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2012 Texas Medicaid Provider Procedures Manual

Clinics and Other Outpatient Facility Services Handbook : 2. Birthing Center : 2.1 Provider Enrollment

2.1 Provider Enrollment
A birthing center is a place, facility, or institution where a woman is scheduled to give birth following a normal, uncomplicated (low-risk) pregnancy. This term does not include a hospital, an ambulatory surgical center, or the residence of the woman giving birth.
A birthing center must be licensed as a birthing center by the Department of State Health Services (DSHS) and meet the minimum standards as required by the Texas Health and Safety Code, Chapter 244.010. To enroll in Texas Medicaid, a birthing center must be licensed to provide a level of service commensurate with the professional services of a doctor of medicine (MD), doctor of osteopathy (DO), or certified nurse-midwife (CNM) who acts as birth attendant. Texas Medicaid may reimburse birthing center providers only for those services that the attending physician or CNM determines to be reasonable and necessary for the care of the mother or newborn child.
Providers cannot be enrolled if their license is due to expire within 30 days. A current license must be submitted.
Birthing centers are encouraged to refer clients for Texas Health Steps (THSteps) services.
Refer to:
Section 1: Provider Enrollment and Responsibilities (Vol. 1, General Information) for more information about enrollment procedures.
Section 2, “Medicaid Title XIX family planning services,” in the Gynecological and Reproductive Health and Family Planning Services Handbook (Vol. 2, Provider Handbooks) for information on setting up referral procedures for family planning services.
DSHS website (www.dshs.state.tx.us/famplan/) for information about family planning and the locations of family planning clinics receiving Title V, X, or XX funding from DSHS.
Subsection 8.2.46.12.1, “HIV Testing” in the Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (Vol. 2, Provider Handbooks) for information about required HIV testing for pregnant women.

Texas Medicaid & Healthcare Partnership
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