Does Washington Apple Health Cover Home Birth?2026 Coverage, Licensed Midwives, and Why Washington Has the Best Home Birth Access in the Country
Yes. Washington Apple Health (Medicaid) covers deliveries provided by a Licensed Midwife (LM), Certified Nurse-Midwife (CNM), or physician, including planned home births and births in birthing centers or hospitals. [1] Washington is one of 14 states where Medicaid covers non-nurse midwife services, [2] and the state has one of the highest rates of out-of-hospital birth and Medicaid acceptance among midwives in the country. [3]
Washington has built one of the most accessible home birth Medicaid systems in the country. Apple Health explicitly covers planned home births, [1] Licensed Midwives are reimbursed alongside CNMs, [2] and the state's home birth midwifery community is unusually strong because the rate structure makes it economically viable to accept Medicaid clients. [3] If you're on Apple Health and planning a home birth, the legal coverage is firm and the access is real.
On this page
Sources cited (4)
- WA HCA Planned Home Births Billing Guide (2025)
- NACPM Medicaid Reimbursement Rates (2025)
- NASHP, WA + MN Midwifery Profile
- Social Security Act § 1905(a)(17)
Does Washington Apple Health cover home birth?
Yes. The Washington State Health Care Authority (HCA) explicitly states that Apple Health covers deliveries provided by a Licensed Midwife, Certified Nurse-Midwife, or physician, including planned home births. [1] Coverage applies whether the birth occurs at home, in a birthing center, or in a hospital, as long as the provider is enrolled and approved as a Medicaid provider.
Apple Health is administered through both fee-for-service Medicaid and Apple Health Managed Care plans (e.g., Coordinated Care, Community Health Plan of Washington, Molina Healthcare of Washington). All plans must include LM and CNM coverage, and Apple Health publishes a dedicated Planned Home Births and Births in Birthing Centers billing guide for providers. [1]
Which midwife credentials does Washington Apple Health cover?
Washington recognizes two midwifery credentials, both Apple Health-eligible.
Licensed Midwives (LMs) are credentialed by the Washington State Department of Health under RCW 18.50. The Washington LM credential is the state's pathway for direct-entry midwives, equivalent to the national CPM credential elsewhere. LMs provide complete prenatal, intrapartum, postpartum, and newborn care for the first two weeks. Washington LMs must be a Medicaid agency-approved provider to participate in home births and birthing centers. [1]
Certified Nurse-Midwives (CNMs) are licensed by the Washington Nursing Care Quality Assurance Commission as advanced practice registered nurses. CNM services are a federal Medicaid mandatory benefit under § 1905(a)(17). [4]
Washington and Minnesota are profiled by NASHP as states whose Medicaid policies "support diverse pathways to care" because both LMs and CNMs are reimbursed at sustainable rates. [3]
| CREDENTIAL | APPLE HEALTH COVERAGE | WHERE THEY PRACTICE |
|---|---|---|
| Certified Nurse-Midwife (CNM) | Yes (federal mandate) [4] | Hospital, birth center, home |
| Licensed Midwife (LM) | Yes if Medicaid-approved [1] | Birth center or home (primary) |
| Newborn care first 2 weeks | Included with both [1] | Home or follow-up visit |
How does Washington Apple Health reimburse home birth midwives?
Washington's reimbursement structure is one of the reasons home birth access is strong. The state pays both LMs and CNMs at rates that make Medicaid economically viable for solo and small-practice providers, unlike states where the rate gap forces midwives off the Medicaid panel.
Apple Health publishes a Planned Home Births and Births in Birthing Centers billing guide that specifies covered services, billing codes, and reimbursement rates. [1] The global maternity care fee (CPT 59400) is reimbursed at competitive levels for both fee-for-service and Managed Care plans.
Washington also covers birth-center facility fees separately, which means a freestanding birth center can bill for the facility cost while the LM bills for professional services. This dual-billing structure improves the economics for birth center operations.
"Washington and Minnesota show that when Medicaid pays a sustainable rate, midwives accept Medicaid clients in proportion to private-pay clients. The rate is the policy.
NASHP, on Washington and Minnesota's Medicaid midwifery success
How do you find a Medicaid-accepting midwife in Washington?
Washington has a robust home birth midwifery community and several state-level resources for finding a Medicaid-enrolled provider.
Identify your Apple Health plan
Apple Health Managed Care plans include Coordinated Care, Community Health Plan of Washington, Molina, and others. Your enrollment confirmation lists yours.
Use Midwives' Association of Washington State
MAWS maintains a Find a Midwife directory at midwivesofwashington.org. Each profile lists the midwife's payment options, including Medicaid acceptance and current panel status.
Cross-reference with Apple Health provider lookup
The HCA's ProviderOne system lets you confirm a midwife is Medicaid-enrolled and approved for home birth and birth center services.
Contact birth centers directly
Washington has multiple freestanding birth centers (Center for Birth in Seattle, Babies Birth Center in Bellingham, etc.) that staff CNMs and LMs and accept Apple Health. If a community midwife isn't available, a birth center is a fully-covered alternative.
Why does Washington have better home birth access than most states?
Three structural reasons:
Reimbursement parity. Washington reimburses LMs and CNMs at rates that approximate private insurance, eliminating the financial incentive to close Medicaid panels. NASHP profiled Washington and Minnesota as the two states whose Medicaid policies "support diverse pathways to care" because of this. [3]
Credentialing clarity. Washington's LM credential is well-defined under RCW 18.50, and Apple Health has a clear billing guide that specifies what's covered and how. Providers know what to expect.
Cultural acceptance. Washington has one of the highest out-of-hospital birth rates in the country, and the home birth midwifery community is large enough that Medicaid acceptance is normalized rather than exceptional.
The combination means a Medicaid family in Washington has substantively better odds of finding a willing midwife than a Medicaid family in California or Texas, even though all three states technically cover home birth.
Bottom line: Washington Apple Health is the easiest Medicaid program to use for home birth in the United States. LMs and CNMs are both covered, [1] reimbursement is sustainable, [3] and the state's robust home birth midwifery community means provider availability is real. Use the Midwives' Association of Washington State directory to find Medicaid-enrolled providers, and pair with the Apple Health doula benefit for full continuous-care coverage at no out-of-pocket cost.
- Washington State Health Care Authority. Apple Health (Medicaid) Planned Home Births and Births in Birthing Centers. July 2025. View source
- National Association of Certified Professional Midwives. Medicaid Reimbursement Rates by State. 2025. View source
- National Academy for State Health Policy. Medicaid Reimbursement of Midwifery Services in Minnesota and Washington State Supports Diverse Pathways to Care. View source
- Social Security Act § 1905(a)(17), 42 U.S.C. § 1396d(a)(17). Mandatory Medicaid coverage of nurse-midwife services. View source
▶ How we research and review this content Editorial standards
Every guide on Home Birth Partners is researched against primary sources (federal regulations, peer-reviewed clinical literature, and state-level licensing boards) and reviewed by a credentialed midwife before publication.
We update articles when source data changes, when state laws are revised, or at minimum every 12 months. The "Last reviewed" date in the byline reflects the most recent review.
If you spot an error or have a primary source we should add, email [email protected].