Does the Oregon Health Plan Cover Home Birth?2026 OHP Coverage, Prior Authorization, and How to Find an LDM or CNM

Yes. OHP covers planned community births for low-risk pregnancies attended by a Licensed Direct Entry Midwife, Certified Nurse-Midwife, or certified Naturopathic Physician. ^[1] Coverage applies to home births and freestanding birth center births alike, with the same prior authorization workflow.

OHP's policy is uniquely structured around evidence-based eligibility. The Oregon Health Evidence Review Commission sets criteria for what qualifies as a low-risk pregnancy, and OHA checks against those criteria during prior authorization. ^[1] The framework was strengthened after a 2010s policy review and gives Oregon's Medicaid home birth program one of the most rigorous risk-management structures in the country.

Oregon recognizes three credentials for Medicaid-billable home birth attendance.

Licensed Direct Entry Midwives (LDMs) are credentialed by the Oregon Board of Direct Entry Midwifery. The LDM credential is Oregon's pathway for non-nurse midwives. LDMs hold the NARM CPM credential plus Oregon-specific licensure. They specialize in out-of-hospital birth and are OHP-eligible providers when enrolled with OHA. ^[1]

Certified Nurse-Midwives (CNMs) are licensed by the Oregon State Board of Nursing. 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. ^[2]

Certified Naturopathic Physicians with specific natural childbirth certification are also OHP-eligible attendants for planned home birth. ^[1] This is unusual nationally; most states do not recognize NDs for home-birth Medicaid billing.

OHP requires prior authorization from OHA before billing for any planned community birth services. ^[1] The workflow is more involved than most states' but ensures clear coverage when approved.

The provider (LDM, CNM, or ND) submits the prior authorization request to OHA. OHA verifies that the pregnancy meets the Oregon Health Evidence Review Commission's low-risk criteria, then issues written confirmation of enrollment to the provider before any planned community birth services begin. The patient typically requests community birth from her primary obstetric provider no later than week 24 of pregnancy. ^[1]

Once OHA approves the prior authorization, OHP covers most costs of midwifery care, including prenatal visits, the birth itself, postpartum care, and newborn evaluation. Specific covered services and billing codes are detailed in the OHA Planned Community Birth Prior Authorization and Billing Guide. ^[1]

Oregon has a robust home birth midwifery community organized through the Oregon Midwifery Council and individual practices across the state. The fastest path is to start with the OHA enrollment list and then call practices directly.

If OHA's prior authorization review determines that your pregnancy doesn't meet the low-risk criteria set by the Oregon Health Evidence Review Commission, OHP won't authorize home birth. In this case, OHP fully covers hospital-based maternity care attended by a CNM or OB. Many CNMs in Oregon offer hospital and birth-center practice; coverage doesn't disappear, only the place of service changes.

The risk criteria are evidence-based and include factors like prior cesarean (some VBACs are eligible, some aren't), gestational diabetes status, hypertensive disorders, and gestational age. Discuss the criteria with your provider early so you understand which factors might change your eligibility before week 24.