Does TennCare Cover Home Birth in Tennessee? 2026 Coverage Reality and the CPM Medicaid Gap
Partially. TennCare (Tennessee Medicaid) covers Certified Nurse-Midwife services as a federal mandatory benefit. [1] Whether your Managed Care Organization pays for a planned home birth as the setting is a plan-level question, so confirm it with your MCO before hiring anyone. [5,6] Tennessee certifies CPMs through the Department of Health, [2] but CPMs are not among the provider types TennCare reimburses, [3,4] so CPM-attended home birth normally runs on out-of-pocket payment with TennCare still covering prenatal labs and any hospital care.
Tennessee occupies a middle ground in Medicaid home birth coverage. The state certifies both CNMs and CPMs, [2] but TennCare pays only the nurse-midwife pathway: Tennessee is not among the roughly 18 states plus DC whose Medicaid programs reimburse midwives without a nursing degree. [3,4] CNMs who attend home births can bill TennCare through its MCOs, though the subset of CNMs offering planned home birth in Tennessee is small. This guide explains the framework and the workarounds families actually use.
On this page
Sources cited (6)
- Social Security Act § 1905(a)(17)
- TN Council of Certified Professional Midwifery
- NASHP State Tracker (updated 2026)
- MACPAC Maternity Providers Brief (2023)
- TennCare MCO Directory
- KFF 2021 State Survey
Does TennCare cover home birth?
Sometimes, and only through the CNM pathway. TennCare covers Certified Nurse-Midwife services as a federal Medicaid mandatory benefit. [1] That mandate covers the provider, not the setting: in KFF's 2021 survey, 25 of 42 responding state Medicaid programs covered home births, several with conditions attached. [6] TennCare's published rules contain no home-birth-specific policy, so ask your MCO directly how it would handle a planned home delivery billed by a CNM. [5] The structural challenge is supply: most Tennessee CNMs practice in hospitals, and the home birth subset concentrates in Nashville, Knoxville, and a few smaller communities.
For Certified Professional Midwives, the answer is firmer. Tennessee certifies CPMs (the CPM-TN credential) through the Council of Certified Professional Midwifery, [2] but TennCare does not include CPMs among the midwife provider types it reimburses. [3,4] The result is that CPM-attended home birth in Tennessee is paid out of pocket.
Which midwife credentials does TennCare cover?
Tennessee Medicaid pays one midwifery credential and certifies a second that it does not pay.
Certified Nurse-Midwives (CNMs) are licensed by the Tennessee Board of Nursing as advanced practice registered nurses. Tennessee requires CNMs to maintain a collaborative practice arrangement with a physician for prescriptive practice, one of 20 states with that rule. [4] CNM services are a federal Medicaid mandatory benefit under Section 1905(a)(17), [1] and CNMs enroll and bill through TennCare's MCOs. [5]
Certified Professional Midwives (CPM-TN) hold the NARM CPM credential plus state certification from the Council of Certified Professional Midwifery, created by the legislature in 2000. [2] A certificate is required to practice midwifery for compensation in Tennessee. The credential makes CPMs legal home birth providers, but TennCare has no reimbursement pathway for them, [3,4] so most Tennessee CPM clients pay privately.
| CREDENTIAL | TENNCARE COVERAGE | PRACTICAL ACCESS |
|---|---|---|
| Certified Nurse-Midwife (CNM) | Yes (federal mandate) [1] | Bills TennCare through the MCOs [5] |
| Certified Professional Midwife (CPM-TN) | No TennCare billing pathway [3,4] | Home birth is normally self-pay |
| NARM CPM credential | Required for CPM-TN certification [2] | Plus TN Department of Health certificate |
How does TennCare reimburse home birth midwives?
TennCare is delivered through three statewide Managed Care Organizations: BlueCare, UnitedHealthcare Community Plan, and Wellpoint, renamed from Amerigroup in 2024. TennCare Select, administered alongside BlueCare, covers certain groups such as children in state custody. [5] Each MCO administers Medicaid for its members within TennCare guidelines, and midwife networks differ plan to plan.
For CNM services (CPT 59400 global maternity care), rates follow each MCO's fee schedule. Ask the CNM practice which MCOs it participates with and whether it has billed a planned home birth before.
For CPMs, the reimbursement question is settled: TennCare has no CPM billing pathway. [3,4] Tennessee families who hire a CPM usually pay the midwife's fee out of pocket while keeping TennCare active for prenatal labs, ultrasounds, and any hospital care, including a transfer during labor.
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, or Wellpoint). 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: "Is your fee private-pay, and how do you coordinate labs and hospital care with TennCare?"
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 at set times, including a window after first assignment and an annual choice period. If a different MCO has a stronger midwife network, switching is a legitimate path.
Use a freestanding birth center. Some Tennessee birth centers staff CNMs and participate with TennCare MCOs. Confirm the center's network status with your MCO before transferring care; an in-network birth center delivery uses the same Medicaid eligibility as a hospital delivery.
Pay out of pocket plus TennCare for prenatal and transfer. Some Tennessee families pay privately for CPM home birth attendance while keeping TennCare for prenatal labs, ultrasounds, and any hospital transfer. This is the standard workflow because CPMs cannot bill TennCare. [3,4]
Bottom line: TennCare covers CNM services as a federal mandatory benefit, [1] and a CNM home birth is the only version with a possible TennCare billing path; confirm the setting with your MCO before committing. [5,6] Tennessee certifies CPMs through its Council of Certified Professional Midwifery, [2] but TennCare has no CPM reimbursement pathway, [3,4] so most 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 midwives. Use your MCO directory plus the Tennessee Midwives Association, confirm panel status by phone, and consider CNM-staffed birth centers as a covered fallback where in network.
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. View source
- Tennessee Department of Health. Council of Certified Professional Midwifery. Tenn. Code Ann. § 63-29-101 et seq. View source
- National Academy for State Health Policy. Midwife Medicaid Reimbursement Policies by State. Updated April 2026. View source
- Medicaid and CHIP Payment and Access Commission. Access to Maternity Providers: Midwives and Birth Centers. May 2023. View source
- Division of TennCare. Managed Care Organizations. Tennessee State Government. 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.
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