2027 OB Global Code Retirement: Crosswalk, Payer Status & Checklist
On January 1, 2027, CPT® deletes 59400, 59510, 59610, 59618, and 13 related maternity codes. Antepartum and postpartum care move to E/M visits, and labor management and delivery get their own codes. Bringing together all information related to what changes, how to split a pregnancy that crosses 2027, where each payer stands, and what to complete before 31 December, this page is a one-stop version for you to prepare ahead.
One global package becomes four reported phases
The single 9-to-10-month bundle is replaced by service-level reporting. Gynecology codes are not affected.
Antepartum care
Every prenatal visit is reported as it happens with an office/outpatient E/M (99202–99215), leveled by MDM or time. Append modifier TH where the payer requires it. Normal pregnancy counts as a moderate-complexity problem.
Labor management
New. Reported once per calendar day, face-to-face, in addition to delivery. Initial vs. subsequent day; straightforward vs. complex. Not reported for a scheduled cesarean unless labor occurs.
Delivery
Two vaginal and two cesarean codes. 1st/2nd-degree repair is included; 3rd and 4th-degree repair are separately reportable. Routine same-day postpartum care is included in the delivery code.
Postpartum care
Office postpartum visits use E/M codes (e.g. 99213). Inpatient days after delivery use hospital E/M (99221–99239). 59430 is gone.
The 2027 OB crosswalk
Every deleted maternity code and what replaces it for dates of service on or after January 1, 2027. Filter by delivery type.
| Deleted 12/31/2026 | What it covered | Report from 1/1/2027 |
|---|---|---|
| Vaginal delivery | ||
| 59400 | Global: antepartum + vaginal delivery + postpartum | E/M visits (antepartum & postpartum) + 59080–59083 labor mgmt + 59431 |
| 59409 | Vaginal delivery only | 59431 (+ labor mgmt days as applicable) |
| 59410 | Vaginal delivery + postpartum | 59431 + E/M postpartum visits |
| Cesarean delivery | ||
| 59510 | Global: antepartum + cesarean + postpartum | E/M visits + labor mgmt (if labored) + 59502 primary or 59503 repeat |
| 59514 | Cesarean delivery only | 59502 primary / 59503 repeat |
| 59515 | Cesarean + postpartum | 59502/59503 + E/M postpartum visits |
| 59525 | Subtotal/total hysterectomy after cesarean (add-on) | New stand-alone hysterectomy-after-cesarean code (59504; confirm descriptor in CPT 2027 Professional Edition) |
| Vaginal birth after cesarean (VBAC) | ||
| 59610 | Global VBAC: antepartum + vaginal delivery + postpartum | E/M visits + 59080–59083 + 59432 |
| 59612 | VBAC delivery only | 59080–59083 + 59432 |
| 59614 | VBAC delivery + postpartum | 59080–59083 + 59432 + E/M postpartum |
| 59618 | Global: cesarean after attempted VBAC, with antepartum + postpartum | E/M visits + 59080–59083 + 59503 repeat cesarean |
| 59620 | Cesarean after attempted VBAC, delivery only | 59503 |
| 59622 | Cesarean after attempted VBAC + postpartum | 59503 + E/M postpartum |
| Antepartum & postpartum bundles | ||
| 59425 | Antepartum care only, 4–6 visits | E/M per visit (99202–99215), modifier TH per payer policy |
| 59426 | Antepartum care only, 7+ visits | E/M per visit, modifier TH per payer policy |
| 59430 | Postpartum care only | E/M per visit (office) or hospital E/M (inpatient days after delivery) |
| Other | ||
| 59050 | Fetal monitoring during labor by consulting physician, supervision & interpretation | 59051 (revised: consulting physician/QHP, interpretation and report) |
| 59080 | Initial labor day, straightforward |
| 59081 | Initial labor day, complex |
| 59082 | Subsequent labor day, straightforward |
| 59083 | Subsequent labor day, complex |
Straightforward requires every AMA criterion; otherwise it is complex. One code per day per patient regardless of fetuses; a continuous visit across midnight is one service. No separate admission E/M on a labor management day.
| 59431 | Vaginal delivery, with or without episiotomy |
| 59432 | Vaginal delivery after previous cesarean |
| 59502 | Cesarean delivery, primary |
| 59503 | Cesarean delivery, repeat |
Delivery care starts when labor ends or is interrupted—for example, when labor stops progressing, and the physician decides to perform a cesarean. It includes routine postpartum care on the delivery date. Do not bill a separate E/M service that day.
