SECTION 354.1261. Benefits and Limitations

(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.

Source Note: The provisions of this §354.1261 adopted to be effective February 1, 2011, 35 TexReg 11847; amended to be effective January 1, 2013, 37 TexReg 9771