Texas Levels of Maternal Care Verification Program: Frequently Asked Questions


Who is ACOG?

The American College of Obstetricians and Gynecologists (ACOG) is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, ACOG strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. 

What is ACOG’s mission? 

The College, as the premier organization for obstetricians and gynecologists and providers of women’s health care, will provide the highest quality education worldwide, continuously improve health care for women through practice and research, lead advocacy for women’s health care issues nationally and internationally, and provide excellent organizational support and services for our members.

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. 

On the DSHS website, you can find information about maternal designation levels of care and DSHS webinar recordings for each level. To access the webinar recordings, scroll down the page to, “Maternal Levels of Care Designation” and you’ll see, “Provider training webinars/Webinar recordings.”

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, the Levels of Maternal Care Verification Program was developed through a partnership led by ACOG and SMFM, and included a core team of representatives and clinicians from the Centers for Disease Control and Prevention, American Academy of Family Physicians, American College of Nurse-Midwives, Arizona Perinatal Trust, and National Perinatal Information Center. This team developed the new Levels of Maternal Care Verification Program—which involves a comprehensive on-site review to verify the maternal level of care of a hospital in alignment with the ACOG/SMFM guidelines.  ACOG collaborated with a number of hospitals in diverse geographic locations and with different staffing capacities and capabilities to pilot-test the program and ensure it could be customized by hospitals to meet their unique circumstances.

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 has developed a program with the involvement of key organizations in Texas. In addition, ACOG has opened an office in Texas dedicated to partnering with your hospital to improve maternal outcomes—and working together to decrease maternal mortality and severe maternal morbidity in the state.

ACOG 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.

To apply for a site survey, simply fill out the online application.

Is there any obligation to implement any part of the ACOG consultation?

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

ACOG offers a discount of $750 per hospital for health care systems that contract with ACOG to survey four or more of their hospitals.

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

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

We anticipate that the first 8–10 site visits, which will serve as “pilots” to evaluate the program and further refine the processes, will begin in early summer and likely last into the fall of 2018. We will then follow with regularly scheduled site visits starting in the fall – winter time frame. 

If you have any questions, please email us at txmaternalcare@acog.org.


Request an ACOG site visit survey 


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