Beginning January 1, 2027, CPT will retire the global obstetric package and replace it with separate reporting for antepartum care, labor management, delivery, and postpartum care. Antepartum and postpartum visits will be reported using individual E/M codes, allowing reimbursement to more accurately reflect the services provided by individual practitioners.
The current codes and global obstetric package coding model for reporting maternity care has been in effect for over 30 years. Over the last three decades there have been many changes in how obstetric care is managed and delivered. Notable changes include evolution in the scope and intensity of labor management and postpartum care and the provision of care by multiple unaffiliated providers. Using a bundled payment model like global care does not accurately reflect this more intense level of service and makes reimbursement across multiple providers a challenge. To more precisely report and reimburse for these services the AMA is changing the payment model and restructuring the codes available for reporting maternity care.
Changes to CPT include deletion of 17 codes, the addition of 12 codes and revision of six codes. The updates also include new subsections and revised guidelines, and the relocation of some existing codes.
In the past, changes to CPT coding have more commonly included the consolidation of services, such as adding the provision of imaging to the work included in primary procedure codes. However, beginning on Jan 1, 2027, the global obstetric package, which reports bundled services, will be retired and maternity care will be reported with codes for four individual phases of pregnancy:
This change allows for reporting of individual services by individual providers.
The biggest change comes in how antepartum and postpartum encounters with a provider are reported and billed. The global package codes for these services are being deleted and provision of these services will now be reported per individual encounter with the appropriate E/M codes. This changes the billing timeline for many patients from bundled billing to ongoing billing per encounter. This also increases the importance of the ability to accurately select E/M codes for individual visits for maternity care.
As the Jan 1, 2027, implementation date draws closer watch for Health Information Associates to release comprehensive educational material related to the updates. In the meantime, please visit CPT® 2027 Maternity Care Services code changes | American Medical Association to download a PDF with the CPT 2027 codes, descriptors and guidelines for maternity care services and review FAQs related to the upcoming changes.
To learn more about the foundations of accurate selection of CPT codes for E/M services please visit HIALearn.com to review the course Provider Training: Coding and Documentation Fundamentals.
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For more than 30 years, HIA has been the leading provider of compliance audits, coding support services and clinical documentation audit services for hospitals, ambulatory surgery centers, physician groups and other healthcare entities. HIA offers PRN support as well as total outsource support.
The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.