Provider Eligibility

The MassHealth agency pays only freestanding birth centers who are participating in MassHealth on the date of service. Freestanding birth centers must meet the following eligibility requirements. (A) In-state Providers. To be eligible for participation as a MassHealth FBC provider, the applicant must meet the MassHealth and DPH requirements specified as follows: (1) for each service location, complete and submit the application for enrollment to MassHealth on the form provided for this purpose by MassHealth; (2) be located and legally doing business in the Commonwealth of Massachusetts; (3) operate under an FBC clinic license issued by DPH, in accordance with 105 CMR 140.000: Licensure of Clinics; and (4) be accredited by the Commission for the Accreditation of Birth Centers (CABC). (B) Out-of-state Providers. To participate in MassHealth, an out-of-state FBC must meet the requirements specified as follows: (1) obtain a MassHealth provider number from the MassHealth agency; (2) participate in its own state’s Medicaid program; and (3) operate as a provider of freestanding birth center services as authorized by the governing or licensing agency in its state.