Does BadgerCare Cover Home Birth in Wisconsin?2026 Coverage Since the 2017 Licensed Midwife Medicaid Expansion
Yes. BadgerCare (Wisconsin's Medicaid program) covers home birth attended by Licensed Midwives. Wisconsin added Licensed Midwives as Medicaid providers in January 2017. [1] Wisconsin is unique in that both CNMs and CPMs can be credentialed as Licensed Midwives under the same state credential. [2] Wisconsin HMOs do not contract with out-of-hospital midwives, so coverage in practice is strongest under fee-for-service BadgerCare. [3]
Wisconsin made a major Medicaid policy shift in January 2017 when Licensed Midwives were added as Medicaid providers. [1] BadgerCare (the Wisconsin Medicaid brand) now covers home birth with no out-of-pocket cost when Medicaid is the primary insurance. [3] But Wisconsin's structure has a quirk worth understanding: Wisconsin licenses both CNMs and CPMs under a unified Licensed Midwife credential, [2] and Wisconsin's HMOs don't contract with out-of-hospital midwives, [3] which means practical coverage works best under fee-for-service BadgerCare rather than HMO BadgerCare.
On this page
Sources cited (4)
- ForwardHealth LM Medicaid Provider Update (2017)
- WI DSPS Midwife Licensing
- Blissful Midwifery on BadgerCare HMO Limits
- Social Security Act § 1905(a)(17)
Does BadgerCare cover home birth?
Yes. BadgerCare has covered home birth attended by Licensed Midwives since January 2017. [1] Coverage applies to both planned home births and freestanding birth-center births. There is no out-of-pocket cost for clients with Medicaid as their primary insurance, when the midwife is enrolled as a Medicaid provider and the client is on fee-for-service BadgerCare. [3]
The practical caveat: Wisconsin HMO BadgerCare plans do not contract with out-of-hospital midwives. [3] This means the coverage works smoothly for fee-for-service BadgerCare clients but variably for HMO clients depending on the plan and the midwife's specific arrangements. The fee-for-service / HMO distinction matters more in Wisconsin than in most states.
Which midwife credentials does BadgerCare cover?
Wisconsin uses a unified Licensed Midwife credential rather than maintaining separate CNM, CPM, and LM tracks.
Wisconsin Licensed Midwives are credentialed by the Wisconsin Department of Safety and Professional Services. [2] Both CNMs and CPMs can be credentialed as Licensed Midwives in Wisconsin under the same legal framework. CNMs typically hold the AMCB credential plus Wisconsin LM licensure; CPMs hold the NARM credential plus Wisconsin LM licensure. Both are eligible Medicaid providers when enrolled with ForwardHealth. [1]
Unlicensed lay midwives cannot bill Wisconsin Medicaid. The unified LM credential is the path for any midwife wanting to practice and bill in Wisconsin.
A Wisconsin Licensed Midwife who happens to also hold the AMCB CNM credential gets the federal § 1905(a)(17) mandatory benefit protection for her CNM scope of practice on top of the state LM credential. [4] CPM-credentialed Wisconsin LMs are covered under the state's 2017 expansion rather than the federal mandate.
| CREDENTIAL | BADGERCARE COVERAGE | PRACTICE SETTING |
|---|---|---|
| WI Licensed Midwife (LM) | Yes (since 2017) [1] | Birth center or home |
| LM with CNM credential | Yes (federal mandate + state expansion) [1,4] | Hospital, birth center, home |
| LM with CPM credential | Yes (state expansion) [1,2] | Birth center or home |
| FFS BadgerCare | Strongest coverage [3] | Most reliable for home birth |
| HMO BadgerCare | WI HMOs don't contract with out-of-hospital LMs [3] | Coverage variable |
How does Wisconsin Medicaid reimburse home birth midwives?
