The American Medical Association approved new billing codes that end bundled pregnancy billing starting in January 2027, replacing the longstanding 13-visit global package with a more itemized, fee-for-service approach. For clinicians, that opens path for separate billing of prenatal visits, remote monitoring, postpartum care, and delivery services that were previously folded into one code.

The Move

• The AMA approved new maternity care billing codes for use beginning in January 2027.

• Current pregnancy and delivery billing generally uses bundled “global” codes built around 13 prenatal visits, regardless of whether a patient receives fewer, more, or more complex services.

• The new structure allows clinicians and hospitals to bill more individual components of care separately, including prenatal visits, remote monitoring, postpartum care, and labor and delivery services.

Why it Matters for Care

• The change better matches payment to actual work when patients need more surveillance, telehealth, home monitoring, or intensive postpartum follow-up.

• That is especially relevant as OB-GYNs manage rising maternal risks tied to mental health conditions, hemorrhage, and cardiac conditions.

• At the bedside, clinicians may have stronger financial support for care that has been hard to capture under one global code.

Between the Lines

• ACOG has argued the old payment model no longer reflects modern maternity care or the variation in labor complexity and postpartum needs.

• Moving away from bundled billing creates incentives to document and code each service more precisely — but also raises concern that fee-for-service could drive higher utilization and spending.

• The politics are familiar: specialty societies want payment aligned with clinical complexity, while payers and policy experts worry about downstream cost growth in an already expensive area of care.

What to Watch

• How commercial insurers, Medicaid programs, and hospital revenue-cycle teams implement the codes before the January 2027 start date.

• Whether payers treat more services as preventive maternity care under the Affordable Care Act or shift more costs to patients for labor, delivery, and other nonpreventive services.

• Whether states, regulators, and employer plans push back if itemized maternity billing increases total spending.

Source: Straight Arrow News