Preparing for the Obstetric Code Transition: What OB/GYN Practices Need to Know About 2027 Maternity Billing Changes

Preparing for the Obstetric Code Transition: 2027 Maternity Billing Changes: What OB/GYN Practices Need to Know

Obstetric billing is changing. Starting September 1, 2026, the way antepartum services are coded and billed will shift significantly, and practices that are not prepared will feel it in their revenue cycle.

At BillingFreedom, we have spent over a decade specializing in OB/GYN billing and coding. Our AAPC-certified team understands maternity reimbursement inside and out, from global obstetric packages to E/M documentation, across both commercial payers and Medicaid. We have already mapped the transition, updated our workflows, and are ready to move your practice through this change without disruption.

So you can stop worrying about the September deadline and focus on your patients. Here is everything you need to know.

Rationale for Transitioning Using the CPT Evaluation and Management Codes

• E/M codes for antepartum services are already incorporated into existing contracts, claims processing systems, and electronic health records.
• CPT rules already allow E/M codes when only one to three antepartum visits are provided.
• Leveraging E/M codes allows for a defined education and transition period for antepartum services while minimizing disruption for health plans, OB/GYNs, and coding staff.
• OB/GYNs are already trained in E/M coding, and ACOG has established educational resources.
• Certain Medicaid programs currently use E/M codes for prenatal visits.
• BillingFreedom understands that this approach reduces reliance on retrospective, end‑of‑year billing for bundled prenatal care codes and mitigates the administrative burden associated with high year‑end claim volumes. This is why we ensure that a team of trained professionals is at your disposal to monitor your practice and ensure these codes are put to use, keeping your practice running smoothly.

Transitioning from Global Obstetric Payment

The first antepartum visit is typically at 8–10 weeks of gestation. Based on that first visit, a typical antepartum visit schedule, and a normal gestation, patients who present for their first antepartum visit in the following date ranges will likely use the codes listed:

• Until May 15, the payer may use the global obstetric codes.
• From May 15 to July 14 only: Utilize 59426 + delivery only.
• From July 15 to Sept 1 only: Utilize 59425 + delivery.
• Starting September 1: Transition to E/M codes.

Given these parameters, consider the following examples:

• For pregnancies with a first 10-week visit between January 1, 2026, and August 31, 2026, use the current global obstetric codes, including antepartum-only codes
• For pregnancies with a first 10-week visit on or after September 1, 2026, use the existing E/M codes for antepartum visits, provided they total fewer than 4 encounters prior to 2027. This is consistent with current CPT guidelines.

Criteria for Transition

Starting September 1, 2026, the first prenatal visit after confirmation of pregnancy must be billed with E/M codes and the appropriate ICD-10-CM codes.

*Antepartum care is reported using appropriate evaluation and management (E/M) codes based on the specific location.

Your Practice Does Not Have to Navigate This Alone

The September 2026 transition is one of the most significant shifts in obstetric billing in recent years, and the window to prepare is narrowing. Between understanding the new code structure, updating internal workflows, retraining staff, and ensuring every claim is submitted correctly from day one, the administrative weight of this change is real.

That is exactly where BillingFreedom comes in.

Our team of trained billing and coding professionals has already done the groundwork. We have studied the transition timeline, aligned our processes with the updated CPT guidelines, and built  the systems your practice needs to move through this change without revenue disruption. From the first prenatal visit billed under E/M codes to accurate ICD-10-CM pairing and clean claim submission, we handle every step with precision so your reimbursements arrive on time, every time.

Denied claims, delayed payments, and compliance gaps are not setbacks your practice should be absorbing during a regulatory transition. With BillingFreedom managing your OB/GYN revenue cycle, you can trust that your billing is in the hands of certified professionals who specialize in this and are already prepared for what is coming in September.

Your focus belongs with your patients. Ours is on making sure you get paid for the care you provide.

For more details about our exceptional OB/GYN billing services, please don't hesitate to contact us via email at info@billingfreedom.com or call us at +1 (855) 415-3472. 

Your financial tranquility is our priority!