CommercialCoverageMedium impact
Home Birth by Certified Nurse Midwives 11.01.23
Excellus BlueCross BlueShield·NY · OB-GYN·Women's Health (Obstetrics & Gynecology)
Effective date
Oct 16, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield established new coverage criteria for home births by certified nurse midwives, requiring CNMs to be licensed registered nurses with collaborative physician relationships. For non-participating CNMs, specific documentation requirements including $1 million/$3 million malpractice insurance must be met for referral approval.
Action Required
Before October 16, 2025: Billing team must verify CNM credentials and collaborative relationships with physicians or hospitals per NY Education Law Section 6951 for all Excellus home birth claims. For non-participating CNM referrals, obtain and submit documentation of state license, collaborative relationship, and malpractice insurance ($1M/$3M minimum) before services are provided. Claims without proper CNM credentials or required documentation will be denied.