- Key Takeaways
- The 2027 maternity coding changes delete 17 CPT codes, including global codes 59400, 59510, 59610 and 59618, effective January 1, 2027.Â
- Maternity care is now reported in four phases: antepartum and postpartum care with E/M codes, plus new labor management (59080 to 59083) and delivery codes.Â
- For pregnancies that cross January 1, antepartum care is reported with 2026 codes for 2026 visits, and each 2027 visit with its own E/M code.
- Payers are setting their own transition rules, and some, including state Medicaid programs, took effect in September 2026.Â
- CMS has proposed Medicare G-codes that would preserve a global-style option, but the final rule is not expected until November 2026.Â
On January 1, 2027, obstetric coding goes through its biggest overhaul in about three decades. The AMA’s CPT Editorial Panel is retiring the global maternity codes and replacing them with separate reporting for four phases of care: antepartum, labor management, delivery and postpartum.Â
The date is closer than it looks. A patient who started prenatal care this fall will probably deliver after the old codes stop being valid. That means the 2027 maternity coding changes are already reaching pregnancies on your schedule today.Â
This article covers what the AMA changed, which codes go away, how the new codes work, and how to bill a pregnancy that crosses January 1. It also covers where Medicare and your other payers still have decisions to make.Â
What Changed in the CPT 2027 Maternity Care Section
The restructure touches 35 codes: 17 deleted codes, 12 new codes and 6 revised codes. The AMA’s reasoning is that one bundled code no longer matches how obstetric care is delivered. Global codes no longer reflect contemporary team-based obstetric care, growing complexity and varied care patterns such as telehealth and consultations. Reporting care by phase gives payers and practices a clearer record of what was done, and when.Â
Under the new structure:Â
- Antepartum care is billed per encounter using E/M codesÂ
- Labor management has its own codes for the first timeÂ
- Delivery is reported with new vaginal and cesarean delivery codesÂ
- Postpartum care is billed per encounter using E/M codesÂ
For a practice, the shift is concrete. Under the global model, a routine pregnancy produced one professional claim after delivery. From 2027, it produces a claim for each prenatal visit, each day of labor management, the delivery itself and each postpartum encounter.Â
Payment values follow a separate track. The RUC submitted its recommendations to CMS in February 2026, and final values are scheduled for publication in early November 2026 for implementation on January 1, 2027. The RUC also affirmed that, if CMS adopts them, the RVUs for the new codes are anticipated to be budget neutral.
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Which Global OB Codes Are Deleted in 2027
Group | Deleted codes | What they covered |
Global packages | 59400, 59510, 59610, 59618 | Antepartum, delivery and postpartum care (vaginal, cesarean, VBAC, cesarean after attempted VBAC) |
Delivery only | 59409, 59514, 59612, 59620 | Delivery without antepartum or postpartum care |
Delivery plus postpartum | 59410, 59515, 59614, 59622 | Delivery and postpartum care, no antepartum care |
Antepartum only | 59425, 59426 | 4 to 6 visits, or 7 or more visits |
Postpartum only | 59430 | Postpartum care as a separate procedure |
Other | 59050, 59525 | Fetal monitoring by a consulting physician; hysterectomy after cesarean |
Only four of these are true global packages. The others are the component codes practices used for split care, and they are retired at the same time. The AMA’s postpartum guidance confirms the deletion of 59430, the delivery-plus-postpartum codes (59410, 59515, 59614, 59622) and the global codes that included postpartum care (59400, 59510, 59610). Â
Deleted codes are invalid for dates of service on or after January 1, 2027, and claims systems and clearinghouses should reject them. Any chargemaster entry, fee schedule or payer contract that names one of these codes needs updating before then. For how the global package works for 2026 dates of service, see our guide to global obstetrical package billing. Â
The New 2027 Maternity Billing Codes, Phase by Phase
Phase | How it is reported from January 1, 2027 | Codes |
Antepartum | Per encounter, by setting, using MDM or time | E/M codes (TH modifier where the payer requires it) |
Labor management | Per calendar day: initial or subsequent, straightforward or complex | 59080, 59081, 59082, 59083 |
Delivery | Delivery only, including placenta and routine same-day postpartum care | 59431, 59432, 59502, 59503 |
Postpartum | Inpatient hospital E/M and discharge, then outpatient E/M | E/M codes |
Related procedures | Cesarean hysterectomy, third- and fourth-degree repair, uterine tamponade | 59504, 59433, 59434, 59623 |
Antepartum CareÂ
