Supplement 25-13: Birthing Options Program Billing and Reimbursement
Effective January 1, 2026, this Birthing Options Program (BOP) guidance supersedes Supplement 25-07 and sets a flat rate: the Medical Assistance Division reimburses the birth center one flat rate for labor and delivery and the newborn facility charge. Licensed Birth Centers keep the split billing model, with facility charges billed on the UB/837I format under provider type 405 and professional services billed on the CMS-1500 or 837P under provider types 322 and 323. No prior authorizations are required for BOP services.