Does the Oregon Health Plan Cover Home Birth? 2026 OHP Coverage, Prior Authorization, and How to Find an LDM or CNM
Yes. The Oregon Health Plan (OHP) covers planned community birth, including home birth, for low-risk pregnancies attended by a Licensed Direct Entry Midwife (LDM), Certified Nurse-Midwife (CNM), or certified Naturopathic Physician. [1] Prior authorization from the Oregon Health Authority (OHA) is required before billing, and the pregnancy must meet criteria set by the Oregon Health Evidence Review Commission. [1]
Oregon was one of the first states to integrate Licensed Direct Entry Midwives into its Medicaid program, and the Oregon Health Plan continues to cover planned home birth as a recognized place of service for qualifying low-risk pregnancies. [1] The trade-off is a more rigorous prior authorization workflow than most other states require. This guide explains how OHP covers home birth, who's eligible, and the steps to set up coverage with an LDM or CNM.
On this page
Sources cited (2)
- OHA, Planned Community Birth Guide
- Social Security Act § 1905(a)(17)
Does the Oregon Health Plan cover home birth?
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.
Which midwife credentials does Oregon Medicaid cover?
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.
| CREDENTIAL | OHP COVERAGE | PRACTICE SETTING |
|---|---|---|
| Certified Nurse-Midwife (CNM) | Yes (federal mandate) [2] | Hospital, birth center, home |
| Licensed Direct Entry Midwife (LDM) | Yes if OHA-enrolled [1] | Birth center or home |
| Naturopathic Physician (certified) | Yes if OHA-enrolled [1] | Home or birth center |
How does Oregon's prior authorization process work?
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]
How do you find a Medicaid-accepting midwife in Oregon?
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.
Verify your OHP coverage type
Are you on OHP fee-for-service or a Coordinated Care Organization (CCO)? CCOs (e.g., CareOregon, PacificSource) administer OHP for most members. Your enrollment lists your CCO.
Check the OHA-enrolled midwife list
OHA maintains a list of LDMs and CNMs approved to bill OHP for community birth services. Ask your CCO for the in-network list, or contact OHA directly if you're on fee-for-service.
Cross-reference with the Oregon Midwifery Council
The Oregon Midwifery Council and Home Birth Partners both maintain directories of practicing LDMs and CNMs. Check both for midwives in your county.
Request community birth by week 24
OHP works best when the request comes early. Talk to your primary obstetric provider before week 24 to initiate the prior authorization workflow.
What if your pregnancy doesn't meet the low-risk criteria?
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.
For a full guide to home birth midwives in Oregon, including licensing, costs by region, and what to ask before hiring, see our Oregon home birth midwife guide.
Bottom line: Oregon's OHP provides genuine coverage for planned home birth attended by LDMs, CNMs, and certified Naturopathic Physicians, [1] with a more rigorous prior authorization process than most states. Request community birth by week 24 of pregnancy, work with an OHA-enrolled provider, and confirm your low-risk eligibility with the Oregon Health Evidence Review Commission criteria. The Oregon Midwifery Council and individual practices like Artemis and Willamette Birth are useful resources for navigating the system.
- Oregon Health Authority, Health Systems Division. Community Birth Prior Authorization and Billing Guide. View source
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. 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].