Midwives

Midwives in B.C. offer primary health care to healthy pregnant people and their newborn babies from early pregnancy, through labour and birth, and up to six weeks postpartum. Midwifery services are a benefit under the B.C. Midwifery Program for eligible B.C. residents enrolled with MSP.  Midwives are funded by the Ministry of Health.

The British Columbia College of Nurses and Midwives (BCCNM) is the regulating body for midwives.

This page has information for midwives on enrolling with MSP, payment schedules and referrals that midwives can make.

On this page:

Enrolment with MSP

Midwives are eligible to enrol with MSP and obtain an MSP billing number. Enrolment is contingent on continued registration with the British Columbia College of Nurses and Midwives (BCCNM).

Licensed midwives who register with MSP are called "enrolled" midwives. Enrolled midwives can bill MSP directly for eligible services provided to eligible MSP beneficiaries.

The services of a midwife who is not enrolled or is no longer enrolled are not MSP benefits. These services can be billed directly to the patient for an amount more than that set in the midwifery payment schedule, provided the patient is advised of the practitioner's payment protocol before the service is rendered.

MSP billing numbers

Each practitioner enrolled with MSP is assigned a billing number consisting of two numbers:

• a practitioner number, which identifies the practitioner rendering the service, and
• a payment number, which identifies the person or group (e.g. clinic, hospital) to which payment is to be made.

The practitioner and payment numbers are usually the same. However, they differ where a practitioner designates another practitioner or a group, such as a clinic or hospital, to receive that practitioner's MSP fee-for-service payments. For more information, visit Assignment of Payment.

All claims submitted to MSP must include the practitioner number of the practitioner who performed the service. A practitioner cannot bill under another practitioner's number. The practitioner whose number appears on the MSP claim assumes full responsibility for the service provided.

How to enrol

Complete form HLTH 2996 – Application for MSP billing number (midwives) (PDF, 126KB).

Attach a copy of your BCCNM registration, available from the BCCNM online directory.

Sign and mail the form and copy of your registration to:

Health Insurance BC Provider Programs
PO Box 9840 Stn Prov Govt, Victoria B.C. V8W 9E7

Health Insurance BC (HIBC) will mail written confirmation of applicant’s MSP practitioner number.

Referrals

Midwives can make referrals to many medical specialists, and directly request many diagnostic procedures and laboratory tests.

Medical specialists that midwives may refer to for consultations – under review

SPECIALTY	SPECIALTY CODE
ANAESTHESIA	18
CARDIOLOGY	26
CLINCIAL IMMUNOLOGY AND ALLERY	45
DERMATOLOGY	01
ENDOCRINOLOGY	51
GASTROENTEROLOGY	56
GENERAL SURGERY	08
HEMATOLOGY ONCOLOGY	74
INFECTIOUS DISEASES	67
INTERNAL MEDICINE	15
NEPHROLOGY	59
OBSTETRICS & GYNAECOLOGY	05
ORTHOPEDIC SURGERY	10
PAEDIATICS	14
PSYCHIATRY	03

Procedures that midwives may request directly for patients – under review

FEE ITEM NAME	FEE CODE
AMNIOCENTESIS, TRANSABDOMINAL	00787
DOPPLER ECHOCARDIOGRAPHY	08679
EXTREMITY B SCAN	08658
FOETAL HEART MONITORING  - INTERPRETATION ONLY	00790
GUIDED AMNIOCENTESIS	04680
INJECTION, VENEPUNCTURE	00012
OBS B SCAN (14 WKS GESTATION OR OVER) - ADD FETUSES	86051
OBS B SCAN < 14 WKS/NUCHAL TRANSLUCENCY - ADD FETUS	86056
OBS.B-SCAN < 14 WKS/NUCHAL TRANSLUCENCY-SINGLES	86055
PELVIC B SCAN – NON-OBSTETRICAL	08653
RENAL B SCAN	08649

Laboratory tests that midwives may request directly for patients

Midwives may request some laboratory tests. For the list of laboratory tests that midwives may request, view the Practitioner schedules on the Provincial Laboratory Medicine Services website.

Visit Laboratory services for health professionals for information on laboratory service benefits under the Laboratory Services Act.

To make an outpatient referral to an approved laboratory facility for an MSP funded laboratory test, complete the following steps:

1. Use the HLTH 1901 – Standard out-patient laboratory requisition (PDF, 628KB) form, or equivalent. Complete all fields. This information ensures test results are sent to the appropriate ordering practitioner/worksite. 

2. If copies to a physician are required, complete the Copy To Physician/MSP Practitioner Number section (upper right-hand side of form).

3. Select the appropriate box(es) on the requisition for the test or tests being ordered or use the Free Text box.

4. Sign and date the form before providing it to the patient.

Agreements and service contracts

The following information is intended to assist midwives on service contracts in tracking services provided.

• HLTH 1974 – Midwifery alternative payment arrangement application (PDF, 1.4MB)
• Midwifery contract reporting requirements (PDF, 134KB)
• Midwifery service contract templates: Questions and answers (49.8KB)

Scope of Services

All midwifery services provided under service contract (both clinical and non-clinical) are to be within regulated midwifery scope as set out in the Health Professionals Act and Midwives Regulation B.C. (Reg. 103/95).  

Clinical Services are traceable to one or more patients, with direct patient care typically involving care provided to individuals during normal pregnancy, labour, delivery, and the postpartum period.  

Non-Clinical Services are not traceable to a specific patient(s), and typically include providing pre/postnatal health prevention and promotion activities; health care/service planning activities; participating in the development and implementation of protocols or pathways; and coordinating perinatal training for nurses and/or other medical staff.  

The following documents are related to the most recent agreements between the Midwives Association of BC and the Ministry of Health.

• Temporary amendments to Consultive Care and Assessment Fee Item notes (PDF, 128KB) - Updated February 1, 2021
• 2022-2025 Midwifery Main Agreement and Rural Subsidiary Agreement (PDF, 1.4MB)  – signed March 7, 2024

Payment schedule and billing codes

Midwives can provide a wide array of services to their patients. However, only the services listed in the MSC (Medical Services Commission) Payment Schedule can be billed to MSP.

The midwifery Payment Schedule identifies the terms and conditions of payments to midwives for midwifery services rendered.

Payments for midwifery services are made through the MSP claims submission and processing system - usually electronically via Teleplan. Midwifery services provided to MSP beneficiaries who are out of the province cannot be claimed as MSP benefits.

This payment schedule sets out payment for midwifery services rendered to an eligible client in each of the five phases of a full course of care, from conception up to and including six weeks post-partum. Payment is subject to the terms of the Medicare Protection Act.

Midwifery is commonly a shared practice; more than one midwife can deliver services to an eligible client. Only one midwife may bill MSP for the service in accordance with the payment schedule.

View the Midwifery Payment Schedule (PDF, 397KB) for billing codes, terms and definitions.

HIBC contact information

All inquiries about enrolment with MSP or claims processing and payment issues should be directed to HIBC Practitioner Services.

604-456-6950 (Vancouver)
1-866-456-6950 (Elsewhere in B.C.)