Maternity billing is undergoing one of its most significant coding restructurings in recent years. Beginning January 1, 2027, the American Medical Association (AMA) will replace the traditional global maternity care reporting structure with separate reporting for antepartum care, labor management, delivery, and postpartum services.

For years, obstetric practices have commonly used global maternity codes to represent multiple services delivered throughout pregnancy and the postpartum period. Although this approach simplified billing, it did not always reflect how maternity care is delivered across multiple providers, facilities, and care teams.

The revised CPT structure is designed to provide more detailed reporting of individual services and better reflect modern obstetric care.

According to the AMA, the 2027 update includes 17 deleted codes, 12 new codes, and six revised codes. The changes become effective January 1, 2027.

For OB-GYN practices, this transition affects coding procedures, claim preparation, EHR configurations, payment reconciliation, and staff responsibilities.

Practices that continue using the previous global maternity billing workflow for 2027 dates of service may encounter invalid code submissions, claim rejections, and reimbursement delays.

Why the Global Maternity Billing Model Is Changing

The traditional global obstetric package generally combines several stages of maternity care into one reporting structure. Depending on the service and applicable requirements, it can include prenatal care, delivery, and postpartum services.

However, maternity care has become more complex. Patients may receive prenatal services from one physician, labor management from another provider, delivery care at a hospital, and postpartum follow-up from a separate clinical team.

This creates challenges when a single global code is expected to represent care delivered by different providers or organizations.

Limitations of the Previous Billing Structure

The traditional approach can create several operational difficulties:

• Multiple provider involvement: Different clinicians may participate in prenatal, labor, delivery, and postpartum care.

• Patient transfers: High-risk pregnancies may require transfers between hospitals or specialized facilities.

• Variable prenatal schedules: Patients may receive different numbers and types of prenatal encounters.

• Telehealth services: Remote consultations and other virtual encounters require appropriate service-level reporting.

• Postpartum care differences: The timing and complexity of postpartum services can vary considerably.

The revised CPT structure separates maternity services into more specific reporting categories. This gives practices a clearer way to report the services they actually provide.

For billing departments, however, greater reporting detail also means more responsibility for accurate encounter-level coding and documentation.

What Changes in the CPT 2027 Maternity Code Structure?

The new maternity reporting framework separates care into four primary phases: antepartum, labor management, delivery, and postpartum.

Each phase has different coding and reporting requirements.

1. Antepartum Care: Individual E/M Reporting

Beginning January 1, 2027, antepartum encounters will be reported using appropriate evaluation and management (E/M) codes rather than the previous global antepartum care codes.

The applicable E/M code should reflect the actual service provided, documentation, and relevant CPT requirements.

This allows practices to report prenatal encounters according to the location and nature of the service, including office, hospital, and telehealth settings when applicable.

Billing teams should review how prenatal encounters are documented and ensure that each reported service supports the selected E/M level.

2. Labor Management: New Daily Reporting Codes

The 2027 CPT structure introduces separate labor management codes for initial and subsequent days.

The new codes distinguish between straightforward and complex labor management:

Labor management includes applicable clinical work such as examinations, monitoring, interpretation of physiological information, and labor induction or augmentation.

The reporting structure requires attention to the calendar date, facility admission, provider involvement, and applicable code guidelines.

Practices should not automatically assign a complex labor management code based only on a high-risk pregnancy diagnosis. The documented circumstances must support the applicable coding criteria.

3. Delivery Care: Separate Vaginal and Cesarean Reporting

Delivery care will also have a revised coding structure.

The new codes distinguish between vaginal delivery and cesarean delivery, including relevant delivery circumstances.

Examples include:

• 59431: Vaginal delivery, with or without episiotomy.

• 59432: Vaginal delivery, with or without episiotomy, following a previous cesarean.

• 59502: Primary cesarean delivery.

• 59503: Repeat cesarean delivery.

The new structure separates delivery care from labor management when both services are appropriately reportable.

Certain services, including applicable laceration repairs and additional obstetric procedures, also have distinct reporting provisions.

Billing teams should review the complete 2027 CPT code descriptions and guidelines rather than relying solely on older global maternity coding references.

4. Postpartum Care: Separate E/M Reporting

The previous standalone postpartum care codes will be deleted and replaced with appropriate E/M reporting under the new structure.

This means postpartum encounters must be documented and coded according to the actual services provided.

For facility births, subsequent hospital care codes may be used for applicable management days following the delivery date until discharge.

Routine postpartum care furnished on the same calendar day as delivery is incorporated into the delivery care code under the new guidelines.