Wisconsin Medicaid reimburses Licensed Midwives through ForwardHealth, the state's Medicaid administration system. The 2017 ForwardHealth update specifically added Licensed Midwives as enrolled provider type. [1]
For global maternity care (CPT 59400), BadgerCare reimburses LMs at the ForwardHealth fee schedule. Each midwife decides whether to enroll as a Medicaid provider; not all LMs participate. The 2017 expansion makes participation possible, but practice-level decisions about whether to accept Medicaid clients depend on each midwife's economics and capacity.
The HMO BadgerCare situation is the structural quirk. Wisconsin's BadgerCare HMOs don't contract with out-of-hospital midwives, [3] which means an HMO BadgerCare client has limited options for using her HMO benefits to cover an LM-attended home birth. Some HMO clients can request out-of-network coverage; others may need to switch to fee-for-service BadgerCare for the pregnancy.
"Wisconsin solved the credentialing question with a unified LM credential and the coverage question with the 2017 ForwardHealth expansion. The remaining barrier is Wisconsin's HMO BadgerCare plans, which don't contract with home birth midwives.
On the Wisconsin BadgerCare structure
How do you find a Medicaid-accepting midwife in Wisconsin?
Wisconsin's Licensed Midwife community is concentrated in Madison, Milwaukee, Eau Claire, and the Fox Valley. The Wisconsin Guild of Midwives and individual practices like Mama Moon Midwifery, Transitions Birth Services, First Memory Midwifery, and Paradigm Midwifery (Madison) are useful starting points.
Determine if you're on FFS or HMO BadgerCare
Your enrollment confirmation lists which type. The distinction matters significantly for home birth coverage in Wisconsin.
If HMO BadgerCare: ask about out-of-network coverage
Wisconsin HMO BadgerCare doesn't contract with out-of-hospital LMs, [3] so you'll need to ask about out-of-network coverage workflows. Some HMOs allow this; others don't.
Search for Wisconsin Licensed Midwives by region
Home Birth Partners and the Wisconsin Guild of Midwives both maintain provider directories. Most LMs serve Madison, Milwaukee metro, Eau Claire, and Green Bay regions.
Confirm Medicaid enrollment by phone
Each Wisconsin LM decides individually whether to enroll as a Medicaid provider. Ask each midwife: "Are you currently enrolled with Wisconsin Medicaid as a Licensed Midwife provider, and accepting BadgerCare clients in 2026?"
What if your HMO BadgerCare plan won't cover an LM home birth?
Wisconsin's HMO BadgerCare structure creates a genuine coverage gap for home birth midwifery. Three options:
Switch to fee-for-service BadgerCare. This is the cleanest path. Fee-for-service BadgerCare covers LM-attended home birth without HMO network restrictions.
Use a freestanding birth center. Several Wisconsin birth centers staff CNMs (who are also Wisconsin LMs) and accept BadgerCare. Birth-center delivery is fully covered with the same Medicaid eligibility as hospital delivery.
Hospital-based CNM care. Wisconsin's HMO BadgerCare plans do contract with hospital-based CNMs. If home birth isn't workable under your specific HMO, hospital-based CNM-attended birth approximates the experience while keeping you in network.
Pay out of pocket plus BadgerCare for prenatal labs and hospital backup. Some Wisconsin families pay private-pay for an LM's home birth attendance while keeping BadgerCare for prenatal labs, ultrasounds, and any hospital transfer.
Bottom line: BadgerCare has covered home birth attended by Licensed Midwives since January 2017, [1] and Wisconsin's unified LM credential covers both CNMs and CPMs under the same state framework. [2] Coverage works best for fee-for-service BadgerCare clients; HMO BadgerCare plans don't contract with out-of-hospital midwives. [3] Determine your plan type first, then use the Wisconsin Guild of Midwives directory and confirm enrollment with each practice. Switching from HMO to fee-for-service BadgerCare may unlock home birth coverage if your HMO can't provide an in-network LM.
- Wisconsin Department of Health Services, ForwardHealth. Licensed Midwives May Now Become Wisconsin Medicaid Providers. 2016-51 Update. View source
- Wisconsin Department of Safety and Professional Services. Midwife Licensing. View source
- Blissful Midwifery. Does Badger Care cover Home Birth? 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.
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