IHCP Maternity Billing Changes 2027: Complete Guide to New CPT Codes and Modifiers

Maternity billing changes on January 1, 2027 . The AMA is retiring the global obstetric codes and will be splitting out the various segments of maternity care into separately coded parts: prenatal visits, labor management, delivery, and postpartum care. These changes will be fully implemented by Indiana Health Coverage Programs (IHCP) for fee-for-service and managed claims and will no longer accept global codes on any claim, including when it is the secondary payer. This guideline covers the deleted codes, the new labor management and delivery codes, the required TH and U1 to U4 modifiers, and the crosswalks your team needs to bill correctly from day one.

2027 Maternity CPT Code Changes: What the AMA Is Revising Nationwide

The aim of AMA is to align coding with contemporary obstetric practice and to improve the definition and accuracy of the reporting of maternity services.

Here is a closer look at the major national updates:

• Retirement of long-used maternity codes: Many established maternity codes will be end-dated, including the bundled “global” obstetric payment codes.
• End of global maternity billing: Bundled codes that combined prenatal, delivery, and postpartum services will no longer be used.
• New procedure codes: New CPT codes will split maternity care into separate service categories.
• Updated labor management coding: New codes will be introduced for the initial day and subsequent days of labor management.
• Shift of prenatal and postpartum care to E/M codes: These services will be reported with evaluation and management codes along with maternity-specific modifiers.
• Better national pregnancy data: The changes will improve nationwide visibility into pregnancy-related outcomes and quality data.

Non-Global Maternity CPT Codes IHCP Will Stop Accepting in 2027

The following maternity codes, currently covered by the IHCP, will be end-dated nationwide and cannot be billed for dates of service (DOS) on or after January 1, 2027:

• 59409: Vaginal delivery
• 59425: Antepartum care, 4 to 6 visits
• 59426: Antepartum care, 7 or more visits
• 59430: Postpartum care only
• 59514: Cesarean delivery only
• 59525: Subtotal or total hysterectomy following cesarean delivery
• 59612: Vaginal delivery after a previous cesarean delivery, with or without episiotomy and/or forceps
• 59620: Cesarean delivery after an attempted vaginal delivery following a previous cesarean delivery

Global Maternity CPT Codes IHCP Will Stop Accepting as Secondary Payer in 2027

The following “global” maternity codes, which the IHCP currently covers only when it is the secondary payer, will be end-dated nationwide for dates of service (DOS) on or after January 1, 2027:

• 59400: Vaginal delivery along with care provided before and after delivery
• 59410: Vaginal delivery along with postpartum care
• 59510: Routine obstetric care covering antepartum care, cesarean delivery, and postpartum care
• 59515: Cesarean delivery along with postpartum care
• 59610: Routine obstetric care covering antepartum care and vaginal delivery
• 59614: Vaginal delivery only, after a previous cesarean delivery, with or without episiotomy and/or forceps, including postpartum care
• 59618: Routine obstetric care covering antepartum care, cesarean delivery, and postpartum care, after an attempted vaginal delivery following a previous cesarean delivery
• 59622: Cesarean delivery only, after an attempted vaginal delivery following a previous cesarean delivery, including postpartum care

New Maternity CPT Codes effective January 1, 2027. 

Below are the new maternity codes that will apply for dates of service (DOS) on or after January 1, 2027: 

• 59080: Labor management on the initial day, straightforward, per day
• 59081: Labor management on the initial day, complex, per day
• 59082: Labor management on a subsequent day, straightforward, per day
• 59083: Labor management on a subsequent day, complex, per day
• 59431: Vaginal delivery, with or without episiotomy
• 59432: Vaginal delivery, with or without episiotomy, after a previous cesarean delivery
• 59433: Repair of an episiotomy or laceration, third-degree laceration
• 59434: Repair of an episiotomy or laceration, fourth-degree laceration
• 59502: Primary cesarean delivery
• 59503: Repeat cesarean delivery
• 59504: Subtotal or total hysterectomy performed after or during the same encounter as a cesarean delivery
• 59623: Uterine tamponade, such as with a balloon, catheter, vacuum, or packing material

How IHCP Will Implement the 2027 Maternity CPT Code Changes

The revised maternity CPT codes will be implemented across the board in the IHCP on or after January 1, 2027. These are fee-for-service and managed care billings changes. 

Key IHCP Maternity Billing Changes Effective January 1, 2027

This section outlines the billing changes that will apply to DOS on or after January 1, 2027.