Where each payer stands for now
CPT defines the codes, while each payer sets its own rules for edits, modifiers, bundling, and payment rates. We update this table using payer bulletins and claims from the 100+ OB/GYN practices we serve. Check back each week through January for updates.
| Payer | Status | What they have said | What we are doing for clients |
|---|---|---|---|
| Medicare (CMS) | Final rule pending | CY 2027 PFS proposed rule (July 14) adopts the new CPT codes and also floats 15 HCPCS G-codes that would keep a global-style option for Medicare. ACOG opposes the G-codes. Comment period closed Sept 14; final rule expected on or about Nov 1, 2026. | Both pathways built in our templates. We load whichever CMS finalizes the day the rule drops. |
| Anthem (commercial) | Transition announced | October bulletin confirms the 1/1/2027 CPT change, with implementation tied to the CMS final decision. Current global billing stays in place for 2026 dates of service. | Keep billing global through 12/31. Antepartum visit counts logged per patient so the split is clean. |
| UnitedHealthcare (commercial) | Transition announced | October obstetrical policy notice mirrors Anthem: new codes effective 1/1/2027, pending CMS final rule; do not adopt early. | Same as Anthem. Watching for the UHC reimbursement policy update after the final rule. |
| Cigna | Holding current guidance | Stated in August that it is not changing its maternity billing guidance at this time. No 2027 instructions published yet. | Global through 12/31; requesting written 2027 guidance from provider relations. |
| Aetna | Retiring globals, details TBD | Confirmed the global codes retire 1/1/2027. Separate-code and transition guidance not yet published. | Awaiting bulletin; antepartum documentation already leveled by MDM/time. |
| Blue Cross VT | Early transition live | From Sept 1, 2026, first prenatal visit and subsequent antepartum visits are billed with E/M codes; earlier 2026 dates keep 59425/59426. | Model for how other Blues may move. Already billing E/M + TH where instructed. |
| Highmark | Early transition live | Members due on or after 1/1/2027: E/M + TH. Patients starting maternity care Oct 1 or later enter the new model. | Due-date rule applied at the first OB visit. |
| Capital Blue Cross | Early transition live | E/M + TH for certain new antepartum patients from Sept 1; TH on all maternity codes from Nov 1. | TH modifier added across the board Nov 1. |
| Blue KC | Early transition live | E/M billing from Sept 1 for patients expected to deliver on or after 1/1/2027. | Due-date rule applied. |
| Select Health | Hard cutover 1/1 | Current codes through Dec 31, then E/M + TH. | Clean split at the calendar boundary. |
| Health Plan of Nevada | No 2027 bulletin yet | Continuing current global billing for 2026 dates of service. | Global through 12/31; written guidance requested. |
| State Medicaid programs | Varies by state | Over 40% of US births are Medicaid-financed and each agency sets its own timeline; some will lag the CPT date. Our state-by-state OB Medicaid guidelines track each one. | See your state in the OB/GYN guidelines library |
When pregnancy care spans 2026 and 2027
If a patient’s pregnancy is confirmed in June 2026 & she delivers in February 2027, her care spans two code sets. If the global codes are retired as scheduled, you cannot later use them to bundle her earlier visits.
Count the 2026 antepartum visits
Bill each phase of care as it is provided:
Document each prenatal visit
Record the medical decision-making (MDM) or total time for each visit to support its E/M level. Follow any early-transition requirements from your payers and prepare your documentation for 2027.
Every encounter needs its own ICD-10
Z34.xx for supervision of normal pregnancy (by trimester & parity), Z3A weeks of gestation, O09 for high-risk supervision, Chapter 15 O-codes for complications. Vague Dx that hid inside the global will now drive denials.
Review fee schedules that list global codes
Ask your payer’s provider relations team for the 2027 rates for each new code. Confirm whether prenatal E/M visits have visit limits or patient cost-sharing. ACOG opposes visit limits & prior authorization requirements.
The 10-item readiness checklist
Tick items as you go; this page remembers your progress on this device.
The 2027 OB Transition Kit
The exact templates we built for our own OB/GYN clients, free for any practice that asks.
- Printable 2027 crosswalk (all 17 deleted codes → replacements)
- Prenatal E/M documentation template with MDM prompts and Z34/Z3A/O09 picklist
- Labor management daily note template (straightforward vs. complex criteria)
- Payer transition request letter you can send to provider relations
- Contract addendum language replacing global-code fee terms
- Split-year worksheet for patients due in 2027
2027 OB Coding FAQ
OB/GYN billing is our focus.
If you want a second set of eyes on your 2027 readiness, we'll audit your OB claims and EDD list for free and show you exactly where revenue will leak in January.
Sources: AMA CPT® 2027 Maternity Care Services code changes and guidelines; AAFP maternity coding guidance; ACOG Payment for Obstetric Services; CMS CY 2027 Physician Fee Schedule proposed rule (CMS-1848-P); payer bulletins as cited in the tracker. CPT® is a registered trademark of the American Medical Association. Code descriptions here are paraphrased; the CPT 2027 Professional Edition controls final language. This page is educational and does not replace payer policy. BillingFreedom® is a registered service mark of BillingFreedom LLC.