Each prenatal encounter is reported with the appropriate E/M service based on the patient’s location, such as office, hospital or telehealth, and standard E/M rules apply using medical decision making or time. The revisions do not assign a fixed level of complexity to a patient across all antepartum visits. Each visit is judged on its own. Â
To identify pregnancy-related encounters, the AMA points to ICD-10-CM pregnancy codes such as Z34 or chapter O codes, and to the HCPCS TH modifier where applicable. Whether TH is required is a payer decision. Â
Labor Management Codes for 2027Â
Four new codes, each reported per calendar day:Â
- 59080: Initial day labor management, straightforwardÂ
- 59081: Initial day labor management, complexÂ
- 59082: Subsequent day labor management, straightforwardÂ
- 59083: Subsequent day labor management, complexÂ
The bar for “straightforward” is strict. Every criterion must be met: singleton vertex presentation, routine maternal and fetal monitoring, no physician intervention needed on fetal monitoring, normal progression or routine induction, stable medical conditions, and no prior cesarean. Any deviation, such as multiples, non-vertex presentation, deteriorating conditions or a prior cesarean, makes labor management complex. Â
Two rules matter most for coders. Once labor management begins, hospital E/M services by the same clinician stop for that day. And a planned or scheduled cesarean has no labor management code. Â
DeliveryÂ
Vaginal delivery is reported with 59431, or 59432 after a previous cesarean. Both include delivery of the placenta, repair of first- or second-degree lacerations by the delivering clinician or their group, and routine same-day postpartum care. Cesarean delivery is 59502 for a primary cesarean and 59503 for a repeat, typically reported once per delivery regardless of the number of fetuses. Â
If a patient labors before a cesarean, for example in a failed trial of labor, labor management may still be reported separately. Third- and fourth-degree repairs are reported with 59433 and 59434, and a hysterectomy at the same encounter as a cesarean is reported with new code 59504. Â
Postpartum CareÂ
Routine same-day postpartum care is included in the delivery code. After the day of delivery, inpatient care is reported with subsequent hospital care E/M codes per day until discharge, then a discharge day management code. Outpatient postpartum visits are reported with E/M codes under usual rules. New code 59623 covers uterine tamponade for postpartum hemorrhage.Â
How to Bill Pregnancies That Span January 1, 2027
This is where most of the transition risk sits. No single code covers a pregnancy that crosses the date. Practices report antepartum care separately for each calendar year, using the codes and guidelines in effect when the services were provided.
For 2026 antepartum care:Â
- 1 to 3 visits: E/M codesÂ
- 4 to 6 visits: 59425Â
- 7 or more visits: 59426Â
The 4-to-6 and 7-or-more codes are reported at the conclusion of the last encounter, so the date of service should generally reflect the final antepartum encounter included in the code. From January 1, 2027, each prenatal visit is its own E/M service, and the delivery is reported with the new labor management and delivery codes.
A Worked ExampleÂ
This is a fictional timeline for illustration only:Â
Date | Service | How it is reported |
Sept 8 to Dec 29, 2026 | Five prenatal visits | 59425, dated Dec 29, 2026 |
Jan to Mar 2027 | Each prenatal visit | One E/M code per visit, with TH if the payer requires it |
Mar 18, 2027 | Admitted in labor; singleton vertex, no prior cesarean, uncomplicated labor; vaginal delivery the same day | 59080 + 59431 |
Mar 19, 2027 | Inpatient postpartum day | Subsequent hospital care E/M |
Mar 20, 2027 | Discharge | Hospital discharge day management |
Apr 2027 | Postpartum office visit | Office E/M |
E/M levels depend on what each visit’s documentation supports. Under the global model, a thin prenatal note cost nothing. In 2027, it can cost you the visit.Â
Your Payers May Set Different RulesÂ
The AMA’s guidance is the CPT baseline. Several payers have already published their own transition rules, and some take effect before January:Â
- MassHealth: issued billing guidance effective September 1, 2026 for prenatal services furnished before the new coding structure takes effect, and plans further guidance in 2027.Â
- New Mexico Medicaid: ties its rules to the date of the first prenatal visit. For pregnancies with a first 10-week visit on or after September 1, 2026, practices bill existing E/M codes with the TH modifier if there are fewer than four encounters before 2027.Â
- Blue Cross VT: told providers that prenatal claims for dates of service before September 1, 2026 should be billed with 59425 or 59426.Â
These are examples, not a complete list. Ask each of your top payers for its transition policy in writing, especially for claims that won’t go out until after delivery.
