Neonatal System Development

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The purpose of the Neonatal Levels of Care Designation is to comply with 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 neonatal levels of care designation rule became effective on June 9, 2016 and the designation for neonatal level of care is an eligibility requirement for Medicaid reimbursement beginning September 1, 2018. The Perinatal Advisory Council (PAC) is developing recommendations for the maternal rules.


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Neonatal System Development


Survey Organizations 

Advisory Council and Subcommittee

  • 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.

  • The Centers of Excellence for Fetal Diagnosis and Therapy
    The Centers of Excellence for Fetal Diagnosis and Therapy subcommittee advises the PAC and the Texas Health and Human Services Commission in the development of rules to establish the criteria a health care entity or program in the state of Texas will have to meet to receive designation as a Center of Excellence for Fetal Diagnosis and Therapy 

Neonatal Facility Designation



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

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


Resource Documents

These tools may be used to evaluate your facilities compliance with the Neonatal Level of Care that you will be applying for. 

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:

Neonatal Application Packet Submission and Completion of the Self Audit Tool- September 14, 2016
View System Requirements

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: Neonatal 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 19, 2022