Practices should review their postpartum scheduling, documentation, charge capture, and claim submission procedures to avoid missing separately reportable services.

How to Handle Pregnancies That Cross January 1, 2027

One of the most important challenges for OB-GYN billing teams is the transition for patients whose pregnancies begin in 2026 but continue into 2027.

These cases require careful handling because the applicable reporting structure changes according to the date of service.

The AMA has issued specific transition guidance addressing antepartum encounters that occur in both calendar years.

Reporting Antepartum Visits During 2026

For antepartum visits furnished in 2026, the existing 2026 CPT guidelines continue to apply.

Under the AMA's transition guidance:

• Four to six antepartum visits during 2026 are reported using CPT 59425.

• Seven or more antepartum visits during 2026 are reported using CPT 59426.

• Three or fewer antepartum visits during 2026 are reported individually using appropriate E/M codes.

Practices should not apply the 2027 reporting structure retroactively to services furnished during 2026.

Reporting Antepartum Visits During 2027

For services furnished on or after January 1, 2027, the revised CPT guidelines apply.

Antepartum encounters will be reported individually using appropriate E/M codes rather than waiting to submit a traditional global antepartum code.

This means one pregnancy may involve different reporting approaches across two calendar years.

For example, a patient may have several prenatal visits during 2026 and continue receiving prenatal care during 2027. The 2026 encounters must follow the previous reporting rules, while the 2027 encounters must follow the revised CPT structure.

Why Transition Management Matters

If billing teams fail to separate services by date of service, they may:

• Submit deleted codes for 2027 encounters.

• Report 2026 services using incorrect guidelines.

• Overlook separately reportable prenatal visits.

• Create duplicate charges or inconsistent claim records.

• Experience payment delays while correcting claims.

Practices should create a transition process for patients already receiving maternity care before the new coding structure takes effect.

How the 2027 Changes Affect OB-GYN Medical Billing and Reimbursement

The transition creates additional billing responsibilities for obstetric practices. Instead of managing one broad global maternity claim, billing teams must accurately capture and report services across multiple phases of care.

This can affect both administrative workload and financial performance.

Increased Charge Capture Requirements

With separate reporting for antepartum, labor, delivery, and postpartum services, practices need a reliable process for capturing each billable encounter.

Missed encounters can result in unbilled services and lost revenue.

Billing teams should coordinate with clinical staff to ensure that completed services are recorded and transferred into the billing workflow.

More Detailed Coding Reviews

The new structure requires coders to understand the differences between labor management, delivery care, and postpartum services.

They must also distinguish between straightforward and complex labor management based on applicable documentation and code guidelines.

Incorrect code selection can result in claim edits, denials, and payment discrepancies.

Greater Need for Accurate Provider Attribution

When multiple physicians or facilities participate in maternity care, the billing team must identify which provider performed each service and whether the organization is eligible to report it.

This is especially important when patients transfer between facilities or receive care from separate obstetric teams.

Changes to Payment Reconciliation

The previous global payment structure and the revised service-level reporting approach are not interchangeable.

Practices should review payer fee schedules, reimbursement arrangements, and contract language to understand how the new reporting structure affects expected payments.

Medicare, Medicaid, and commercial payers may have different implementation instructions. Practices should verify payer-specific requirements rather than assuming that every plan will process the transition identically.

Common 2027 Maternity Billing Mistakes to Avoid

The transition to the new CPT structure creates several opportunities for billing errors, particularly during the first months of implementation.

OB-GYN practices should monitor the following areas.

Using deleted global maternity codes for 2027 services: The previous global maternity codes will no longer be valid for dates of service on or after January 1, 2027. Claims must follow the new reporting structure.

Applying 2027 rules to 2026 encounters: Services furnished during 2026 must continue to follow the applicable 2026 CPT reporting guidelines.

Combining labor management and delivery incorrectly: These services have separate reporting requirements. Billing teams should review the documentation and applicable CPT instructions before submitting both.

Incorrectly selecting labor complexity: Straightforward and complex labor management are distinct reporting categories. Documentation must support the selected code.

Missing postpartum encounters: Postpartum services must be captured according to the new reporting structure. Practices should not assume that every postpartum service is automatically included in the delivery claim.

Ignoring payer-specific transition policies: Medicaid programs and commercial insurers may issue separate implementation instructions. Practices should verify their requirements before submitting claims.

Failing to update billing software: Outdated code libraries, charge templates, and claim edits can cause avoidable rejections and rework.