Medicare and the Proposed Obstetric G-Codes
Medicare adds a second variable. In its CY 2027 Physician Fee Schedule proposed rule, CMS adopted the AMA’s recommendations to update the maternity care code set effective January 1, 2027. CMS is also considering 15 new HCPCS G-codes that would preserve a global maternity payment option for Medicare alongside the new CPT structure.Â
ACOG has pushed back. ACOG welcomed the inclusion of the new CPT codes but objected directly to the proposed G-codes. Its concern is that running two billing structures at once adds administrative burden for obstetric practices. Â
CMS accepted comments through September 14, 2026, and is expected to release the final rule later this fall. Until then, the Medicare side is unsettled. Â
For most OB practices, Medicare is a small share of deliveries, so Medicaid and commercial payers will shape the transition more than CMS. But if the G-codes are finalized, a practice with Medicare patients could be running two maternity workflows in 2027.Â
What Unbundled Maternity Billing Means for Your Revenue Cycle
The change is less about how much you get paid and more about how and when.Â
- Timing shifts. Revenue that arrived in one post-delivery payment now arrives encounter by encounter. That can bring cash in earlier, but it also means many more claims, each with its own chance of denial.Â
- Documentation carries more weight. Every prenatal and postpartum visit has to support the E/M level billed, and labor management notes have to support straightforward or complex.Â
- Contracts need attention. If a payer agreement or fee schedule names 59400, 59510 or 59610, find out how the payer will pay for 2027 dates of service. A payer contract review before January is cheaper than an underpayment discovered in March.Â
- Claim edits will change. The AMA expects claims editing to flag combinations that should not be reported together, such as straightforward and complex labor management by the same physician on the same date.Â
Don’t plan for a revenue bump. Plan for a timing shift and more places where small errors cost money.
How to Prepare Before January 1, 2027
For practice leadersÂ
- Count the patients due on or after January 1, and break that count out by payer.Â
- Get each major payer’s transition policy in writing.Â
- Flag contracts and fee schedules that name deleted codes, and start those conversations now.Â
- Record denial rate, days in A/R and reimbursement per delivery for the rest of 2026, so Q1 2027 has a baseline.Â
For coding and billing teamsÂ
- Confirm when your practice management system, EHR and clearinghouse will load the 2027 codes, and when you can test.Â
- Update prenatal and postpartum templates for per-visit E/M documentation.Â
- Train on the labor management complexity criteria and the same-day E/M rule.Â
- Build a list of 2026 patients who will need a 59425 or 59426 close-out.Â
An OB documentation audit on a sample of patients due in early 2027 will show quickly where templates fall short.Â
Conclusion
The 2027 restructure replaces a single bundled claim with phase-by-phase reporting, and the CPT side is settled. What isn’t settled is how each payer will apply it, and whether Medicare adds a G-code option. Practices that identify their crossover patients, confirm payer rules in writing and fix documentation templates this quarter will start 2027 with fewer surprises. Practices that wait will likely find out from denials.Â
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Sources
- CPT 2027 Maternity Care Services code changes, American Medical AssociationÂ
- FAQs: CPT 2027 Maternity Care Services code changes, American Medical AssociationÂ
- FAQs: CPT 2027 coding for maternity care spanning the transition date, American Medical AssociationÂ
- AMA clarifies billing for maternity care spanning 2026 and 2027, California Medical AssociationÂ
- Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule, Centers for Medicare & Medicaid ServicesÂ
- ACOG statement on new maternity codes in the 2027 Medicare Physician Fee Schedule proposed rule, American College of Obstetricians and GynecologistsÂ
- Unbundling Global Maternity Services, New Mexico Health Care AuthorityÂ
- June 2026 Global Maternity Coding Changes Notification, Blue Cross VTÂ
- CMS Releases CY 2027 Medicare Physician Fee Schedule Proposed Rule, Society of Gynecologic OncologyÂ
Frequently Asked Questions
Is 59400 being deleted in 2027?
Yes. 59400, 59510, 59610 and 59618 are deleted along with 13 other maternity codes. They remain valid for dates of service through December 31, 2026.Â
Will payers accept global OB codes for 2027 dates of service?
Not under CPT. The AMA states that deleted codes are invalid for dates of service on or after January 1, 2027. Medicare could still adopt its own G-codes, but those would be separate HCPCS codes, not the old CPT global codes.
Are the CMS obstetric G-codes final?
No. They were proposed in July 2026, and the final rule is expected in November 2026.
How do I bill antepartum care that spans 2026 and 2027?
Report 2026 visits with 2026 rules: E/M codes for 1 to 3 visits, 59425 for 4 to 6, or 59426 for 7 or more, dated at the last 2026 visit. Report each 2027 visit with its own E/M code. Check payer-specific rules first, since some differ.Â
Is the TH modifier required on prenatal visits in 2027?
It depends on the payer. The AMA suggests considering TH where applicable to mark maternity-related services, and some Medicaid programs already require it.
