Yes, midwives accept Medicaid. Certified nurse-midwife (CNM) services are a mandatory benefit under federal Medicaid law, meaning every state Medicaid program must cover them. But whether a specific midwife near you takes Medicaid, and what that coverage actually looks like in practice, depends on the type of midwife, your state, and the birth setting you choose.
What Federal Law Requires
Federal law classifies certified nurse-midwife services as a mandatory Medicaid benefit. This applies in all 50 states and the District of Columbia. Care at licensed birth centers is also a mandatory benefit. So if you have Medicaid and want to see a CNM, your state program is legally required to cover those services.
That said, “coverage” and “access” are not the same thing. A state can cover CNM services while reimbursing midwives so poorly that few practices can afford to take Medicaid patients. The gap between what the law promises and what patients experience on the ground is significant in some states.
Coverage Depends on the Type of Midwife
There are three main midwife credentials in the U.S., and Medicaid treats each one differently.
Certified nurse-midwives (CNMs) are registered nurses with graduate-level midwifery training. They have licensure in every state, can prescribe medications, and are universally covered by Medicaid and most private insurance. If you’re on Medicaid, this is the credential with the fewest access barriers.
Certified professional midwives (CPMs) are trained specifically in out-of-hospital birth. They are licensed in 35 states but have mandated Medicaid coverage in only 14. If you’re interested in a home birth or birth center birth with a CPM, your state may not cover it at all.
Certified midwives (CMs) hold the same certifying-body credential as CNMs but enter midwifery without a nursing background. Only 10 states recognize CMs, and third-party reimbursement, including Medicaid, is more limited for this group.
How Reimbursement Rates Vary by State
Even where Medicaid covers midwifery care, the amount it pays varies widely. Some states reimburse CNMs at the same rate as physicians. Others pay as little as 75% of the physician rate, which can make it financially difficult for midwifery practices to keep their doors open to Medicaid patients.
States that reimburse CNMs at 100% of the physician rate include California, Colorado, Connecticut, Delaware, Georgia, Illinois, Maryland, Michigan, Minnesota, Missouri, New Hampshire, New Mexico, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Utah, Vermont, Virginia, West Virginia, and Wyoming. At the other end, Hawaii, Indiana, Kansas, Kentucky, and North Dakota reimburse at just 75%. Most remaining states fall somewhere between 80% and 95%.
These numbers matter because they directly affect whether a midwife near you can afford to accept your insurance. A practice operating on thin margins may cap the number of Medicaid patients it takes or stop accepting Medicaid entirely.
Why Some Midwives Limit Medicaid Patients
Low reimbursement is the single biggest reason midwives and birth centers restrict Medicaid enrollment. In a national study of birth centers participating in a federal demonstration program, about half reported that Medicaid reimbursement was too low to cover their baseline costs of care. Seven of 34 centers surveyed said inadequate payment had led them to restrict the number of Medicaid patients they served. One center stopped accepting Medicaid altogether. At least three centers encouraged or required Medicaid patients to deliver at the hospital instead of the birth center because the reimbursement didn’t cover the cost of a birth center birth.
Administrative burden compounds the problem. Birth centers and small midwifery practices typically have lean staff, sometimes with no one dedicated to billing. In states where Medicaid is delivered through managed care organizations (MCOs), midwives must negotiate separate contracts with each MCO, submit prior authorizations, and track reimbursements across multiple systems. Some MCOs have refused to include birth centers in their networks at all, reasoning that hospitals already offer similar services.
Birth Setting and What’s Covered
Where you plan to give birth affects your coverage. Midwife-attended births in hospitals are the most straightforward for Medicaid billing because hospitals handle the facility side. Birth centers have a mandatory Medicaid benefit on paper, but roughly 30 states actually reimburse birth center facility fees with Medicaid dollars, and not all publish their rates. The reimbursement often falls short of what a birth center needs to stay viable.
Home births have more uneven coverage. More than half of states (25 out of 42 surveyed by KFF in 2021) cover home births under Medicaid. Some states require that home births be attended by a physician or CNM. Texas requires a physician to submit a prior authorization during the third trimester confirming the patient is low-risk before Medicaid will cover a CNM-attended home delivery. If you’re considering a home birth on Medicaid, check your state’s specific rules, because this is the setting where coverage gaps are most common.
Postpartum Coverage Has Expanded
Medicaid historically cut off pregnancy-related coverage 60 days after delivery. That changed with the American Rescue Plan of 2021, which gave states the option to extend coverage to 12 months postpartum. Most states have now adopted this extension. This means your postpartum visits with a midwife, including the standard six-week checkup and any follow-up care in the months after, are more likely to be covered than they were a few years ago.
How to Confirm a Midwife Takes Your Plan
Because Medicaid is administered differently in every state, and most states now use managed care organizations rather than a single fee-for-service system, the steps to verify coverage are specific to your situation.
- Check your MCO’s provider directory. If your Medicaid coverage is through a managed care plan (most are), start with that plan’s online directory or call the member services number on your card. Search for “certified nurse-midwife” or “midwifery” as a provider type.
- Call the midwife’s office directly. Ask whether they accept Medicaid and, specifically, which managed care plans they contract with. A midwife might accept one MCO in your state but not another.
- Ask about birth setting. If you want a birth center or home birth, confirm that the facility fee (not just the midwife’s professional fee) is covered. Some practices have learned the hard way that only part of the bill gets reimbursed.
- Contact your state Medicaid office. If you’re having trouble finding an in-network midwife, your state Medicaid agency can help you verify provider enrollment and may be able to connect you with participating practices.
Federal Efforts to Improve Access
The Centers for Medicare and Medicaid Services (CMS) launched the Transforming Maternal Health (TMaH) Model, which provides funding to state Medicaid agencies to expand access to midwives, doulas, and birth centers. Selected states began participating in early 2025. The model specifically targets reducing unnecessary cesarean sections for low-risk pregnancies, improving prenatal care for chronic conditions, and building stronger connections between clinical care and community-based support during the postpartum period. While this won’t change your coverage overnight, it signals a federal push toward making midwifery care more accessible for Medicaid enrollees in participating states.