How OBGYN Practices Can Prepare for the 2027 Maternity Billing Changes

The 2027 maternity billing changes will significantly alter how OBGYN practices report maternity care. Beginning January 1, 2027, the CPT maternity care structure will move away from the traditional global model toward more detailed reporting across four phases: antepartum care, labor management, delivery, and postpartum care. The American Medical Association (AMA) has confirmed that 17 existing codes will be deleted, 12 new codes will be added, and six codes will be revised.

For OBGYN practices, this is not simply a coding update. It can affect documentation, EHR workflows, charge capture, claims submission, payer contracts, reimbursement, AR, and denial management.

Practices that begin preparing now will have more time to test their systems, train staff, review payer requirements, and identify potential revenue risks.

For a broader explanation of the upcoming changes, see What Is the 2027 Maternity Billing Change and How Should OBGYN Practices Prepare?.

Understand What Is Changing

The most important step is understanding how maternity services will be reported in 2027.

Under the new CPT structure:

Antepartum care will generally be reported using the appropriate E/M code for each encounter.

Labor management will have new codes that distinguish initial and subsequent days and straightforward versus complex management.

Delivery care will use new delivery-specific codes for vaginal and cesarean deliveries.

Postpartum care will generally be reported using appropriate E/M services rather than the current postpartum global codes.

This means practices will need more detailed charge capture throughout the pregnancy instead of relying primarily on one global maternity claim.

Start With a 2026 Baseline

Before changing the billing process, understand how your practice performs under the current system.

Review at least six to twelve months of maternity billing data and identify:

• Number of maternity patients
• Average prenatal visits
• Delivery volume
• Vaginal versus cesarean deliveries
• Postpartum visits
• Payer mix
• Average reimbursement
• Denial rate
• Underpayment rate
• Maternity AR
• Average days to payment

This baseline will help administrators compare 2027 results against historical performance.

It will also help identify which payers and service categories could have the greatest financial impact.

Identify Pregnancies That Cross Into 2027

One of the most important transition issues is the patient whose maternity care begins in 2026 but continues into 2027.

The AMA states that maternity services provided in 2026 continue to follow the 2026 reporting guidelines, while the new reporting structure applies beginning January 1, 2027. Practices should also confirm any special transition policies with individual payers.

Create a transition report containing:

• Patient
• Payer
• Initial prenatal visit
• Expected delivery date
• Services already provided
• Services remaining
• Current billing status
• Applicable payer instructions

This allows the billing team to monitor these pregnancies separately.

Review Every Payer

Do not assume that every payer will handle the transition identically.

Medicare, Medicaid programs, and commercial health plans may have different reimbursement policies, claims-editing requirements, or implementation instructions.

Your payer review should cover:

Coding requirements: Which codes and modifiers must be reported?

Effective date: When will the payer begin accepting the new structure?

Contract language: Does the current contract reference deleted global maternity codes?

Fee schedules: How will reimbursement be calculated?

Claims edits: What code combinations may trigger denials?

Transition rules: How will pregnancies crossing January 1 be handled?

The AMA specifically recommends that health plans and organizations review contracts and fee schedules that reference deleted global codes, update claims systems and edits, coordinate with vendors, and plan for transition scenarios.

Update Your EHR and Billing System

Your billing workflow cannot remain unchanged while the coding structure changes.

Review whether your EHR and practice-management system can capture individual maternity encounters correctly.

Pay particular attention to:

• E/M charge capture
• Labor-management codes
• Delivery codes
• Postpartum encounters
• Modifiers
• Diagnosis coding
• Provider attribution
• Claim edits
• Payment posting
• Denial reporting

The goal is to have the system configured and tested before January 1 rather than discovering problems after claims are submitted.

Train Providers on Documentation

Coding changes also create documentation changes.

Providers should understand that services reported separately must be supported by appropriate documentation.

Training should cover how to document:

• Prenatal encounters
• Medical decision-making
• Time when applicable
• High-risk pregnancy management
• Labor management
• Delivery services
• Postpartum encounters
• Complications and additional procedures

The new structure is designed to provide more granular reporting of maternity care, so documentation needs to accurately reflect the care delivered.

Train Coders and Billers Separately

Providers are not the only people who need training.

Coders should understand the new code definitions and guidelines.

