Does South Dakota Medicaid Cover Home Birth? 2026 CNM Coverage and the South Dakota Board of CPMs
Yes for CNM services, with a caveat on the setting. South Dakota Medicaid covers Certified Nurse-Midwife services as a federal mandatory benefit, [1] and its obstetrical manual lists CNMs as billable practitioners. [4] The manual publishes no policy specific to planned home birth, so confirm setting billing with South Dakota Medicaid before you commit. CPMs have been licensed in South Dakota since 2017, [2] but the state is not among the roughly 18 states plus DC whose Medicaid programs pay midwives without a nursing degree. [5] Freestanding birth center services are covered under a dedicated manual. [3]
South Dakota has a small but distinctive midwifery framework. A state Board of Certified Professional Midwives has licensed CPMs since 2017 under SDCL chapter 36-9C. [2] Licensure did not bring Medicaid billing: South Dakota Medicaid's obstetrical manual does not list CPMs among billable practitioners, [4] and national trackers do not count South Dakota among states that pay non-nurse midwives. [5] CNM services are covered as a federal mandate, [1] and freestanding birth centers have their own billing manual. [3] Sioux Falls and Rapid City have the largest pools of practitioners. This guide explains the framework.
On this page
Sources cited (6)
- Social Security Act § 1905(a)(17)
- SD Board of CPMs
- SD Medicaid Freestanding Birth Center Manual
- SD Medicaid Obstetrical Services Manual
- NASHP State Tracker (updated 2026)
- KFF 2021 State Survey
Does South Dakota Medicaid cover home birth?
The honest answer is a qualified one. South Dakota Medicaid covers CNM services as a federal mandatory benefit, [1] and its obstetrical billing manual lists certified nurse midwives among the practitioners who can bill for maternity care. [4] The manual does not publish a policy for planned home birth as a setting. In KFF's 2021 survey, 25 of 42 responding state Medicaid programs said they covered home births, several with conditions attached. [6] Before you plan a Medicaid-funded home birth in South Dakota, ask SD Medicaid or your CNM's billing office to confirm how a home delivery would be paid.
For freestanding birth centers, South Dakota Medicaid has a specific billing manual. [3] A birth center is defined in state law as a facility, not a home. The facility receives an all-inclusive flat rate per delivery, and professional services by physicians, physician assistants, nurse practitioners, and nurse midwives are billed separately, limited to vaginal delivery codes. [3]
For CPMs, South Dakota created a licensure board in 2017. [2] Medicaid billing has not followed. CPMs are not listed in the state's obstetrical manual, [4] and South Dakota is not among the roughly 18 states plus DC that reimburse midwives without a nursing degree. [5] Plan on paying out of pocket for a CPM-attended home birth.
Which midwife credentials does South Dakota Medicaid cover?
South Dakota recognizes two midwifery credentials.
Certified Nurse-Midwives (CNMs) are licensed by the South Dakota Board of Nursing as Advanced Practice Registered Nurses under SDCL chapter 36-9A. CNM services are a federal Medicaid mandatory benefit, [1] and the state's obstetrical manual lists CNMs as billable practitioners. [4]
Certified Professional Midwives (CPMs) are licensed by the South Dakota Board of Certified Professional Midwives, a Department of Health board created in 2017 under SDCL chapter 36-9C. [2] The license authorizes out-of-hospital practice, but South Dakota Medicaid has not added CPMs as a billable provider type. [4,5]
| CREDENTIAL | SD MEDICAID COVERAGE | PRACTICE SETTING |
|---|---|---|
| Certified Nurse-Midwife (CNM) | Yes (federal mandate) [1] | Hospital, birth center; confirm home billing [4] |
| Certified Professional Midwife (CPM) | No Medicaid billing pathway [4,5] | Out-of-hospital; self-pay [2] |
| Freestanding birth center | Yes per SD Medicaid manual [3] | Birth center facility only [3] |
How do you find a South Dakota Medicaid-accepting midwife?
South Dakota's home birth midwifery community is small. Most CNMs and CPMs are concentrated in Sioux Falls and Rapid City, with very few outside those metros.
For a full guide to home birth midwives in South Dakota, including licensing, costs by region, and what to ask before hiring, see our South Dakota home birth midwife guide.
Identify how your South Dakota Medicaid works
South Dakota Medicaid runs on fee-for-service billing with care management programs such as BabyReady rather than commercial managed-care plans. [4] Your enrollment paperwork lists any program you are assigned to.
Search for CNMs offering planned home birth
Cross-reference the SD Medicaid provider directory with American College of Nurse-Midwives affiliate listings. Most SD CNMs work in hospitals; the home birth subset is small.
Confirm credential, Medicaid enrollment, and home billing by phone
Ask each practice whether it attends planned home births and how it has billed SD Medicaid for them in the past. Get the answer before signing a contract.
Plan for travel if rural
Outside Sioux Falls and Rapid City, very few midwives offer planned home birth. Some rural SD families travel to a metro for prenatal care and birth.
What if no SD Medicaid-accepting midwife is available?
South Dakota Medicaid covers Certified Nurse-Midwives. Sioux Falls has the most Medicaid-enrolled CNMs. Rapid City and the Black Hills have a smaller pool. Rural South Dakota and reservation areas may have no Medicaid-enrolled CNM within reasonable driving distance.
If your area has no Medicaid-accepting CNM offering home birth, consider:
Hospital birth with a CNM. South Dakota Medicaid reimburses CNM hospital births. Sanford, Avera, and Monument Health operate the state's major delivery units; ask each about CNM-attended birth options.
Self-pay with a licensed CPM. South Dakota licenses CPMs through the Board of Certified Professional Midwives under SDCL 36-9C, [2] but CPMs cannot bill Medicaid. Some SD CPMs offer sliding-scale fees for Medicaid-eligible families. Commonly quoted totals run $3,500 to $5,500.
Tribal health programs. Reservation residents may have access to Indian Health Service maternity care that operates outside the state Medicaid framework. IHS facilities provide hospital-based midwifery in some locations.
Doula support. South Dakota Medicaid covers doula services when referred by a physician, physician assistant, certified nurse practitioner, or certified nurse midwife. [4] A Medicaid-covered doula paired with hospital or birth center midwifery care keeps continuous labor support in place when home birth funding falls through.
For a complete guide to South Dakota home birth covering licensing, transfer hospitals, and what to ask, see our South Dakota home birth midwife guide.
Bottom line: South Dakota Medicaid covers CNM services as a federal mandatory benefit [1] and pays freestanding birth centers under a dedicated manual. [3] The state has licensed CPMs since 2017 through its Board of Certified Professional Midwives, [2] but no Medicaid billing pathway exists for them. [4,5] If you want a Medicaid-funded home birth in South Dakota, the realistic route is a CNM willing to attend, and you should confirm home-birth billing with SD Medicaid before committing. Most practitioners cluster in Sioux Falls and Rapid City.
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. View source
- South Dakota Department of Health. Board of Certified Professional Midwives. SDCL ch. 36-9C. View source
- South Dakota Medicaid. South Dakota Medicaid Billing and Policy Manual: Freestanding Birth Center. Updated December 2025. View source
- South Dakota Medicaid. South Dakota Medicaid Billing and Policy Manual: Obstetrical Services. Updated February 2026. View source
- National Academy for State Health Policy. Midwife Medicaid Reimbursement Policies by State. Updated April 2026. View source
- Kaiser Family Foundation. Medicaid Coverage of Pregnancy-Related Services: Findings from a 2021 State Survey. May 2022. 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.
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].