How much do states reimburse CPMs/LMs through Medicaid?

CPM Medicaid Reimbursement as a Percentage of Physician Reimbursement

For this dataset, reimbursement amounts are based on CPT code 59400, which represents the global fee—including prenatal care, birth, and one postpartum visit.

The percentage listed reflects the CPM/LM reimbursement rate as a proportion of the physician reimbursement rate. In cases where a state-specific physician rate was not publicly available, a national average of $2,200 was used instead. These estimates are marked with an asterisk (*), and the corresponding percentages should be interpreted as approximate.

For insights or corrections to the information listed, please contact Zev@nacpm.org. When submitting updates, kindly include relevant sources to ensure accuracy and reliability.

Sources:

American College of Obstetricians and Gynecologists. (2024). Payment parity for obstetric services. https://www.acog.org/advocacy/policy-priorities/payment-parity-for-obstetric-services

Illinois Medicaid. (2025, July 23). State reimbursement update [Email communication].

National Academy for State Health Policy. (2022, April). Certified nurse midwife (CNM) reimbursement policies. NASHP. https://nashp.org/midwife-medicaid-reimbursement-policies-by-state/

National Academy for State Health Policy. (2022, April). Certified nurse midwife (CNM) reimbursement policies [Chart]. https://www.nashp.org/wp-content/uploads/2022/04/CNM-Reimbursement-Policies_Chart.pdf

National Association of Certified Professional Midwives. Medicaid Reimbursement Availability for Licensed NARM-Evaluated Direct Entry Midwives. Internal dataset based on self-reported information from NACPM members, 2025.

New Mexico Health Care Authority. (2025). Fee schedules. https://www.hca.nm.gov/providers/fee-schedules

Texas Medicaid & Healthcare Partnership. (2025). Fee schedules. https://public.tmhp.com/FeeSchedules

State Medicaid Program Fee Schedule Sources:

Alabama Medicaid Agency. (2024, October 17). Physician fee schedule. https://medicaid.alabama.gov/content/Gated/7.3G_Fee_Schedules/7.3G_Physician_Fee_Schedule_10-17-24.pdf

Alaska Department of Health. (n.d.). Fee schedules. https://extranet-sp.dhss.alaska.gov/hcs/medicaidalaska/Provider/Sites/FeeSchedule.html

Arizona Health Care Cost Containment System. (2024, October). FFS physician rates. https://www.azahcccs.gov/PlansProviders/RatesAndBilling/FFS/Physicianrates/FFSCodes.aspx?schedule=2024OctoberPhysicianRates

California Department of Health Care Services. (n.d.). Medi-Cal provider rates. https://mcweb.apps.prd.cammis.medi-cal.ca.gov/rates?page=1&tab=rates

Colorado Department of Health Care Policy & Financing. (n.d.). Provider rates and fee schedule. https://hcpf.colorado.gov/provider-rates-fee-schedule

District of Columbia Medicaid. (n.d.). Fee schedule inquiry. https://www.dc-medicaid.com/dcwebportal/nonsecure/getFeeScheduleInquiry

Idaho Department of Health and Welfare. (n.d.). Fee schedule document. https://publicdocuments.dhw.idaho.gov/WebLink/DocView.aspx?id=32996&dbid=0&repo=PUBLIC-DOCUMENTS

Minnesota Department of Human Services. (n.d.). MHCP fee schedule. https://mn.gov/dhs/partners-and-providers/policies-procedures/minnesota-health-care-programs/provider/billing/fee-schedule/mhcp.jsp

Montana Medicaid. (2025, January). Physician services fee schedule (revised). https://medicaidprovider.mt.gov/docs/feeschedules/2025/January2025PhysicianServicesFeeScheduleRevised.pdf

New Hampshire Department of Health and Human Services. (2025, January 1). Fee schedule: Covered procedures report. https://nhmmis.nh.gov/.../2025+Fee+Schedule+...01-01-2025.pdf

New Jersey Medicaid. (2022). CPT/HCPCS code schedule. https://www.njmmis.com/downloadDocuments/CPTHCPCSCODES2022.pdf

Oregon Health Authority. (n.d.). OHP fee schedule. https://www.oregon.gov/oha/HSD/OHP/Pages/Fee-Schedule.aspx

South Carolina Department of Health and Human Services. (n.d.). Fee schedules. https://www.scdhhs.gov/providers/fee-schedules

Vermont Medicaid. (n.d.). CPT code fee schedule. https://www.vtmedicaid.com/#/feeSchedule/cptCodes

Virginia Department of Medical Assistance Services. (n.d.). Procedure fee files. https://www.dmas.virginia.gov/for-providers/rates-and-rate-setting/procedure-fee-files-cpt-codes/

Washington State Health Care Authority. (2025, April 1). Physician fee schedule. https://www.hca.wa.gov/assets/billers-and-providers/physician-20250401.xlsx

Wyoming Medicaid. (n.d.). Fee schedules. https://www.wyomingmedicaid.com/portal/fee-schedules

Novitas Solutions. (n.d.). Medicare JH fee lookup (multiple instances). https://www.novitas-solutions.com/webcenter/portal/MedicareJH/FeeLookup