How OB-GYN Practices Can Prepare for the 2027 Transition

Preparing for the new maternity billing structure requires coordination between providers, coders, billers, administrators, and EHR vendors.

A structured implementation plan can help practices reduce disruptions and maintain accurate claim submissions.

1. Update CPT Code Libraries

Ensure that billing software and EHR systems contain the appropriate 2027 maternity codes and descriptions.

Remove outdated codes from applicable 2027 charge templates and review claim-scrubbing rules.

2. Review Patients With Ongoing Pregnancies

Identify patients whose maternity care spans the 2026 and 2027 calendar years.

Separate encounters by date of service and establish a process for applying the correct reporting guidelines to each period.

3. Train Providers and Billing Staff

Educate clinical and administrative teams on the differences between antepartum, labor management, delivery, and postpartum reporting.

Providers should understand what documentation is needed to support the services performed, while billing staff should understand the corresponding code requirements.

4. Review Payer Contracts and Policies

Contact Medicare Administrative Contractors, Medicaid programs, and commercial payers where appropriate to confirm implementation requirements.

Review fee schedules and reimbursement arrangements to identify potential payment differences under the new reporting structure.

5. Strengthen Claim Audits

Review a sample of maternity claims during implementation to identify coding errors, missing encounters, incorrect service attribution, and payer-specific issues.

Use the findings to update internal procedures and staff training.

6. Monitor Denials and Reimbursement

Track claims submitted under the new structure and review rejection reasons, payment discrepancies, and outstanding balances.

Early monitoring can help identify systematic problems before they affect a larger volume of claims.

Why Outsourced OB-GYN Medical Billing Support Can Help

Managing the transition to the 2027 maternity coding structure can be challenging for practices with limited billing resources.

Internal teams must continue processing daily claims while learning new code requirements, updating systems, and resolving payer questions.

An experienced medical billing partner can help practices manage these responsibilities through structured coding review, claim processing, denial follow-up, and payment monitoring.

When evaluating an outsourced billing company, OB-GYN practices should consider whether it provides:

• OB-GYN billing knowledge: Familiarity with obstetric and gynecological coding requirements.

• Charge capture support: Processes for identifying and recording separately reportable maternity services.

• Claim review: Pre-submission checks for incorrect codes, missing information, and payer-specific requirements.

• Denial management: Investigation and correction of rejected or underpaid claims.

• Accounts receivable follow-up: Monitoring outstanding balances and unresolved claims.

• Payment reconciliation: Comparing expected reimbursement with actual payer payments.

• Billing performance reporting: Regular visibility into claims, collections, and denial trends.

Practices seeking broader billing support can explore medical billing services to understand how professional billing workflows can help manage claim accuracy and reimbursement.

A qualified billing partner should also help identify recurring issues instead of simply resubmitting corrected claims without addressing the underlying cause.

How The Medicator's Supports OB-GYN Billing Operations

The Medicator's provides medical billing and revenue cycle support for independent practices, specialty groups, and multi-location healthcare organizations.

For OB-GYN practices, accurate billing requires coordination across prenatal care, procedures, delivery-related services, postpartum encounters, and payer requirements.

The Medicator's supports medical practices through:

• Medical billing and coding workflow support.

• Claim preparation and submission.

• Billing quality checks.

• Denial identification and follow-up.

• Payment posting and reconciliation.

• Accounts receivable management.

• Revenue cycle performance analysis.

As the 2027 maternity coding changes take effect, practices should review their existing billing processes to identify outdated code references, incomplete charge capture, and opportunities to improve claim management.

A structured review can help administrators understand where billing errors originate and which workflows need attention.

Need support managing your OB-GYN billing operations? Contact The Medicator's at (888) 277-1460 or visit the contact page to discuss your practice's requirements.

Conclusion: Prepare Your OB-GYN Practice for the 2027 CPT Transition

The 2027 maternity billing changes represent a significant shift from traditional global obstetric reporting to separate reporting for antepartum care, labor management, delivery, and postpartum services.

With 17 deleted codes, 12 new codes, and six revised codes, practices must update their billing systems, train staff, and review their claim workflows before and after implementation.

Pregnancies that cross January 1, 2027, require particular attention because services furnished in 2026 and 2027 follow different reporting guidelines.

OB-GYN practices that prepare early, maintain accurate documentation, and monitor payer processing can reduce avoidable billing errors and improve revenue cycle consistency during the transition.

Professional medical billing support can also help practices manage the additional administrative work while keeping their focus on patient care.