Following are some tips for billing midwifery services furnished to BCBSNM Medicaid Members in licensed birth centers and as home births. For more details, see the billing procedures and reimbursement information, Supplement #19-02, previously issued by the New Mexico Human Services Department.
Services Provided in a Licensed Birth Center
- Submit claims using a CMS-1500 form
- Include the National Provider Identifier for the licensed birth center and the individual certified nurse-midwife or licensed midwife on the claim
- Include the NPI of the business entity or midwife group practice, if applicable
Services Provided as a Home Birth
- Submit claims using a CMS-1500 form
- Be aware that certified nurse-midwives and licensed midwives are the only midwifery providers who can be reimbursed for a home birth
Additional Billing Recommendations
- Accurate documentation: Ensure all services provided are documented for accurate billing and as a reference in case of audits or disputes. Use standardized codes to describe the services provided.
- Regular training: Stay current with the latest billing codes and regulations.
- Claims management: Submit claims promptly to avoid delays in reimbursement, and monitor claims for accurate processing.
The foregoing tips are neither comprehensive nor do they constitute billing advice and following the tips is not a guarantee of coverage or payment, which depend on full compliance with all applicable contractual, programmatic and legal term, conditions and requirements.
If you have questions, contact your BCBSNM Provider Network Representative. You can learn about upcoming trainings through our Provider Training and News and Updates pages, or sign up for our monthly Blue Review℠ newsletter.