Global Maternity Billing Changes will reshape how obstetric services are documented, coded, and reimbursed beginning January 1, 2027.
Beginning January 1, 2027, that familiar model will undergo a major restructuring.
The American Medical Association is revising the maternity-care section of the CPT code set to move beyond the traditional global billing model. According to the AMA, the update includes 35 code changes: 17 deleted codes, 12 new codes, and six revised codes.
This is not a North Carolina-only change.
It is a nationwide CPT update that will affect physicians, health systems, payers, electronic health record vendors, coding teams, billing departments, and other organizations involved in maternity care.
While the effective date may feel distant, the operational work needs to begin now.
Global Maternity Billing Changes: Preparing for the 2027 Transition
The current global maternity model does not always reflect how obstetric care is delivered today.
Maternity services may involve multiple providers, changing care teams, telehealth visits, consultations, transfers of care, complex pregnancies, and different clinicians managing the prenatal, delivery, and postpartum portions of care.
The AMA has explained that global maternity codes no longer adequately reflect modern, team-based obstetric care and varying care patterns. The revised structure is intended to provide greater detail and transparency regarding the individual services performed throughout a pregnancy.
Global Maternity Billing Changes
Beginning January 1, 2027, many of the maternity codes traditionally used to report global or bundled obstetric care will be deleted or revised. The restructured framework will require more granular reporting of maternity services.
For example, the AMA has stated that current postpartum-care codes will be deleted and postpartum services will generally be reported per encounter using applicable evaluation and management codes.
Routine postpartum care performed on the same calendar day as delivery will remain incorporated into the delivery service. For facility births, subsequent hospital care may be reported for each management day following the delivery date through discharge.
New and revised codes will also address specific components of labor management, delivery care, and other maternity services. The complete reporting requirements will depend on the final 2027 CPT code set, payer policies, place of service, provider involvement, and the services documented.
This Is More Than a Coding Update
Organizations that treat this as an annual code-table update may underestimate its impact. The restructuring could affect nearly every point in the maternity revenue cycle.
Provider Documentation
When services are reported separately, documentation must clearly support each individual encounter and service.
Providers may need additional education regarding:
- Visit-level documentation requirements
- Evaluation and management code selection
- Labor and delivery management
- Transfers of care
- Services performed by multiple clinicians
- Postpartum encounters
- Complications and separately reportable services
Documentation that was sufficient to support a global package may not automatically support the more detailed coding structure.
Charge Capture
Organizations will need a reliable method for capturing services that were previously included within a global package. Revenue cycle teams should evaluate whether prenatal visits, hospital management, delivery services, postpartum visits, and related procedures will flow accurately from the clinical record to the billing system.
A missed encounter under a visit-level billing model may become missed revenue rather than simply one component of an already-reported global service.
EHR and Practice Management Configuration
Electronic health record and practice management systems may require substantial updates.
Potential areas of impact include:
- Charge preference lists
- Coding edits
- Claim-scrubbing rules
- Provider templates
- Order and diagnosis mapping
- Charge-routing logic
- Global-period edits
- Fee schedules
- Work queues
- Reporting dashboards
- Interface testing
Organizations should not assume their technology vendors will manage every internal workflow or payer-specific requirement automatically.
Claim Volume and Staffing
Separately reported maternity services may result in a greater number of charges and claims than organizations currently produce under global billing.
Higher claim volume can create additional work across:
- Coding
- Charge review
- Billing
- Payment posting
- Denial management
- Patient-account services
- Payer follow-up
Leaders should assess whether current staffing models and productivity expectations will remain appropriate after implementation.
Payer Reimbursement
Although the CPT changes are national, payer implementation may not be uniform.
Each payer must determine how it will cover, price, edit, and reimburse the new or revised codes. Medicaid programs, Medicare Advantage plans, commercial insurers, and managed-care organizations may release guidance on different timelines.
