MMP 26-43

Michigan Bulletin MMP 26-43, issued November 2, 2026 by MDHHS, establishes Medicaid coverage for planned home-based labor and delivery services effective January 1, 2027, pursuant to Section 1982 of Public Act 22 of 2025. The policy applies to Medicaid, Healthy Michigan Plan, MI Coordinated Health, and the Maternity Outpatient Medical Services (MOMS) program, with MOMS coverage contingent on CMS State Plan Amendment approval. Eligible providers include Licensed Midwives (LM), Certified Nurse Midwives (CNM), and physicians, each working within their state-defined scope of practice. Coverage is limited to low-risk pregnancies, defined as a routine, uncomplicated prenatal course with adequate prenatal care as defined by ACOG and documented by the homebirth provider. Covered services include antepartum, prenatal, delivery, and postpartum care; laboratory and limited ultrasound services using FDA-approved devices; newborn care in the immediate postpartum period; medication and immunization administration; telemedicine visits; lactation support; labor management prior to hospital transfer; and transfer of care. Excluded conditions include prior cesarean with other than low transverse incision, multiple gestation, breech presentation at term, gestational age below 36 weeks 0 days or beyond 43 weeks 0 days, placenta previa, vasa previa, hypertensive disorders, insulin-dependent diabetes, uncontrolled gestational diabetes, and active infectious disease such as HIV or tuberculosis. At inception of care, providers must establish and document a patient-specific transfer protocol to a designated hospital. In the event of emergent transfer, homebirth providers must immediately arrange transport, notify hospital staff, provide emergency stabilization until transfer is complete, and share pertinent clinical information with the receiving provider. Medicaid separately reimburses homebirth supplies and supports once per homebirth using HCPCS code S8415, inclusive of all supplies and supports utilized during labor and delivery. Professional claims must include the rendering provider's NPI; services billed jointly are covered for a single provider only. FQHCs, RHCs, Tribal Health Centers, and Tribal FQHCs are reimbursed at PPS or AIR methodology for qualifying clinic visits, while non-clinic homebirth services are reimbursed under FFS methodology on a professional claim form. Homebirth and newborn services provided by Licensed Midwives are carved out of Medicaid Health Plans and reimbursed through Medicaid FFS. The bulletin also extends Medicaid reimbursement to enrolled doulas for labor and delivery support services provided in the home setting, effective January 1, 2027.