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Medical Billing for Freestanding Birth Centers & Midwifery Practices

Birth Center Billing That Pays What You Earn

Birth center and midwifery billing involves global obstetric care packages, facility fee billing for freestanding birth centers, certified nurse midwife (CNM) billing under Part B, and the complex coordination between the birth center's facility claim and the attending midwife's professional claim. Medicaid covers the majority of birth center deliveries and has state-specific global OB package requirements that differ significantly from commercial payer rules. 360Solutions provides birth center billing specialists who manage global OB packages, facility fee billing, and Medicaid reimbursement optimization for every delivery.

38%
avg birth center revenue lost from facility vs. professional claim errors
$1,600
avg additional revenue per delivery with correct global OB billing
92%
first-pass rate for birth center claims with specialist billers
Birth Center Billing Challenges
Where practices lose the most revenue:
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Global OB Package Billing
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Freestanding Facility Fee Billing
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CNM Billing Under Part B
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Medicaid State-Specific Rules
Birth Center Billing Challenges

Where Birth Center Practices Lose Revenue

These are the coding and billing pitfalls that cost birth center practices the most — and where our specialised billers add the most value.

Global OB Package Billing

The global OB package (59400 for vaginal delivery; 59510 for cesarean) includes antepartum care, delivery, and postpartum care in a single bundled payment. Practices must track which antepartum visits are included in the global package vs. which are separately billable when the provider changes mid-pregnancy.

Freestanding Facility Fee Billing

Freestanding birth centers bill a separate facility fee (UB-04 claim type) for use of the birth center environment, supplies, and nursing staff. Many birth centers bill only the professional claim — missing the entire facility component. Facility credentialing with payers is a prerequisite.

CNM Billing Under Part B

Certified nurse midwives bill independently under Medicare Part B and most commercial plans, but their services are reimbursed at 100% of the Medicare physician fee schedule. Billing under the supervising physician's NPI instead of the CNM's own NPI loses this revenue distinction.

Medicaid State-Specific Rules

Medicaid covers most birth center deliveries, but state Medicaid programs have widely varying rules on global package composition, allowed services, and birth center facility fee rates. We maintain state-specific Medicaid billing protocols for each state where our clients operate.

Coding Intelligence

High-Risk CPT Groups

Code ranges payers audit most aggressively in Birth Center.

59400 / 59410
Global OB — vaginal delivery / delivery only — with postpartum care
59510 / 59515
Global OB — cesarean delivery / delivery only — with postpartum care
59025 / 59020
Nonstress test / contraction stress test — antepartum testing
59430 / 59160
Postpartum care only / curettage for postpartum hemorrhage
99213 / 99214
Antepartum visits billed separately when provider change occurs mid-pregnancy
Denial Intelligence

Common Denial Patterns

Knowing these before submission is the difference between a 60% and a 96% first-pass rate.

Antepartum visit billed separately when already included in global OB package count

Birth center facility fee not credentialed with payer — facility claim rejected entirely

CNM services billed under physician NPI rather than CNM's own enrolled NPI

Cesarean delivery code billed without corresponding antepartum care documentation

Medicaid global OB package submitted with incorrect visit count per state-specific rules

Free Denial Audit

Send us your last 90 days of remittance data — we'll identify your top 3 fixable denial sources at no cost.

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Our Process

How 360Solutions Works for Birth Center Practices

01

Free 2-Week Billing Audit

We review your last 90 days: denial breakdown by category, AR aging by payer, charge lag, collection rate, and any recurring coding issues specific to your specialty. No commitment required.

02

Specialty Coder Assignment

You are paired with a coder trained specifically in birth center coding. They learn your providers, your documentation patterns, and your payer mix before touching a claim.

03

Parallel Billing Transition

We run alongside your current billing for 10–14 days with zero cash flow disruption. Claims keep moving during the transition. Your account manager provides daily status updates.

04

Live KPI Dashboard

Real-time visibility into billed, paid, denied, AR aging, and collection rate — segmented by provider and payer. No black box, no month-end surprises.

05

Weekly Account Manager Call

Every week your dedicated account manager walks through last week's KPIs, denial trends, and any action items. Critical issues are escalated the same day — not at the next scheduled call.

Birth Center Billing FAQ

Questions From Birth Center Practices

We split the global package into individual antepartum visits (59425 for 4-6 visits; 59426 for 7+ visits) for the visits handled by the departing provider, then bill the delivery provider for the remaining antepartum visits and delivery. The total across all providers must not exceed the full global package value.
Yes. We manage the CNM's professional claim on CMS-1500 and the birth center's facility claim on UB-04 for the same delivery event, ensuring consistent procedure codes, patient information, and delivery dates between both claims.
We maintain state-specific Medicaid billing protocols, verify global OB visit count requirements, and submit claims according to each state's birth center facility fee schedule. We also manage Medicaid prior auth where required for non-emergency transfers or high-risk deliveries.
When a patient transfers to a hospital during active labor, the birth center bills for antepartum services provided up to the transfer. The hospital bills for the delivery. We manage the split billing between the birth center and the receiving hospital to prevent double-billing and ensure each entity is paid for services actually provided.
Ready to Fix Your Birth Center Billing?

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No-Obligation Audit

Two weeks, no contract. A certified birth center billing specialist reviews your claims, denial patterns, and AR — and shows you exactly what is recoverable.

Start Free Audit → Call +1 (209) 889-4056