405 IAC 5-16.5-4 Limitations

Sec. 4. (a) Services provided in a birthing center shall be limited in the following manner: (1) A member must be considered as having a normal, uncomplicated, or low-risk pregnancy. (2) A delivery shall be performed by a: (A) certified nurse midwife; or (B) physician. (3) Surgical services are limited to episiotomy and episiotomy repair and shall not include operative obstetrics or cesarean sections. (4) Labor shall not be inhibited, stimulated, or augmented with chemical agents during the first or second stage of labor. (5) Systemic analgesia may be administered. Local anesthesia may be administered for pudendal block and episiotomy repair. (6) General and conductive anesthesia shall not be administered at a freestanding birthing center. (7) A birthing center shall not routinely keep a member in the facility for in excess of twenty-four (24) hours. (b) Medicaid reimbursement is not available for birthing center facility services if the services provided are such that the services ordinarily could have been provided in a physician's office. If such services are provided at a freestanding birthing center, the services will be reimbursed at the fee or rate allowed for the same service provided in a physician's office. (c) Freestanding birthing center services rendered in a member's home are noncovered services.