What Is a Certified Nurse Midwife (CNM)?
A Certified Nurse Midwife (CNM) is an advanced practice registered nurse (APRN) who specializes in reproductive health, pregnancy, childbirth, and postpartum care. CNMs are trained to provide both medical and emotional support across the perinatal spectrum, with the clinical authority to diagnose conditions, prescribe medications, and oversee delivery.
In the U.S., CNMs must hold a graduate-level nursing degree, national board certification from the American Midwifery Certification Board (AMCB), and appropriate state licensure. While commonly associated with labor and delivery, CNMs also provide comprehensive primary care services for women across the lifespan, including well-woman exams, contraception management, and gynecologic counseling.
Within CMS care frameworks, CNMs are recognized as Qualified Health Professionals (QHPs), enabling them to supervise staff, bill directly for services, and lead care teams—particularly in women’s health, Medicaid perinatal programs, and rural underserved populations.
Key Functions of a CNM in Care Management Settings
Certified Nurse Midwives bring a dual expertise in clinical care and supportive counseling, making them essential providers in integrated and value-based care teams. Their contributions span primary care, chronic disease prevention, maternity support, and postpartum monitoring—especially for Medicaid and underserved populations.
In CMS-aligned care settings, CNMs may:
-
Serve as the primary provider for prenatal, intrapartum, and postpartum care
-
Manage routine and complex pregnancies within their licensure scope
-
Prescribe medications and coordinate treatment for reproductive health conditions
-
Bill Medicare or Medicaid directly for services under their NPI
-
Lead care teams for Maternity Care Home models or similar bundled-payment programs
-
Supervise clinical staff such as RNs, LPNs, or doulas
-
Document time for Principal Care Management (PCM) or other relevant CMS codes when managing chronic or high-risk maternal conditions
Because CNMs operate under an advanced practice license, they are well-positioned to support longitudinal, relationship-based care, especially for women navigating multiple pregnancies, social risk factors, or chronic comorbidities.
The Role of a CNM in Care Delivery
Certified Nurse Midwives (CNMs) play a central role in perinatal and reproductive health delivery, often serving as the lead provider for low- to moderate-risk pregnancies and primary gynecologic care. Their training blends medical, emotional, and psychosocial competencies, offering a holistic approach to maternal and preventive care.
In a care delivery context, CNMs often:
-
Serve as the primary point of contact throughout the pregnancy journey—from prenatal visits through labor, delivery, and postpartum recovery
-
Offer family planning services, contraception counseling, and menopause support
-
Provide education and advocacy to patients in underserved, rural, or Medicaid-supported settings
-
Manage common conditions (e.g., UTIs, STIs, menstrual disorders) and refer more complex cases to OB/GYNs
-
Address social determinants of health by coordinating with doulas, case managers, or behavioral health providers
-
Deliver babies in hospital, birthing center, or home settings (based on licensure and credentialing)
Unlike traditional nurses or general NPs, CNMs specialize in continuity of reproductive care, which makes them vital to population health strategies for women of childbearing age.
Billing and Supervision Rules for Certified Nurse Midwives (CNMs)
Certified Nurse Midwives (CNMs) are considered Qualified Health Professionals (QHPs) by the Centers for Medicare & Medicaid Services (CMS). This grants them full authority to bill independently, supervise team members, and participate in value-based care models—often in rural or maternal health initiatives.
Billing Eligibility:
-
CNMs can bill Medicare Part B and state Medicaid programs using their National Provider Identifier (NPI)
-
They are eligible to report time-based codes including:
-
Principal Care Management (PCM)
-
Chronic Care Management (CCM) when managing qualifying conditions (e.g., gestational diabetes, hypertension)
-
Annual Wellness Visits (AWVs) and preventive screenings for women
-
-
CNMs may also participate in Maternity Bundled Payment models or Accountable Care Organizations (ACOs)
Supervision Scope:
-
CNMs can supervise clinical staff (e.g., RNs, LPNs, medical assistants)
-
They may delegate tasks such as vitals gathering, patient education, and care plan implementation
-
In most states, CNMs can practice independently or under collaborative agreements with physicians, depending on state law
-
They may also serve as clinical preceptors or team leads in maternal health programs
Overall, CNMs function as autonomous providers in many regions—particularly within Medicaid or maternal care frameworks—ensuring women receive high-touch, coordinated care without relying solely on OB/GYN availability.
Frequently Asked Questions about Certified Nurse Midwives (CNM)
1. What is a Certified Nurse Midwife (CNM)?
A CNM is an advanced practice registered nurse (APRN) with specialized training in reproductive, prenatal, and postpartum care. CNMs are licensed to provide medical care and deliver babies in various settings.
2. Is a CNM a type of doctor?
No. CNMs are not physicians, but they are licensed to provide many of the same services in reproductive care, especially for low- to moderate-risk pregnancies. They collaborate with OB/GYNs for high-risk cases.
3. Can CNMs bill Medicare or Medicaid?
Yes. CNMs are considered Qualified Health Professionals (QHPs) and can bill CMS programs directly for services, including prenatal care, contraception counseling, and postpartum support.
4. What’s the difference between a CNM and an OB/GYN?
A CNM is an advanced practice nurse; an OB/GYN is a physician. CNMs focus on holistic care for normal pregnancies, while OB/GYNs handle surgical and high-risk procedures.
5. Do CNMs only deliver babies?
No. CNMs also provide general reproductive healthcare, including Pap smears, STI treatment, menopause management, and patient counseling.
6. Where do CNMs typically work?
CNMs work in hospitals, birthing centers, clinics, and sometimes home settings. They often serve rural or underserved populations through Medicaid or federally funded programs.