Does Vermont Medicaid Cover Home Birth? 2026 Coverage for Licensed Midwives and Certified Nurse-Midwives
Yes. Vermont Medicaid enrolls both Licensed Midwives (LMs) and Certified Nurse-Midwives, and its provider manual covers midwife billing in detail, including what happens when a planned home birth transfers to the hospital. [1] Vermont insurance law separately requires plans with maternity benefits to cover licensed midwife and CNM services at home. [2] Vermont is one of at least 18 states plus DC whose Medicaid programs pay midwives without a nursing degree. [3] Confirm current enrollment and billing codes with your midwife and Green Mountain Care.
Vermont has been an early adopter of broad midwifery Medicaid coverage. The state licenses midwives through the Office of Professional Regulation, [4] Vermont Medicaid reimburses them directly, [1] and an insurance statute on the books since 2011 requires maternity plans to cover midwife care at home. [2] In 2025, Act 19 added licensure for freestanding birth centers, a setting Vermont previously did not license. [2] If you're on Vermont Medicaid and planning a home birth, the legal groundwork is in place; your work is finding a midwife with room on the calendar.
On this page
Sources cited (5)
- VT Medicaid Provider Manual
- 8 V.S.A. § 4099d
- NASHP State Tracker (updated 2026)
- Vermont Statutes Ch. 85
- Social Security Act § 1905(a)(17)
Does Vermont Medicaid cover home birth?
Yes. Vermont Medicaid recognizes and reimburses two midwife types: Certified Nurse Midwives and Licensed (Professional) Midwives, laypersons certified by the North American Registry of Midwives. [1] The provider manual includes practical home birth billing rules, down to how a midwife bills when a planned home delivery turns into a hospital admission. [1]
Vermont insurance law backs this up. 8 V.S.A. § 4099d requires health insurance plans that provide maternity benefits to cover services by a licensed midwife or CNM within their scope of practice, delivered in a hospital, another health care facility, or at home. [2] Act 19 of 2025 added licensed birth centers to that statute and directed the state to seek federal approval for Medicaid birth center payment; Vermont had no licensed birth centers when the law passed. [2]
Vermont Medicaid is administered by the Department of Vermont Health Access as Green Mountain Care. The state's small population makes Vermont's midwifery community tight-knit, with most LMs and CNMs concentrated in the Burlington-Montpelier corridor and the larger towns.
Which midwife credentials does Vermont Medicaid cover?
Vermont recognizes two midwifery credentials.
Licensed Midwives (LMs) are credentialed by the Vermont Office of Professional Regulation under Title 26, Chapter 85 of the Vermont Statutes. [4] Vermont LMs hold the NARM Certified Professional Midwife credential plus Vermont-specific licensure. They specialize in out-of-hospital birth and enroll directly as Vermont Medicaid providers. [1,3]
Certified Nurse-Midwives (CNMs) are licensed by the Vermont Board of Nursing as advanced practice registered nurses. CNM services are a federal Medicaid mandatory benefit under § 1905(a)(17), [5] and Vermont's midwifery coverage statute reaches CNM care in home settings as well. [2]
Unlicensed midwives cannot bill Vermont Medicaid. The LM credential is the path for direct-entry practice, and the NARM CPM credential is required for licensure. [4]
| CREDENTIAL | VT MEDICAID COVERAGE | PRACTICE SETTING |
|---|---|---|
| Certified Nurse-Midwife (CNM) | Yes (federal mandate + VT statute) [2,5] | Hospital, home; birth centers once licensed |
| Licensed Midwife (LM) | Yes; enrolls as VT Medicaid provider [1,3] | Home birth practice |
| NARM CPM credential | Required for LM licensure [4] | Bundled with state license |
How does Vermont Medicaid reimburse home birth midwives?
Vermont Medicaid reimburses LMs and CNMs through the Department of Vermont Health Access. Vermont runs its Medicaid program directly rather than through commercial managed-care plans, so billing goes to Green Mountain Care rather than an MCO network.
The provider manual sets licensed midwife reimbursement at 90 percent of the Vermont Medicaid rate paid to a physician for the same service, limited to specific procedure codes; CNMs are paid at 100 percent of the Medicaid rate on file. [1] Delivery codes are valid for pregnancies of 30 or more weeks gestation. If a planned home birth transfers to hospital care during labor, the manual lays out how the home midwife and the delivering provider each bill. [1]
For global maternity care (CPT 59400), Vermont's reimbursement falls within standard fee schedule ranges. Vermont's small midwifery community means practices often accept Medicaid as part of their patient mix. Ask each midwife which services they bill to Green Mountain Care and which, if any, fall to you.
How do you find a Medicaid-accepting midwife in Vermont?
Vermont's home birth midwifery community is small and concentrated in Burlington, Middlebury, Montpelier, and the Mad River Valley. The Vermont Midwives Association (vermontmidwivesassociation.org) and VT Midwives (vtmidwives.org) are useful starting points.
Confirm your Vermont Medicaid status
Vermont Medicaid covers pregnancy services for eligible Vermonters. Your enrollment confirmation lists your status.
Search for licensed midwives by region
Home Birth Partners and the Vermont Midwives Association both maintain provider directories. Most LMs and CNMs offering planned home birth serve the Champlain Valley and central Vermont.
Call midwives to confirm panel availability
Vermont's small midwifery community means popular practices fill schedules early. Ask each midwife: "Are you accepting Medicaid clients with my due date in 2026?"
Ask about specific billing experience
Ask each midwife: "Which fees do you bill Vermont Medicaid, and which fees might I owe out of pocket?" Practices that bill Green Mountain Care regularly can answer this in one call.
What if no midwife in your area accepts Medicaid?
Vermont's small midwifery community means rural Vermont families sometimes can't find a local Medicaid-accepting midwife. Three options:
Travel to Burlington or central Vermont. Some Vermont families relocate temporarily for late prenatal care and birth, particularly when no local midwife is available.
CNM-staffed hospital care. Vermont hospitals with CNM-staffed maternity programs are covered by Vermont Medicaid. The University of Vermont Medical Center in Burlington has an active CNM service.
Cross-border care. Some Vermont families work with midwives in nearby New Hampshire, New York, or Massachusetts. Out-of-state Medicaid coverage requires reciprocity and may not work for all plans, but it's an option worth asking about if you're near a state border.
For a full guide to home birth midwives in Vermont, including licensing, costs by region, and what to ask before hiring, see our Vermont home birth midwife guide.
Bottom line: Vermont Medicaid reimburses both Licensed Midwives and CNMs, with home birth billing written into the Green Mountain Care provider manual, [1] and 8 V.S.A. § 4099d requires maternity plans to cover midwife care at home. [2] Vermont is one of at least 18 states plus DC paying midwives without a nursing degree. [3] The community is small and concentrated around Burlington. Use the state association directories, confirm Medicaid enrollment and panel space by phone, and keep hospital-based CNM care or cross-border options in reserve if no local midwife has room.
- Department of Vermont Health Access. Green Mountain Care Provider Manual: Midwife Services and Obstetrical Care. View source
- Vermont Statutes Annotated, Title 8, § 4099d. Midwifery coverage; home births. As amended by Act 19 (2025). View source
- National Academy for State Health Policy. Midwife Medicaid Reimbursement Policies by State. Updated April 2026. View source
- Vermont Statutes Online. Title 26, Chapter 85: Midwives. View source
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. 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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