Maternal Levels of Care Designation

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The purpose of the Maternal Levels of Care Designation is to implement House Bill 15, 83rd Legislature, Regular Session, 2013, which added Health and Safety Code, Subchapter H, Hospital Level of Care Designations for Neonatal and Maternal Care, Sections 241.181 - 241.187. House Bill 3433, 84th Legislature, Regular Session, 2015 amended Health and Safety Code, Chapter 241 and requires the development of initial rules to create the neonatal/maternal level of care designation by March 1, 2018. The maternal levels of care designation rule became effective on March 1, 2018 and the designation for maternal level of care is an eligibility requirement for Medicaid reimbursement beginning September 1, 2021. 


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Maternal Levels of Care Development


Survey Organizations 

Advisory Council

  • Perinatal Advisory Council

    The Perinatal Advisory Council, created by House Bill 15 of the 83rd Texas Legislature (Regular Session), develops and recommends criteria for designating levels of neonatal and maternal care, including specifying the minimum requirements to qualify for each level designation and a process for the assignment of levels of care to a hospital, makes recommendations for dividing the state into neonatal and maternal care regions, examines utilization trends in neonatal and maternal care, and recommends ways to improve neonatal and maternal outcomes. 

Maternal Levels of Care Designation



The non-refundable maternal application fees for a three-year designation period are as follows:

  • Level I maternal facility application fees are as follows:
    • <=100 licensed beds fee is $250.00; or
    • >100 licensed beds fee is $750.00.
  • Level II maternal facility application fee is $1,500.00.
  • Level III maternal facility application fee is $2,000.00.
  • Level IV maternal facility application fee is $2,500.00.


Resource Documents

These tools may be used to evaluate your facilities compliance with the Maternal Level of Care that you will be applying for. 
The complete self-assessment tool for Level I facilities with the specific documents to be submitted in the application packet will be posted on June 1, 2018 with the application for designation.

Provider training webinars: Introduction and review of the new requirements. Recordings of the training are listed below. Each link will take you to a page where you must enter your name and email address to access the video.  Webinar recordings:

PowerPoint presentations from webinars:

Contact Us

By email

By mail

Send mail correspondence to: 
Person's name  
Texas Department of State Health Services  
EMS/Trauma Systems 
Attn: Maternal Designation Program  
PO Box 149347 MC 1876 
Austin, Texas 78714-9347

Staff Contacts

For general assistance, please contact:
Courtney Ennis  - (512) 289-1867
For designation process or rule clarification, please contact: 
Perinatal Designation Coordinators
Debbie Lightfoot, R.N. - (512) 987-0565

Kathie Stephens, R.N. - (512) 987-0638 

Designation Program Manager
Elizabeth Stevenson, R.N. - (512) 284-1132

Last updated January 13, 2022