Perinatal and Neonatal Referral Centers

The Maryland perinatal and neonatal systems are modeled after American College of Obstetrics and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) standards of care. These standards range from Level I (basic perinatal and neonatal care) to Level IV (high-risk perinatal and neonatal care). MIEMSS is responsible for oversight of the Level III and IV Maryland perinatal and neonatal referral centers, which include 15 hospitals offering obstetric services. Of these 15 hospitals, 13 are Level III perinatal and neonatal centers, and two are Level IV centers.

Abby Butler
Director, Perinatal and Neonatal Referral Centers
443-531-3311 (cell)  |


Hospital Year of
III Anne Arundel Medical Center 2021
III Frederick Health Hospital 2022
III Greater Baltimore Medical Center 2022
III Holy Cross Hospital 2022
III Johns Hopkins Bayview Medical Center 2022
IV Johns Hopkins Hospital 2020
III Johns Hopkins Howard County General 2022
III MedStar Franklin Square Medical Center 2021
III Mercy Medical Center 2021
III Saint Agnes Hospital (Ascension) 2022
III Shady Grove Medical Center (Adventist) 2022
III Sinai Hospital of Baltimore (LifeBridge Health) 2022
III Univ of MD Capital Region 2023
IV Univ of MD Medical Center 2020
III Univ of MD Saint Joseph's Medical Center 2022



In 1997, MIEMSS incorporated the Level III, Level III+ and Level IV Perinatal Standards from the Maryland Perinatal System Standards from the Maryland Department of Health (MDH) in to regulations for the purpose of maternal-neonatal transports. MIEMSS began the designation process for the Level IV Perinatal Centers.  Hospital designation site visits for Level IV centers were on December 14-15, 2000.  Site visits for all centers were completed in 2003.

We have a review team that is comprised of MIEMSS staff, two members of the MDH staff and out of state specialty care physicians.  As members of the review team, we familiarize ourselves with each hospital’s application and the designation standards, inspect the hospital’s physical plant, interview the team members and management personal and examine the perinatal documents which will include patient care records and protocol manuals. Perinatal Referral Centers are designated as Level III.

We have adopted the MDH Perinatal System Standards as the standards that we use as a part of COMAR. Current regulations are available on the Division of State Documents webpage.

COMAR Title 30 Subtitle 08 refers to the regulations that apply to the designation of specialty referral centers.  Chapter 12 regulations are specific to the perinatal and neonatal centers.

30.08.12 – Perinatal and Neonatal Referral Center Standards
Pages - COMAR Search (


Each perinatal center must comply with the perinatal system standards.  Determining that a center is in compliance with the appropriate standards is part of the verification process.  The designation can be either provisional or full.  A full designation is for a period not to exceed 5 years.

MIEMSS has enforcement powers and may take appropriate disciplinary action if an investigation determines that a specialty referral center has violated the regulations. Disciplinary action could include requiring corrective action, placing a referral center on probation, lowering a center’s level of designation, or suspending or revoking the designation.

For more information about Perinatal Programs at MIEMSS, please call the Office of Perinatal Programs at (443) 531-3311.

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