Billers should understand:

• Claim sequencing
• Modifier requirements
• Payer-specific rules
• Rejection management
• Denial follow-up
• Payment posting
• Underpayment identification

Consider running sample maternity cases through the entire revenue cycle before implementation.

Build a Maternity Revenue Forecast

The new structure could change the timing and visibility of reimbursement because services will be reported more granularly.

Review your historical maternity volume and model potential 2027 scenarios.

For example, compare:

2026 global maternity revenue

versus

Estimated 2027 revenue from antepartum + labor management + delivery + postpartum services.

Do not assume that the change will automatically increase or decrease revenue. Actual results will depend on payer policies, contracts, utilization, coding accuracy, and final payment values.

The AMA notes that CMS released proposed relative values in July 2026 and plans to publish final values in November 2026 for implementation January 1, 2027.

Create a Payer-Specific Billing Matrix

A simple internal matrix can help keep your team organized.

Payer	2027 Structure	Effective Date	Modifier Rules	Fee Schedule	Notes
Medicare	Verify final policy	Jan. 1, 2027	Confirm	Pending final policy	Monitor CMS
Medicaid	Verify state policy	Confirm	Confirm	Confirm	Review state guidance
Commercial A	Confirm	Confirm	Confirm	Confirm	Contact payer
Commercial B	Confirm	Confirm	Confirm	Confirm	Contact payer

Update this document whenever a payer releases new guidance.

Test Before January 1

Do not wait for the first 2027 claim to test your workflow.

Run representative cases through your billing system, including:

• Routine prenatal care
• High-risk pregnancy
• Multiple prenatal encounters
• Labor management
• Vaginal delivery
• Cesarean delivery
• Postpartum care
• Complicated deliveries
• Pregnancies that cross from 2026 into 2027

Look for claim-edit problems, missing charges, incorrect modifiers, and payer-specific issues.

Monitor Denials From Day One

The first quarter of 2027 should receive close revenue-cycle attention.

Track maternity-specific:

• Claim rejection rate
• Denial rate
• Days in AR
• Underpayments
• Corrected claims
• Appeal volume
• Appeal success
• Payment turnaround
• Payer-specific denial trends

The purpose is to identify problems early.

If one payer begins rejecting a large percentage of maternity claims, the practice should investigate the common cause rather than treating every denial as an individual problem.

Watch for Revenue Leakage

A more detailed billing model creates more opportunities to capture services, but it can also create new forms of revenue leakage.

For example, a practice could lose revenue if:

• a prenatal encounter is not captured,
• a postpartum service is missed,
• the wrong E/M level is reported,
• a required modifier is missing,
• a delivery service is incorrectly coded,
• a payer rejects a valid claim, or
• staff continue following the old global-billing workflow.

A monthly maternity revenue audit can help identify these issues.

Review Your Billing Partner

Your billing partner should have a clear 2027 implementation plan.

Ask:

1. Have you reviewed the new CPT maternity codes?
2. How will you handle pregnancies crossing January 1?
3. Have payer policies been reviewed?
4. Has the billing system been tested?
5. How will maternity denials be monitored?
6. How will underpayments be identified?
7. What reports will management receive?
8. How will coding and documentation issues be communicated to providers?

If the answers are unclear, the practice has time to address the problem before implementation.

For practices reviewing their billing support options, Best OBGYN Billing Companies 2026 can provide another starting point for evaluating billing partners.

A Practical Preparation Timeline

August–September 2026

Review the CPT changes, establish your current maternity revenue baseline, and begin payer research.

October 2026

Update EHR workflows, billing configurations, documentation templates, and internal procedures.

November 2026

Begin claim testing, complete staff training, and review CMS's final payment policies when released.

December 2026

Finalize payer-specific workflows, review transition pregnancies, complete testing, and establish January monitoring reports.

January 2027

Launch the new process and closely monitor claims, denials, payments, AR, and underpayments.

The Goal Is a Controlled Transition

The 2027 maternity billing changes are significant, but OBGYN practices have time to prepare.

The key is to treat the transition as a revenue-cycle project rather than only a coding project.

Coding, documentation, EHR configuration, payer contracts, claims submission, payment posting, denial management, and financial reporting all need to work together.

Final Thoughts

The transition to the 2027 maternity care CPT structure will change how OBGYN practices capture and report services. The AMA says the new framework is intended to provide more granular reporting across antepartum, labor management, delivery, and postpartum care and better reflect contemporary team-based obstetric care.