Page 154 - Medicare Benefit Policy Manual

A certified nurse-midwife is a registered nurse who has successfully completed a
program of study and clinical experience in nurse-midwifery, meeting guidelines
prescribed by the Secretary, or who has been certified by an organization recognized by
the Secretary. The Secretary has recognized certification by the American College of
Nurse-Midwives and State qualifying requirements in those States that specify a program
of education and clinical experience for nurse-midwives for these purposes. A nurse-
midwife must:

• Be currently licensed to practice in the State as a registered professional nurse;
and

• Meet one of the following requirements:

1. Be legally authorized under State law or regulations to practice as a nurse-
midwife and have completed a program of study and clinical experience
for nurse-midwives, as specified by the State; or

2. If the State does not specify a program of study and clinical experience
that nurse-midwives must complete to practice in that State, the nurse-
midwife must:

a. Be currently certified as a nurse-midwife by the American College
of Nurse-Midwives;

b. Have satisfactorily completed a formal education program (of at
least one academic year) that, upon completion, qualifies the nurse
to take the certification examination offered by the American
College of Nurse-Midwives; or

c. Have successfully completed a formal education program for
preparing registered nurses to furnish gynecological and obstetrical
care to women during pregnancy, delivery, and the postpartum
period, and care to normal newborns, and have practiced as a
nurse-midwife for a total of 12 months during any 18-month period
from August 8, 1976, to July 16, 1982.

C. Covered Services

1. General - Effective January 1, 1988, through December 31, 1993, the coverage of
nurse-midwife services was restricted to the maternity cycle. The maternity cycle is a
period that includes pregnancy, labor, and the immediate postpartum period.

Beginning with services furnished on or after January 1, 1994, coverage is no longer
limited to the maternity cycle. Coverage is available for services furnished by a nurse-
midwife that he or she is legally authorized to perform in the State in which the services