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99%
Birth Center

Midwifery and birth center billing services for natural birth facilities.

Specialty highlight

99%

Built around payer rules, documentation requirements, and coding nuances.

Global OB Accuracy

99%

Clean Claim Rate

96%

Overview

Billing in Birth Center

A practical view of what makes this specialty unique.

Birth center billing involves managing the global maternity care for low-risk pregnancies, provided by Certified Nurse-Midwives (CNMs) or other midwives in a homelike, out-of-hospital setting. Our birth center billing service is designed to handle the unique aspects of this model, from global obstetrical packages to facility fees for the birth center itself, ensuring accurate reimbursement for all prenatal, delivery, and postpartum care.

Accurate coding for global midwifery care (59400, 59610).

Standardized into our workflow to reduce rework and protect revenue.

Expertise in billing birth center facility fees (using revenue codes on a UB-04).

Standardized into our workflow to reduce rework and protect revenue.

Management of prenatal care only (59425, 59426) or delivery only (59409, 59612) billing.

Standardized into our workflow to reduce rework and protect revenue.

Coding for newborn care (99460-99463) in the birth center setting.

Standardized into our workflow to reduce rework and protect revenue.

Challenges

What slows reimbursement

The common friction points that trigger delays, denials, and rework.

Key challenges
  • Managing global obstetrical packages for midwifery care.
  • Billing for facility fees for birth center services (delivery room, supplies).
  • Accurately coding for vaginal deliveries (59400, 59409, 59410) performed by midwives.
  • Ensuring proper credentialing and contracting for CNMs with all payers.
  • Navigating state-specific regulations and payer policies for birth center coverage.
Our solutions
  • Certified birth center and midwifery coders with expertise in obstetrical coding.
  • Precise coding for global obstetrical packages for midwifery care (59400, 59610).
  • Expertise in billing for the technical or facility component of a birth center delivery.
  • Meticulous management of the global package, tracking all prenatal, delivery, and postpartum visits.
  • Proactive credentialing and enrollment for CNMs and birth centers with all payers.
  • Detailed support for newborn care and circumcision billing within the birth center.
Features

Operational features that keep claims clean

Repeatable checks, payer alignment, and tight charge capture.

Accurate coding for global midwifery care (59400, 59610).

Included to improve first-pass acceptance and reduce downstream edits.

Expertise in billing birth center facility fees (using revenue codes on a UB-04).

Included to improve first-pass acceptance and reduce downstream edits.

Management of prenatal care only (59425, 59426) or delivery only (59409, 59612) billing.

Included to improve first-pass acceptance and reduce downstream edits.

Coding for newborn care (99460-99463) in the birth center setting.

Included to improve first-pass acceptance and reduce downstream edits.

Support for circumcision billing (54150, 54160) for newborns.

Included to improve first-pass acceptance and reduce downstream edits.

Coding

Coding complexities we watch closely

Modifier usage, documentation rules, and specialty-specific payer edits.

Complexity checklist
  • Global OB coding using the appropriate code based on delivery type and provider.
  • Separate billing for facility (birth center) and professional (midwife) fees.
  • Coding for delivery only (59409) vs. delivery with postpartum care (59410).
  • Billing for care provided by both a midwife and a consulting physician.
Denial triggers

Incorrect coding of global OB packages (e.g., billing for prenatal visits separately).

Bundling of facility and professional fees incorrectly.

Credentialing issues with CNMs.

Lack of prior authorization for birth center services (if required).

Coding for newborn services not covered under mother's plan.

Codes

Common codes (examples)

Reference-only examples to illustrate the typical coding landscape.

CPT

59400 (Vaginal Delivery, Global), 59409 (Vaginal Delivery Only), 59410 (Delivery with Postpartum), 59425 (Antepartum Care, 4-6 visits), 99460 (Newborn Care)

ICD-10

O80 (Encounter for Full-Term Delivery), Z34.90 (Normal Pregnancy), Z38.00 (Single Liveborn), O60.10 (Preterm Labor)

FAQ

Frequently Asked Questions

Got questions? We've got answers

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