Texas Levels of Maternal Care Verification Program: Frequently Asked Questions and Resources

Frequently Asked Questions:

What is Texas maternal levels of care designation?

In compliance with the Texas statute, each hospital in Texas must have designation through the Office of EMS/Trauma Systems Office of the Texas Department of State Health Services (DSHS) by Aug 31, 2020 to receive Medicaid reimbursement for obstetrical care. Levels II to IV must have a hospital site survey prior to applying for designation. Level I facilities do not need a site survey and will provide an attestation of its capabilities. 

Why should I consider being surveyed by ACOG?

ACOG has made Levels of Maternal Care a key organizational priority. In 2015, ACOG and the Society for Maternal-Fetal Medicine (SMFM) released a consensus statement that proposes a national classification system for levels of maternal care. Following the release of the consensus statement, ACOG and SMFM developed the Levels of Maternal Care Verification Program. Due to our involvement in developing this crucial initiative, we are uniquely positioned to conduct hospital designation surveys.  

How will ACOG collaborate with Texas hospitals, providers, and organizations?  

ACOG recognizes the critical importance of implementing a program that is specific to Texas, and developed this program with the involvement of key organizations in the state.

We will assess your hospital’s compliance with the Texas Hospital Level of Care Designations for Maternal Care. We will also offer an optional confidential consultation that includes highlighting strengths in your maternal services and recommendations based on ACOG’s clinical guidelines. We believe that this is a two-way collaboration, and will encourage you to share your ideas and insights on ways to improve maternal outcomes and make an impact on the quality of care for Texas mothers.

Is there any obligation to implement the recommendations?

There is no obligation. We realize that each hospital must consider many factors on whether it would be able to implement some, none, or all of the recommendations.

What are the fees for the ACOG site survey?

The fees vary according to the level for which the facility is applying:

  • Level II:  $9,000
  • Level III: $12,000
  • Level IV: $15,000

We offer a discount of $750 per hospital for health care systems that contract with ACOG to survey four or more hospitals, and a discount of $1,000 per hospital for health care systems that contract with ACOG to survey 10 or more hospitals. 

What should I expect if I apply for a survey from ACOG?

After the facility completes and submits the online application, the point of contact, as designated in the application, will receive an email response confirming receipt of the application. Texas staff will follow up with facilities to discuss the site visit process, agreements, forms, scheduling, and address any questions the facility may have.

Please email us at txmaternalcare@acog.org if you have additional questions.




News Release

Levels of Maternal Care Obstetric Care Consensus

DSHS Maternal Designation Levels of Care Information and Webinar Recordings

Maternal Care Designation Tips

ACOG's Texas Levels of Maternal Care Verification Program has collected practical tips from maternal site visits we've completed at each level. We'd like to share them with you at no cost.

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These tips are provided for educational purposes only. This information should not be considered ACOG guidance and is not meant to be authoritative or imply designation. Texas DSHS makes the determination of designation.

Fact Sheet


Dr. Toy’s Top Ten Tips for a Successful Maternal Site Visit



American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188
Mailing Address: PO Box 96920, Washington, DC 20024-9998