Arizona Group Prenatal Care Coverage Announcement: CHI’s announcement on Arizona’s Group Prenatal Care Coverage policy (November 2024)
Supporting Payment for CenteringPregnancy®
In 2024, 10 state Medicaid programs have made significant strides toward enhancing reimbursement for group prenatal care (GPC), reflecting a growing recognition of its benefits for maternal and neonatal health. These states are leveraging innovative payment mechanisms to improve access to and quality of prenatal care.
The following 10 states have implemented enhanced reimbursement for GPC under their Medicaid programs:
Four of these states—Michigan, Montana, North Carolina and Ohio—extend Medicaid coverage for GPC services delivered through FQHCs, addressing the critical needs of underserved populations and expanding access to high-quality care.
State Medicaid programs and managed care organizations are employing a variety of mechanisms to support GPC, including:
The following resources provide insight into the efficacy of payment for GPC to improve birth and maternal health outcomes, reduce racial disparities and promote care experience satisfaction for birthing people and healthcare providers.
Advocacy & Policy Resources
Arizona
Arizona Group Prenatal Care Coverage Announcement: CHI’s announcement on Arizona’s Group Prenatal Care Coverage policy (November 2024)
Arizona Public Comments for AMPM Policy 410- Maternity Care Services: CHI’s comments on Arizona’s AMPM 410- Maternity Care Services policy (October 2024)
Maryland
Maryland’s CenteringPregnancy Policy & Payment Resource: A resource offering a short overview of Centering, as well as state-specific billing, coding and documentation information (January 2024)
Michigan Group Prenatal Care Coverage Announcement: CHI’s announcement on Michigan’s Group Prenatal Care Coverage policy (October 2024)
Michigan Public Comments for Project 2410 — Maternal, Medicaid Coverage for Group Prenatal Care: CHI’s comments on the Michigan Project 2410- Maternal, Medicaid Coverage for Group Prenatal Care Services policy (August 2024)
Michigan HB 4437 & CHI Statement: Michigan Governor and Legislature passed HB 4437, which approved $5 million for one-time CenteringPregnancy to expand current or new CenteringPregnancy sites. Additionally, $5 million in recurring funds for Medicaid to develop a sustainability pathway for CenteringPregnancy (i.e enhanced reimbursement or MCO contract) (August 2023)
Missouri
Missouri Group Prenatal Care Coverage Announcement: CHI’s announcement on Missouri’s Group Prenatal Care Coverage policy (March 2024)
Expanding Access to Centering: In collaboration with the New Jersey Department of Health and three philanthropic foundations, CHI developed and implemented a program to expand patient access to CenteringPregnancy and CenteringParenting to address racial health disparities in New Jersey (March 2021)
P.L. 1968, c.413: New Jersey legislature approved implementing enhanced payment programs for CenteringPregnancy. Effective December 2019, NJ Medicaid established providers shall receive an additional payment of $7.00 for each NJFC Medicaid beneficiary participating in a CenteringPregnancy group visit billed with 99078 TH and an appropriate E/M code (August 2019)
North Carolina Group Prenatal Care Coverage Announcement: CHI’s announcement on North Carolina’s Group Prenatal Care Coverage policy (May 2024)
Comment Letter to North Carolina Department of Medicaid: CHI’s comments to the North Carolina Department of Medicaid on the proposed 1E-5, Obstetrical Services policies to develop additional reimbursement for group prenatal care. (December 2023)
Senate Bill 20: Effective July 1, 2023, the North Carolina legislature directs the NC Department of Health and Human Services (DHHS) and Department of Health Benefits (DHB) to develop an enhanced reimbursement for group prenatal care sessions, and determine the level of patient participation required for a provider to receive these provider payments. Additionally, the bill directs $2.8 million in recurring funds for each year of the 2023-2025 fiscal biennium to implement the Medicaid-related changes outlined (2023).
Comment letter to North Carolina Department of Health and Human Services on Value-Based Payment Strategy: Read CHI’s comments to the NC Department of Health and Human Services regarding their value-based payment strategy for standard plans and providers in Medicaid Managed Care and alignment of CenteringPregnancy to improve birth outcomes (February 2020).
Texas
Comment Letter to Texas Health and Human Services Department on Postpartum Depression Strategic Plan: Read CHI’s comments on the Texas Health and Human Services Postpartum Depression Strategic Plan draft and relevant success seen within Centering groups (July 2020).