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14.3.1 Deliveries
Deliveries must be performed in a participating Medicaid Title XIX general or acute care hospital or special hospital or facility licensed and approved for the operation of maternity and newborn services or in the home setting. Home deliveries by a CNM are reimbursable when the CNM has received prior authorization from TMHP for a home delivery. The CNM must submit a written request for prior authorization during the client's third trimester of pregnancy. The CNM must include a statement signed by a licensed physician who has examined the client during the third trimester and determined at that time that she is not at high risk and is suitable for a home delivery. Requests for home delivery prior authorizations must be submitted to the TMHP Medical Director at the following address:
Texas Medicaid & Healthcare Partnership
Special Medical Prior Authorization
12357-B Riata Trace Parkway, Suite 150
Austin, TX 78727
Fax: 1-512-514-4213
Claims submitted for home deliveries performed by a CNM without prior authorization are denied.
CNMs must bill procedure code 59410 with type of service (TOS) 2.
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