Prenatal Care Billing With E/M Codes and Modifiers

Prenatal care will be reported with E/M codes 99202 to 99215 and 99341 to 99350, along with two maternity-specific modifiers:

• Modifier TH: Obstetrical treatment or services, prenatal or postpartum
• The correct trimester modifier:
  • U1: First trimester, 0 weeks through 14 weeks, 0 days
  • U2: Second trimester, 14 weeks, 1 day through 28 weeks, 0 days
  • U3: Third trimester, 28 weeks, 1 day through delivery

CPT codes 59425 and 59426 will not be accepted by the IHCP for DOS on or after January 1, 2027, as both codes are being deleted nationwide.

Providers need to choose the E/M code level that matches the complexity of the visit. The IHCP also reminds providers to bill an established patient visit when the member has been seen by the practice within the past 36 months, even if it is the first obstetrical visit of the pregnancy.

The IHCP has been accepting prenatal services billed with the appropriate E/M code and modifiers for claims with DOS on or after October 1, 2026.

Prenatal Care Crosswalk for Discontinued Codes 59425 and 59426

The following prenatal care codes are being discontinued for DOS on or after January 1, 2027, along with the E/M codes to report in their place:

• 59425 (Predelivery care, 4 to 6 visits): Report E/M codes 99202 to 99215 or 99341 to 99350, billed with modifier TH and modifier U1, U2, or U3
• 59426 (Predelivery care, 7 or more visits): Report E/M codes 99202 to 99215 or 99341 to 99350, billed with modifier TH and modifier U1, U2, or U3

Note: Notification of Pregnancy (NOP) procedures are not changing. Providers should keep billing procedure code G9997 (Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter) with modifier TH to the appropriate managed care organization. For more details on NOP billing, forms, and other instructions, refer to the Obstetrical and Gynecological Services provider reference module.

New Labor Management CPT Codes 59080 to 59083

New CPT codes will be accepted for labor management. Providers will report:

• Initial day of labor management: 59080 for straightforward or 59081 for complex
• Subsequent day of labor management: 59082 for straightforward or 59083 for complex

These codes separate the professional services performed during labor before delivery. In line with national coding guidelines, labor management should not be billed for planned or scheduled cesarean deliveries.

Delivery Codes and Required Gestational Age Modifiers

Starting January 1, 2027, all current delivery-only and global delivery codes will be discontinued. A crosswalk from the deleted delivery-only codes to their replacement codes is provided below, and the deleted global delivery codes are covered later in this guide.

Professional claims for obstetrical deliveries will still need one of the following modifiers:

• UA: Delivery before 39 weeks that is not medically necessary
• UB: Delivery before 39 weeks of gestation that is medically necessary
• UC: Delivery at or after 39 weeks of gestation

Non-Global Labor and Delivery Code Crosswalk for 2027

The following Medicaid-covered, non-global labor and delivery codes are being discontinued for DOS on or after January 1, 2027. Here are the new codes to report in their place:

• 59409 (Vaginal delivery):
  • Vaginal delivery: 59431
  • Vaginal delivery after a previous cesarean delivery: 59432
  • Postpartum care: Appropriate E/M codes
• 59514 (Cesarean delivery):
  • Primary cesarean delivery: 59502
  • Repeat cesarean delivery: 59503
  • Postpartum care: Appropriate E/M codes
• 59525 (Cesarean delivery with removal of the uterus): 59504
• 59612 (Vaginal delivery after a previous cesarean delivery):
  • Vaginal delivery: 59432
  • Postpartum care: Appropriate E/M codes
• 59620 (Cesarean delivery after an attempted vaginal delivery following a previous cesarean delivery):
  • Labor management: 59080 to 59083
  • Cesarean delivery after a trial of labor with a previous cesarean delivery: 59503
  • Postpartum care: Appropriate E/M codes

Postpartum Care Billing With Modifiers TH and U4

Postpartum visits must be reported with the appropriate E/M code along with modifier TH and modifier U4. Modifier U4 is what identifies the E/M code as a separate postpartum visit rather than a prenatal care visit. Providers can use the same E/M codes for postpartum care that they use for prenatal care.

Postpartum care CPT code 59430 will be discontinued on December 31, 2026, as listed earlier. The crosswalk for this code is provided below.

Postpartum Care Crosswalk for Discontinued Code 59430

The following postpartum care code is being discontinued, along with the E/M codes to report in its place:

• 59430 (Post delivery care): Report E/M codes 99202 to 99215, 99221 to 99223, 99231 to 99233, or 99341 to 99350, billed with modifier TH and modifier U4

IHCP Ends Global Maternity Billing in 2027

“Global” obstetrical codes will no longer be recognized as valid CPT codes. At present, the IHCP accepts global codes only when it is billed as the secondary payer, after the primary payer has paid for the services in part or in full.

