April 2026. 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].