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, 2020. 


Maternal Facility Designation


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

Related Programs 

Survey Organizations 

American College of Obstetricians and Gynecologists

Texas Perinatal Services

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

Comparison Document for Maternal Levels II, III and IV Requirements

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
Obstetric Care Consensus

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:

Level I Designation – March 22, 2018
Level II Designation – March 27, 2018
Level III Designation – March 28, 2018
Level IV Designation – March 29, 2018

PowerPoint presentations from webinars:

Level I PowerPoint presentation
Level II PowerPoint presentation
Level III PowerPoint presentation
Level IV PowerPoint presentation

Contact Us

Staff Contacts

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

Shyriece Norris- (512) 231-5748

For process or rule clarification, please contact the following: 

Perinatal Designation Coordinators

Debbie Lightfoot, RN – (512) 231-5614

Alisha Wilkin, RN – (512) 834-6743

Danielle Vargas, R.N. – (737) 218-7069

Vicki Gloria, R.N. – (737) 218-7079

Designation Program Manager

Elizabeth Stevenson, RN – (512) 834-6794


Last updated December 17, 2018