Does Pennsylvania Medicaid Cover Home Birth? 2026 HealthChoices Coverage, CNM Services, and How to Find a Medical Assistance Midwife
Yes, when a licensed nurse-midwife attends and your HealthChoices plan agrees to pay. Here's how to check, and what to do if no one near you takes Medical Assistance.
The short version
Pennsylvania Medical Assistance pays for care from licensed midwives, and its rules don't exclude births at home, so a certified nurse-midwife's (CNM's) home birth care can be covered.13 Whether your plan pays depends on whether the CNM is enrolled with your HealthChoices plan, so confirm it in writing before you sign a contract. Certified professional midwives (CPMs) have no Pennsylvania license and can't bill Medical Assistance, and the new certified midwife license is still being set up.24
Jump to what fits your situation
Which midwives Medical Assistance can pay
Pennsylvania Medical Assistance pays midwives who hold a Pennsylvania license.3 Today that means certified nurse-midwives, who are licensed by the State Board of Medicine. Nurse-midwife care is also one of the benefits every state Medicaid program must cover.1
| Credential | Medical Assistance? | Where she attends births |
|---|---|---|
| Certified nurse-midwife (CNM) | Yes13 | Hospital, birth center or home (confirm with your plan) |
| Certified midwife (CM) | License created in 2026; enrollment not set out yet4 | Rules still being written |
| Certified professional midwife (CPM) | No, not licensed in Pennsylvania2 | Home; families pay her directly |
CPMs hold a national credential from the North American Registry of Midwives, and many Pennsylvania families choose them. If you're on Medical Assistance and want a CPM, you'd pay her yourself, or you can look for a CNM who attends home births. Both paths are below.
What Medical Assistance pays for
Pennsylvania pays midwives from a state fee schedule, and HealthChoices plans set their own rates with the midwives in their networks. The payment for the birth includes at least one postpartum visit. On top of that, Medical Assistance pays for up to 12 midwife visits per person in a 365-day period.3
We couldn't find a current published comparison of what Pennsylvania pays CNMs versus physicians. If payment levels matter to you or your midwife, ask your plan or the practice directly. In practice, the bigger limit is who can bill: only licensed midwives, and only some Pennsylvania CNMs attend births at home.
How to find a CNM who takes your plan
HealthChoices plans include UPMC for You, AmeriHealth Caritas, Geisinger Health Plan, Highmark Wholecare and Keystone First, and each has its own network. CNMs who attend home births are most often found around Philadelphia, Pittsburgh and Lancaster.
- Step 1Find your plan's name on your enrollment letter or member card, and call member services.
- Step 2Search the Department of Human Services provider directory on PA.gov for "certified nurse-midwife" in your county.
- Step 3Compare with the list of practicing CNMs kept by the Pennsylvania affiliate of the American College of Nurse-Midwives.
- Step 4Call the practices. Most Pennsylvania CNMs work in hospitals, so ask whether they attend planned home births and whether they take your plan.
I'm a member and I'm pregnant. Which in-network certified nurse-midwives attend planned home births in my county? Will my plan pay for a planned home birth with one of them? Can I have a reference number for this call?
Write down the date, the name of the person you spoke to and the reference number. If the answer is yes, ask for it in writing.
Lancaster County and the surrounding Plain communities have long-established home birth midwives, but some are CPMs or traditional midwives who can't bill Medical Assistance. CNM home birth is easier to find around Philadelphia and Pittsburgh. In central and rural Pennsylvania, expect fewer options and start calling early.
Want help with the search?
Tell us your due date, ZIP code and plan. We'll introduce you by email to midwives who may have space. It's free for families.
If no CNM near you attends home births
For licensing, costs, questions to ask and how the months unfold, see our Pennsylvania home birth guide. Our national Medicaid guide compares how other states handle it.
Not sure which path fits?
We'll introduce you to Pennsylvania midwives who may have space near your due date. Free for families, and you choose who to contact.
How we made this page
Written by the Home Birth Partners editorial team. We used AI tools to help research and draft this page, and a person on our team edited it and checked each rule against the federal statute, the Pennsylvania Code and the state legislature's own pages.- Laws checked: Pennsylvania Medical Assistance midwife rules (55 Pa. Code ch. 1142) and Act 14 of 2026, Oct 26, 2026.
- Midwife review: not yet reviewed by a midwife. We'd welcome review from Pennsylvania midwives and will name reviewers here once they have.
- Spot something wrong? Send us a correction. Midwives can also claim their listing for free.
Sources
- 1Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services.Supports: nurse-midwife services are a required benefit in every state Medicaid program.
- 2National Association of Certified Professional Midwives. Medicaid Reimbursement Rates by State. 2025.Supports: Pennsylvania Medicaid doesn't cover CPMs, who aren't licensed in the state.
- 3Pennsylvania Department of Human Services. 55 Pa. Code Chapter 1142: Midwives' Services (§§ 1142.2, 1142.52, 1142.54, 1142.55).Supports: Medical Assistance pays Pennsylvania-licensed midwives, doesn't exclude home births, includes a postpartum visit with the birth and pays up to 12 midwife visits a year.
- 4Pennsylvania General Assembly. Act 14 of 2026 (SB 507), Certified Midwife licensure.Supports: Act 14 of 2026 created the Certified Midwife license, with rules due within two years.
- 5Anderson, D. A., & Gilkison, G. M. (2021). The cost of home birth in the United States. International Journal of Environmental Research and Public Health, 18(19), 10361.Supports: the $4,650 average home birth midwife fee (survey of 129 practices, fees collected in 2021).