Independent midwives, including certified professional midwives (CPMs), certified nurse-midwives (CNMs) in private practice, and licensed direct-entry midwives, bill families for prenatal, birth, and postpartum care. Most clients pay a global fee that covers the whole course of care, and some also bill insurance or provide a superbill so the family can seek reimbursement.
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Most home birth and birth center midwives charge a global fee that bundles prenatal visits, attendance at labor and birth, and postpartum visits through about six weeks. The fee is usually paid in installments that finish before the due date, often starting with a deposit at intake or after the first visit. Services outside the package are billed separately, such as lab work, ultrasounds, birth supplies kits, newborn screening and metabolic card fees, transfer-of-care mileage, doula-style extended labor support, lactation visits, and well-woman care. Some midwives accept Medicaid or private insurance and bill by CPT code, while others work self-pay and give clients a superbill. Sliding-scale fees and payment plans are common. Rates vary widely by state, licensure, and whether the practice includes an assistant or a birth center facility fee.
| Service | Priced | Typical range |
|---|---|---|
| Global maternity care package (home birth, prenatal through 6 weeks postpartum) | flat fee | $3,500-7,500 |
| Birth center global package (includes professional fee) | flat fee | $4,500-9,000 |
| Initial consult or intake visit | per visit | $100-250 |
| Additional prenatal or postpartum visit outside the package | per visit | $75-175 |
| Birth supplies kit | flat fee | $75-200 |
| Lactation or newborn feeding visit | per visit | $100-200 |
| Well-woman or annual exam | per visit | $150-300 |
| Travel beyond service area | per mile | $0.65-1.00 |
Typical US ranges. Rates vary by region, experience, and job size.
| Description | Qty | Rate | Amount |
|---|---|---|---|
| Global midwifery care: prenatal visits, labor and birth attendance, postpartum visits through 6 weeks (EDD 10/14) | 1 package | $5,800.00 | $5,800.00 |
| Birth supplies kit | 1 kit | $125.00 | $125.00 |
| Newborn screening card and processing fee | 1 each | $40.00 | $40.00 |
| Additional lactation visit (day 10) | 1 visit | $125.00 | $125.00 |
| Deposit received 04/02 | 1 credit | -$1,500.00 | -$1,500.00 |
| Installment payments received (May-July) | 3 credit | -$900.00 | -$2,700.00 |
| Total | $1,890.00 | ||
Notes: Remaining balance of $1,590 due within 30 days of birth. Payment accepted by check, card, HSA/FSA card, or bank transfer. A superbill with CPT and ICD-10 codes is available on request for insurance reimbursement. The global fee is non-refundable after 36 weeks except as described in your care agreement.
The global fee is tied to the pregnancy, and clients and insurers need dates to match services to the right episode of care.
Families want to see the number of prenatal and postpartum visits and birth attendance so they know what was covered and what is extra.
These are often pass-through costs or billed separately, and itemizing avoids confusion about the global fee.
Insurers and reimbursement requests usually require provider credentials, and many states require licensure to be identifiable.
Clients seeking out-of-network reimbursement will need codes such as global obstetric care codes and diagnosis codes.
Installment plans mean most invoices show several credits, and a clear balance prevents disputes.
If a client transfers to a hospital or care ends early, the invoice should show the services actually provided, per your written agreement.
A deposit of $500-1,500 at intake or booking is typical to reserve a due-date spot, with the remaining fee split into monthly installments due by 36-37 weeks. Many practices require the full fee before birth, while others allow a small balance after. Insurance and Medicaid claims follow the payer's timeline, and the client is billed for any portion not covered. Policies for transfers, miscarriage, and early termination of care should be written in the care agreement, including what is refunded. Accepted methods commonly include checks, bank transfer, debit and credit cards, and HSA or FSA cards. Late fees are less common in this field than payment plans, so many midwives address late payments by agreement rather than penalty.
Pregnancy can end early, clients can transfer care, and births can happen before the final installment. A signed agreement stating what is refunded at each stage prevents the hardest billing conversations.
Collecting after birth is harder because families are focused on the baby and may have new expenses. Finishing installments by 36-37 weeks keeps your income predictable.
Many families can recover part of the fee from their insurer or use HSA or FSA funds. A clear superbill with codes and your credentials makes that easier and sets you apart.
Labs, ultrasounds, medications, and newborn screening fees are better listed on separate lines so clients can see the global fee is for your professional care.
Track visit dates alongside payment dates. If a client transfers care or an insurer asks questions, you can show exactly what was provided and paid.
Most independent midwives use a global fee because it matches how families budget for pregnancy. Bill per visit only for care outside the package, such as extra visits, well-woman exams, or clients who join late.
Yes. A superbill lists your credentials, NPI, dates of service, CPT codes, diagnosis codes, and fees charged. Reimbursement depends on the client's plan, so say you cannot guarantee it.
Your care agreement should state this in advance. Many midwives keep the full fee if labor care began, while others prorate. Invoice according to the written policy and itemize what was provided.
Many midwives set it at 36-37 weeks, before the birth window opens. Check your state rules and your agreement, and adjust for clients on sliding-scale or insurance payment arrangements.
Health care services are generally not subject to sales tax, but supplies you sell may be taxed in some states. Check with your state revenue department or a tax professional.
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