Global OB Billing Is Changing in 2027. Practices Need Answers Before January.

For OB/GYN practices, the upcoming maternity coding changes reach far beyond updating numbers in a billing system. They affect how care is documented, when claims are submitted, how reimbursement is negotiated, and what patients are told about their financial responsibility.

Beginning January 1, 2027, the CPT maternity care structure replaces traditional global obstetric codes with separate reporting for prenatal care, labor management, delivery, and postpartum care. The update includes 17 deleted codes, 12 new codes, and six revised codes.

The opportunity is clearer recognition of the care clinicians actually provide. The challenge is making sure payer policies, contracts, and billing systems keep up.

What changes?

Under the new structure, prenatal encounters use appropriate evaluation and management—or E/M—codes. Labor management receives its own codes, distinguishing initial and subsequent days and straightforward versus complex care. Delivery is reported separately, followed by appropriate E/M reporting for postpartum encounters after the delivery date.

Familiar codes—including 59400, 59425, 59426, and 59430—are being deleted for 2027 dates of service. Practices cannot simply keep their existing maternity billing templates and replace the delivery code.

Labor management becomes visible

Managing labor and performing the delivery are distinct parts of maternity care. The new structure allows both to be reported when the clinician performs both services, including on the same date.

That does not mean every clinician covering a shift can submit an additional labor management charge. The rules distinguish coverage from a medically necessary escalation or transfer of care. Practices need documentation and workflows that reflect those distinctions.

Delivery and postpartum care have their own rules

New delivery codes distinguish vaginal delivery, vaginal birth after cesarean, primary cesarean, and repeat cesarean.

Vaginal delivery reporting still includes specified work, such as placenta delivery and first- or second-degree laceration repair by the delivering clinician or group. Third- and fourth-degree repairs have separate new codes.

Routine postpartum care on the delivery date remains included in the delivery code. Later inpatient and outpatient postpartum encounters use appropriate E/M codes under the applicable guidelines.

Separating phases of care does not make every component separately reportable. Teams still need to understand what each code includes.

Pregnancies crossing January 1 need attention now

A patient due in February 2027 may already be receiving care in 2026. Waiting until January to decide how to report those encounters creates an avoidable problem.

The AMA’s September transition guidance says 2026 antepartum services remain subject to 2026 reporting rules. For care spanning the transition:

• Three or fewer prenatal encounters in 2026 use individual E/M reporting.

• Four to six use 59425.

• Seven or more use 59426.

• Prenatal encounters in 2027 use appropriate E/M codes.

Practices should also confirm payer transition policies. For example, five prenatal encounters in 2026 followed by additional visits in 2027 would be reported with 59425 for the 2026 care and appropriate individual E/M codes for the 2027 encounters.

A 2027 due date alone is not a reason to switch every 2026 visit to the new reporting structure.

New codes do not answer the payment questions

The CPT update establishes how services are reported. Practices still need written answers about reimbursement, claims processing, and benefits.

For each payer, ask:

• What rates will apply to prenatal E/M, labor management, delivery, and postpartum services?

• How will care spanning 2026 and 2027 be processed?

• Which modifiers, claim edits, or submission requirements will apply?

• How will patient responsibility be determined for each service?

• Will contracts or fee schedules referencing deleted codes be updated?

The AMA specifically calls for payer preparation involving contracts, fee schedules, systems, and claims edits. As of October 4, 2026, the Medicare payment values discussed in its guidance remain proposed, with a final rule expected in November. Practices should not present proposed values as guaranteed reimbursement.

Patients need an explanation, too

Patients accustomed to a maternity package may see more individual claim entries. Practices should explain which services those entries represent and review existing estimates and deposits against the payer’s transition policy.

More claim lines do not, by themselves, establish what a patient owes. Staff need verified benefit information before promising either no patient responsibility or a copayment at every visit.

Patients should receive a clear explanation before an unexpected statement arrives.

Preparation needs to happen across the practice

Review documentation templates, code selections, payer agreements, estimates, and collection workflows together. Train clinicians and billing staff on E/M requirements and the new maternity guidelines. Identify patients whose care will cross the implementation date.

At Sunshyn Credentialing and Medical Billing, our position is straightforward: practices need usable payer instructions before they submit claims, and patients deserve explanations grounded in their actual coverage.

January 1 is the coding deadline. The work to protect reimbursement and patient trust starts now.

Sunshyn practice resources

For help with billing workflows in your maternal health practice, see Sunshyn's maternal health billing support.

For a structured look at claims and billing workflows, explore the Insurance Billing Mastery learning pathway in the Sunshyn Learning Center.