Organizations should create a payer-readiness tracker that addresses:
- Effective dates
- Covered codes
- Fee schedules
- Modifier requirements
- Authorization rules
- Billing frequency
- Claims-editing logic
- Timely-filing considerations
- Transition rules for pregnancies spanning 2026 and 2027
The CPT restructuring establishes how services may be reported. It does not guarantee that every payer will apply identical payment methodologies.
Why North Carolina Organizations Should Pay Particular Attention
North Carolina Medicaid has already announced that current maternity service codes, including global billing codes, will be removed from its fee schedule beginning January 1, 2027.
That announcement gives North Carolina obstetric practices and health systems an early signal: preparation should not wait until the new year. Organizations serving NC Medicaid beneficiaries should closely monitor additional guidance from NC Medicaid and its managed-care plans regarding reimbursement, system configuration, code requirements, and claims that cross the implementation date.
Commercial payers should be monitored separately because their transition instructions may differ.
The Revenue Risks of Waiting
A poorly managed transition could result in:
- Missed charges
- Incorrect code selection
- Duplicate billing
- Claims-editing failures
- Medical-necessity denials
- Modifier denials
- Unsupported E/M levels
- Underpayments
- Increased accounts receivable
- Higher administrative rework
- Delayed cash flow
The most significant risk may not be one major system failure.
It may be hundreds of small workflow gaps occurring across prenatal offices, hospitals, coding teams, charge-review departments, and payer work queues.
What Revenue Cycle Leaders Should Do Now
Organizations should begin with a cross-functional readiness assessment. The transition provides an opportunity to evaluate your broader Revenue Cycle Management strategy rather than viewing it as only a coding initiative.
The project should include representatives from:
- Obstetric providers
- Clinical operations
- Coding
- Billing
- Revenue integrity
- Compliance
- Information technology
- EHR application teams
- Managed care
- Finance
- Patient financial services
The assessment should address five core areas.
1. Identify Existing Global-Billing Workflows
Document how maternity services are currently scheduled, documented, coded, charged, billed, reconciled, and monitored.
This includes identifying any manual processes that staff members perform outside the EHR.
2. Map the Future Workflow
Determine how separately reportable prenatal, delivery, hospital, and postpartum services will move through the revenue cycle.
Every charge should have a clearly defined source, owner, review process, and reconciliation method.
3. Monitor Payer Guidance
Create an inventory of maternity payers and assign responsibility for monitoring their published policies.
Do not assume that guidance issued by one Medicaid program or commercial payer applies to another.
4. Test Before Implementation
Testing should include more than confirming that a new code appears in the billing system.
Organizations should test complete scenarios involving:
- Prenatal care
- Transfers between providers
- Vaginal delivery
- Cesarean delivery
- Hospital management
- Postpartum care
- Complications
- Multiple clinicians
- Pregnancies that begin in 2026 and continue into 2027
5. Establish Baseline Performance Measures
Before the transition, organizations should document their current maternity revenue-cycle performance.
Useful measures may include:
- Clean-claim rate
- Initial denial rate
- Days to bill
- Charge lag
- Payment variance
- Accounts receivable days
- Avoidable write-offs
- Maternity revenue by payer
- Average reimbursement by delivery type
Without a baseline, it will be difficult to determine whether the new billing structure is causing revenue leakage.
The Bottom Line
The end of traditional global maternity billing is not merely a coding-department issue. It is a clinical documentation, technology, operations, reimbursement, and revenue-cycle transformation.
The organizations best positioned for January 1, 2027, will not be the ones that wait for every payer memo before taking action. They will be the ones that begin mapping workflows, educating teams, testing systems, and identifying financial exposure now.
Revenue cycle leadership is not only about correcting problems after claims are denied. It is about preparing the organization before the first affected claim is ever submitted. Organizations that already have strong Medical Billing Services and revenue cycle workflows in place will be better positioned for the 2027 transition.