Does South Carolina Medicaid Cover Home Birth? 2026 Healthy Connections Coverage and the Licensed Midwife Pathway
Yes for CNMs. South Carolina Medicaid (Healthy Connections) covers Certified Nurse-Midwife services in any setting, including home birth, as a federal mandatory benefit. [1] Approximately 60 percent of births in South Carolina are paid by Healthy Connections. [2] Licensed Midwife Medicaid coverage in South Carolina is included in NACPM's 14-state list, [3] but primary-source SC Department of Health and Human Services materials don't make LM Medicaid billing as clear as the policy summaries suggest. Confirm with SCDHHS before committing.
South Carolina has a long tradition of community midwifery, particularly in the Lowcountry around Charleston, Beaufort, and the Sea Islands. The state's Medicaid program (Healthy Connections) pays for about 60 percent of all births in South Carolina, [2] which makes Medicaid coverage of home birth a high-stakes question for many South Carolina families. CNM coverage is fully reliable; Licensed Midwife coverage is reported by national tracking but harder to confirm at the state primary-source level. This guide walks through both.
On this page
Sources cited (4)
- Social Security Act § 1905(a)(17)
- SCDHHS Maternal Health Care Grant
- NACPM Medicaid Reimbursement Rates (2025)
- NASHP, Medicaid Financing of Midwifery Services (2023)
Does South Carolina Medicaid cover home birth?
Yes when attended by a CNM. Healthy Connections (the South Carolina Medicaid program) 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 Licensed Midwife coverage, the answer is harder to pin down from primary sources. South Carolina is included in NACPM's list of 14 states whose Medicaid programs cover non-nurse midwives. [3] South Carolina does license Licensed Midwives through the Department of Health. However, the SC Department of Health and Human Services materials don't explicitly document LM Medicaid billing workflow with the same clarity as for CNMs.
For families on Healthy Connections considering an LM-attended home birth, the safest approach is to confirm directly with SCDHHS Member Services and your specific Managed Care Organization (Healthy Blue, Molina, Select Health, First Choice, Humana Healthy Horizons).
Which midwife credentials does South Carolina Medicaid cover?
South Carolina recognizes two midwifery credentials.
Certified Nurse-Midwives (CNMs) are licensed by the South Carolina Board of Nursing as advanced practice registered nurses. CNM services are a federal Medicaid mandatory benefit and are reimbursable in any setting where the CNM is licensed to practice. [1]
Licensed Midwives (LMs) are credentialed by the South Carolina Department of Health, Maternal and Child Health Division. SC LMs typically hold the NARM Certified Professional Midwife credential plus state-specific licensure. The state's national listing among 14 CPM-Medicaid states [3] suggests Healthy Connections has authorized LM billing, but the operational workflow is less well-documented in primary SCDHHS materials than the CNM workflow. Practices vary in their experience with successfully billing Healthy Connections for LM-attended home birth.
| CREDENTIAL | SC MEDICAID COVERAGE | PRACTICE SETTING |
|---|---|---|
| Certified Nurse-Midwife (CNM) | Yes (federal mandate) [1] | Hospital, birth center, home |
| Licensed Midwife (LM) | Reported nationally; less clear at SCDHHS [3] | Birth center or home |
| NARM CPM credential | Required for most LMs | Bundled with state license |
How does South Carolina Medicaid reimburse home birth midwives?
Healthy Connections is delivered through fee-for-service Medicaid and through Healthy Connections Choices Managed Care plans (Healthy Blue, First Choice, Molina, Select Health, Humana Healthy Horizons). Each MCO administers Medicaid for its members within SCDHHS guidelines.
For CNM services (CPT 59400 global maternity care), Healthy Connections reimburses at the SCDHHS fee schedule. Per NASHP analysis, South Carolina is among the states reimbursing CNMs at standard physician parity ranges. [4]
For LMs, the reimbursement question is harder to answer from primary sources. Practices with experience billing Healthy Connections for home birth are the best information source about which specific services are reliably reimbursed and which require negotiation.
How do you find a Medicaid-accepting midwife in South Carolina?
South Carolina's home birth midwifery community is concentrated in Charleston, the Lowcountry, Columbia, and Greenville. Charleston has the deepest pool of Licensed Midwives.
Identify your Healthy Connections plan
Your enrollment confirmation lists your MCO. Plans differ in their midwife network coverage.
Search for licensed midwives by region
Home Birth Partners and the South Carolina Midwifery Association both maintain provider directories. Most LMs serve the Charleston metro and the Lowcountry.
Ask about Healthy Connections billing experience
Because LM Medicaid billing in South Carolina is less standardized than CNM billing, ask each midwife: "Have you successfully billed [my Healthy Connections plan] for home birth services in 2025 or 2026?"
Confirm current policy with SCDHHS
Call SCDHHS Member Services at (888) 549-0820 and ask: "Does Healthy Connections currently reimburse Licensed Midwives for planned home birth in South Carolina?" Document the answer.
What if your Healthy Connections plan doesn't cover LM home birth?
If you confirm with SCDHHS or your MCO that Licensed Midwife home birth isn't reliably reimbursed under your specific Healthy Connections plan, three options exist:
Find a CNM offering planned home birth. South Carolina CNMs who attend home births are fewer than LMs but exist, especially in Charleston. CNM home birth is fully covered by Healthy Connections.
Use a freestanding birth center. Charleston has several birth centers that staff CNMs and accept Healthy Connections. Birth-center delivery is fully covered with the same Medicaid eligibility as hospital delivery.
Switch MCOs. SCDHHS allows Healthy Connections members to switch MCOs during open enrollment or after a qualifying life event. If a different MCO has better LM coverage, switching is a legitimate path.
Pay out of pocket plus Medicaid for hospital backup. Some SC families pay private-pay for an LM's home birth attendance while keeping Medicaid for prenatal labs, ultrasounds, and any hospital transfer.
For a full guide to home birth midwives in South Carolina, including licensing, costs by region, and what to ask before hiring, see our South Carolina home birth midwife guide.
Bottom line: South Carolina Healthy Connections reliably covers CNM-attended home birth as a federal mandatory benefit. [1] Licensed Midwife coverage is included in national tracking but less clearly documented in primary SCDHHS materials. [3] Charleston and the Lowcountry have the deepest LM community and most active home birth practices. Confirm with SCDHHS in writing whether LM Medicaid billing is reliable under your specific plan, and consider CNM-staffed birth centers as a fallback if LM Medicaid coverage doesn't work in your area.
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. View source
- South Carolina Department of Health and Human Services. SCDHHS Receives Grant to Invest in Maternal Health Care. View source
- National Association of Certified Professional Midwives. Medicaid Reimbursement Rates by State. 2025. View source
- National Academy for State Health Policy. Medicaid Financing of Midwifery Services: A 50-State Analysis. May 2023, updated April 2026. 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.
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