Universal Billing Codes for Homebirth - Mothering Forums

Thread Tools
#1 of 4 Old 06-27-2012, 12:50 PM - Thread Starter
houstonmomma4's Avatar
Join Date: Jun 2012
Posts: 1
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Anyone pay cash to out of network midwife for homebirth and have to file on your own to insurance. My insurance will cover out of network, but we have already paid and I need to send in a claim. I have no clue how to break up the codes and amounts. We are filing or an in-network exemption, but doubt we will get it. I figure I can get back about a $1000 by filing. Crossing fingers :)

houstonmomma4 is offline  
Sponsored Links
#2 of 4 Old 06-27-2012, 09:34 PM
fayebond's Avatar
Join Date: Jun 2012
Location: Fringe Central, Oddballstate, USA
Posts: 1,529
Mentioned: 18 Post(s)
Tagged: 0 Thread(s)
Quoted: 34 Post(s)

I don't know, but I would ask anyone else in the homebirth community in your area.  A birth center might be able to help you with it, since they file this stuff alot.  Even if they charge you (which, lets face it, midwives as a group are pretty laid back about helping each other out for free) it would be minimal compared to a successful filing/savings.

Slightly crunchy mama of three, one cs, one ubac, one vbac. Planning a vbac in October. Bookworms anonymous member.
fayebond is offline  
#3 of 4 Old 06-28-2012, 03:39 PM
Kim L Mosny CPM's Avatar
Join Date: May 2011
Posts: 12
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

You can not request an in-network authorization/exception or GAP authorization (putting your midwife IN the network) AFTER the fact. This must be done at the onset of care.


You should file a 59400 code for Global Maternity/Obstetrical Care using the total you paid to your midwife.

Diagnosis code is V22.0 Supervision of normal first pregnancy or V22.1 Supervision of other normal pregnancy


Ask your midwife for ONE receipt with the total you paid, submit that ONE receipt with your claim form.

Your date of service (DOS) is the birth date of the baby. The place of service (POS) code for HOME is 12.


Good luck getting reimbursed. I HIGHLY recommend that MY clients allow my billing service to do their filing because when clients "do it themselves" they rarely get any money back (they just don't know enough to do the filing correctly).


Kim Mosny, CPM, LM

Home Birth Midwifery Service

Midlothian, VA


Kim L Mosny CPM is offline  
#4 of 4 Old 07-15-2012, 05:45 PM
amberc727's Avatar
Join Date: May 2007
Posts: 29
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

This is based on my experience...


Depending on your insurance, you may be able to get an in-network exception AFTER the fact.  When I was pregnant with my daughter in 2010, I didn't even know such a thing existed.  I had Aetna and was planning a delivery at a free-standing birth center.  They were out of network, just like the other birth center was where my son was born in 2007.  My MW told me about this exception and Aetna easily granted it, so I thought, hmm...maybe they'd go back and refund some of my money from my son's birth in 07.  Sure enough, they did!  They granted an in-network except for my 1st child's birth, which occured over 2 years earlier! I got over $1K back!  It's worth a try!


Now, if you happen to have BCBS, you're going to be in for a fight.  Many BCBS companies won't grant an in-network exception at all.  I have BCBS of NC and they won't.  I'm working to get BCBS to change their policy on this all together.  If you're interested in signing my petition so more women can get in-network exceptions and deliver with MW's and in birth centers, check this out:  http://www.change.org/petitions/bcbsnc-executive-vp-and-chief-operating-officer-allow-pregnant-women-to-receive-care-at-any-free-standing-birth-center?utm_source=guides&utm_medium=email&utm_campaign=one_hundred_signatures

amberc727 is offline  

User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page

Posting Rules  
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off

Online Users: 9,977

16 members and 9,961 guests
Annika123 , beltransoni3 , Dipanshu , hillymum , Michele123 , msegsims , Nazsmum , pushorpull87 , RollerCoasterMama , samaxtics , sandymils , Siasia , thefragile7393 , tiller , transpecos , worthy
Most users ever online was 449,755, 06-25-2014 at 12:21 PM.