Maternal Levels of Care Designation

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, 2020. 

Register for Hospital Level of Care Designations for Maternal Care Webinars

The rule for Hospital Level of Care Designations for Maternal Care became effective on March 1, 2018. The webinars will clarify questions about the rule content and provide examples of compliance with the different requirements for designation in the rule. The designation process will be described with specifics about survey organizations and designation timelines. Questions about the rule will be accepted at the end of the webinars. 

Rules: Texas Administrative Code, Title 25, Chapter 133, Subchapter K.

Scheduled Maternal Levels of Care Webinars*:

 Level I   Thursday, March 22, 2018, 12:00 PM CDT
 Level II  Tuesday, March 27, 2018, 12:00 PM CDT
 Level IIIWednesday, March 28, 2018, 12:00 PM CDT
 Level IV Thursday, March 29, 2018, 12:00 PM CDT

*Each Level of Care Webinar has a separate registration.

After registering, you will receive a confirmation email containing information about joining the webinar.


The maternal designation rule, effective March 1, 2018 is found at the Texas Administrative Code, Title 25, Chapter 133, Subchapter K.

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

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.

Level I Maternal – Self-Assessment
Level II Maternal – Self-Assessment
Level III Maternal – Self-Assessment
Level IV Maternal – Self-Assessment

Contact Us

Staff Contacts

For technical assistance, call or email the Perinatal Program Specialist:

Jewell Potter - (512) 834-6743

For process or rule clarification, please contact the following: 

Designation Program Manager

Elizabeth Stevenson, RN – (512) 834-6794

Last updated March 19, 2018