Excellus BlueCross BlueShieldAll Plans · Billing Codes · Women's Health (Obstetrics & Gynecology) · NY · OB-GYNMedium impact
Home Birth by Certified Nurse Midwives 11.01.23
Effective date
Jan 1, 2027
Identified
Jun 20, 2026
Summary
Policy 11.01.23 added CPT codes 59080, 59082 and 59431 in a code edit dated 10/30/26, and the source states that these codes are effective 01/01/2027. Home birth by a certified nurse midwife is considered medically appropriate when the individual is essentially healthy and the midwife holds a current state license, meets the collaborative relationship requirements, and maintains malpractice insurance of no less than $1 million per incident and $3 million for multiple incidents that expressly covers home births. The current effective date is October 22, 2026, and the 10/22/26 annual review left the policy intent unchanged.
Get alerts when payers change rules like this one
We check Excellus BlueCross BlueShield and other payers every day and email you when a change matches your specialty and state.
01Future transition 2027-01-01: Billing team: CPT codes 59080 (initial day labor management, straightforward, per day) and 59082 (subsequent day labor management, straightforward, per day) are effective 01/01/2027, and CPT 59431 (vaginal delivery, with or without episiotomy) is also effective 01/01/2027.
02Billing team: Before a referral to a participating or non-participating certified nurse midwife is approved, submit documentation of the midwife's state license, collaborative relationship and malpractice insurance for review.
03Billing team: For non-participating midwives, requests are evaluated on an individual case basis, and where the back-up physician and closest hospital are more than 30 miles from the patient's home, a referral will not be approved.
Codes mentioned
59080590825940059409594105943059431Z33.1
Original notice
Home Birth by Certified Nurse Midwives 11.01.23
excellusbcbs.com · Always check the source before changing claims.
Summaries are AI-assisted. Always confirm against the original payer notice.
What is PolicyChanges
One workspace for payer rules, prior auth, coding and compliance
Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.