(a) Subject to the specifications, conditions, limitations,
and requirements established by the Health and Human Services Commission
or its designee (HHSC), birthing center services are those center
services determined by the attending physician (MD or DO), certified
nurse-midwife (CNM), or licensed midwife (LM), to be reasonable and
necessary for the care of the mother and live newborn child following
the mother's normal, uncomplicated pregnancy.
(1) The attending physician, CNM, or LM must be licensed
at the time and place the services are provided.
(2) Reimbursable services are limited to services provided
by the birthing center during the labor, delivery, and immediate postpartum
periods.
(3) Unless otherwise specified by HHSC, covered services
begin when the mother is in active labor and is admitted to the birthing
center, and end within 24 hours after the birth of the child.
(b) Services provided by a physician, CNM, or LM are
not considered to be birthing center services.
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