Does TennCare Cover Home Birth in Tennessee?2026 Coverage Reality and the CPM Medicaid Restriction
Partially. TennCare (Tennessee Medicaid) covers Certified Nurse-Midwife services in any setting where licensed, including home birth, as a federal mandatory benefit. [1] Tennessee licenses CPMs through the Department of Health, but CPM Medicaid enrollment is restricted in practice. [2] CNM-attended home birth is reliably covered; CPM-attended home birth typically requires out-of-pocket payment with TennCare covering prenatal labs and any hospital transfer.
Tennessee occupies a middle ground in Medicaid home birth coverage. The state licenses both CNMs and CPMs, [2] but TennCare's practical Medicaid enrollment for CPMs is restricted enough that CPM-attended home birth coverage isn't reliable. CNMs who attend home births can bill TennCare, though the subset of CNMs offering planned home birth in Tennessee is small. This guide explains the framework and how to navigate it.
On this page
Sources cited (2)
- Social Security Act § 1905(a)(17)
- TN Midwifery Community Reports
Does TennCare cover home birth?
Yes when attended by a CNM. TennCare covers Certified Nurse-Midwife services in any setting where the CNM is licensed to practice, including home birth, as a federal Medicaid mandatory benefit. [1] The structural challenge in Tennessee is provider availability: most CNMs in Tennessee practice in hospital settings, and the subset attending planned home birth is concentrated in Nashville, Knoxville, and a few smaller communities.
For Certified Professional Midwives, the answer is more constrained. Tennessee licenses CPMs through the Department of Health, but TennCare Medicaid enrollment for CPMs is restricted. [2] Some Tennessee CPMs report being unable to enroll as TennCare billing providers regardless of their willingness to accept Medicaid clients. The result is that CPM-attended home birth in Tennessee typically requires out-of-pocket payment.
Which midwife credentials does TennCare cover?
Tennessee Medicaid recognizes one midwifery credential reliably and one with restrictions.
Certified Nurse-Midwives (CNMs) are licensed by the Tennessee Board of Nursing as advanced practice registered nurses with independent prescriptive authority. [2] CNM services are a federal Medicaid mandatory benefit under § 1905(a)(17), [1] and TennCare reimburses CNMs in any setting where they're licensed to practice.
Certified Professional Midwives (CPMs) are licensed by the Tennessee Department of Health under Health Licensure and Regulation. [2] The credential requires NARM certification plus Tennessee state licensure. While the state recognizes CPMs as legal home birth providers, TennCare Medicaid enrollment for CPMs is restricted in practice, which means most TN CPMs cannot bill TennCare for home birth services. [2]
| CREDENTIAL | TENNCARE COVERAGE | PRACTICAL ACCESS |
|---|---|---|
| Certified Nurse-Midwife (CNM) | Yes (federal mandate) [1] | Reliable; CNMs can bill TennCare |
| Certified Professional Midwife (CPM) | Restricted in practice [2] | Typically requires out-of-pocket |
| NARM CPM credential | Required for CPMs [2] | Plus TN Department of Health licensure |
How does TennCare reimburse home birth midwives?
TennCare is delivered through three Managed Care Organizations (BlueCare, UnitedHealthcare Community Plan, Amerigroup). Each MCO administers Medicaid for its members within TennCare guidelines.
For CNM services (CPT 59400 global maternity care), TennCare reimburses at the standard fee schedule. CNMs in Tennessee can bill TennCare for prenatal, labor and delivery, and postpartum services in any setting where they're licensed to practice, including home.
For CPMs, the practical TennCare reimbursement question is moot because most Tennessee CPMs cannot enroll as TennCare billing providers. [2] Some TN families arrange split coverage: CPM home birth attendance is paid out of pocket while TennCare covers prenatal labs, ultrasounds, and any hospital transfer.
How do you find a TennCare-accepting midwife in Tennessee?
Tennessee's home birth midwifery community is concentrated in Nashville and Knoxville. Memphis and Chattanooga have smaller pools of practitioners. The Tennessee Midwives Association is a useful starting point.
Identify your TennCare MCO
Your enrollment confirmation lists your MCO (BlueCare, UnitedHealthcare Community Plan, Amerigroup). Plans differ in midwife network coverage.
Pull your MCO's midwife provider directory
Search your plan's online directory for "midwife" or "certified nurse-midwife." Note that most listings will be CNMs in hospital settings; out-of-hospital practitioners are rarer.
Cross-reference with state midwife associations
The Tennessee Midwives Association maintains a directory of practicing midwives by region. Cross-reference with your TennCare MCO.
Confirm out-of-hospital scope and TennCare panel by phone
Ask each practice: "Are you a TennCare-billing CNM, and do you attend planned home births?" If you're considering a CPM, ask: "Can you bill TennCare for home birth, or is it private-pay only?"
What if your TennCare plan doesn't have a home-birth CNM in-network?
Three options exist if no in-network home-birth-attending CNM is available:
Switch TennCare MCOs. TennCare allows members to change MCOs during open enrollment. If a different MCO has a more robust midwife network, switching is a legitimate path.
Use a freestanding birth center. Several Tennessee birth centers in Nashville and Knoxville staff CNMs and accept TennCare. Birth-center delivery is fully covered with the same Medicaid eligibility as hospital delivery.
Pay out of pocket plus TennCare for prenatal and transfer. Some Tennessee families pay private-pay for a CPM home birth attendance while keeping TennCare for prenatal labs, ultrasounds, and any hospital transfer. This is the standard workflow when CPM Medicaid billing isn't available.
Bottom line: TennCare covers CNM-attended home birth as a federal mandatory benefit. [1] Tennessee licenses CPMs but TennCare Medicaid enrollment for CPMs is restricted in practice, [2] which means most TN families wanting a CPM-attended home birth pay out of pocket while using TennCare for prenatal labs and any hospital transfer. Nashville and Knoxville have the deepest pools of home-birth-attending CNMs. Use your TennCare MCO directory plus the Tennessee Midwives Association, confirm panel status by phone, and consider CNM-staffed birth centers as a fully-covered fallback.
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. View source
- Tennessee Midwives Association; Clarksville Midwifery; Home Birth Partners directory data. 2025-2026. 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].