Starting with DOS on or after January 1, 2027, the IHCP will not accept global or bundled maternity billing on any claim, even when billed as secondary. Providers will have to bill the prenatal care, labor management, delivery and postpartum care separately, with the appropriate codes for each stage of care. 

Global Labor and Delivery Code Crosswalk for 2027

The following global labor and delivery codes, currently covered only when the IHCP is the secondary payer, are being discontinued. Here are the new codes to report in their place:

• 59400 (Vaginal delivery with care before and after delivery): 59431 or 59432
• 59410 (Vaginal delivery with care after delivery):
  • Vaginal delivery: 59431 or 59432
  • Postpartum care: Appropriate E/M codes
• 59510 (Cesarean delivery with care before and after delivery):
  • Antepartum care: Appropriate E/M codes
  • Labor management: 59080 to 59083
  • Cesarean delivery: 59502 or 59503
  • Postpartum care: Appropriate E/M codes
• 59515 (Cesarean delivery with care after delivery):
  • Cesarean delivery: 59502 or 59503
  • Postpartum care: Appropriate E/M codes
• 59610 (Vaginal delivery with care before and after delivery, after a previous cesarean delivery):
  • Antepartum care: Appropriate E/M codes
  • Labor management: 59080 to 59083
  • Vaginal delivery after a previous cesarean delivery: 59432
  • Postpartum care: Appropriate E/M codes
• 59614 (Vaginal delivery with care after delivery, after a prior cesarean delivery):
  • Vaginal delivery after a previous cesarean delivery: 59432
  • Postpartum care: Appropriate E/M codes
• 59618 (Cesarean delivery with care before and after delivery, after an attempted vaginal delivery following a previous cesarean delivery):
  • Antepartum care: Appropriate E/M codes
  • Labor management: 59080 to 59083
  • Cesarean delivery after a trial of labor with a previous cesarean delivery: 59503
  • Postpartum care: Appropriate E/M codes
• 59622 (Cesarean delivery with care after delivery, after an attempted vaginal delivery following a previous cesarean delivery):
  • Labor management: 59080 to 59083
  • Cesarean delivery after a trial of labor with a previous cesarean delivery: 59503
  • Postpartum care: Appropriate E/M codes

Additional IHCP Maternity Billing Policy Changes for 2027

Along with the code changes, the IHCP is introducing the following maternity billing policy updates.

Prenatal and Postpartum Billing Requirements

• For DOS on or after January 1, 2027, any E/M code billed with modifier TH but without the applicable U modifier will be denied.
• Every prenatal and postpartum service billed as an E/M service must include modifier TH to identify it as a maternity service.
• When modifier TH is billed with one of the prenatal E/M visit codes listed earlier, providers must also add the modifier that indicates the prenatal trimester or postpartum visit:
  • U1: First trimester
  • U2: Second trimester
  • U3: Third trimester
  • U4: Postpartum visit

High-Risk Pregnancy Billing

• The IHCP will end the $10 add-on payment for high-risk prenatal care visits. Providers should instead bill E/M codes that match the complexity level of the visit.
• Under IHCP policy, up to 14 prenatal care visits are reimbursed for a normal pregnancy. The IHCP will continue to reimburse prenatal visits beyond those 14 when the pregnancy is high-risk. This must be shown on the claim by including a diagnosis code from the ICD-10 Diagnosis Codes for High-Risk Pregnancy table in Obstetrical and Gynecological Services Codes, available on the Code Sets webpage at in.gov/medicaid/providers. Additional details on high-risk pregnancy are available in the Obstetrical and Gynecological Services provider reference module.

Concurrent Medical Conditions

Only one E/M code is allowed to be reported for the visit that reflects all of the components or complexity of the visit. Separate concurrent E/M codes won't be allowed as they were previously allowed. 

Drug Administration

The IHCP is keeping its current policy that a drug or vaccine administration procedure code should not be billed separately on the same DOS as a maternity E/M visit. More information is available in the Injections, Vaccines and Other Physician Administered Drugs provider reference module.

Provider Action Steps to Prepare for the 2027 Maternity Coding Transition

To get ready for the January 1, 2027 transition, providers should take the following steps:

• Review the updated CPT guidance published on the AMA website and by the American College of Obstetricians and Gynecologists (ACOG).
• Update billing systems and workflows so discontinued maternity CPT codes are removed.
• Train clinical and billing staff on the new labor management and delivery codes.
• Put modifier TH and the other required modifiers into use for prenatal and postpartum E/M visits.
• Revise internal documentation templates so they support the new coding structure.
• Keep an eye on IHCP provider bulletins for further policy updates.

What This Means for Your Practice

• Remove the sixteen discontinued maternity and global codes from your EHR and charge master, and map them to the new delivery, labor management, and E/M codes before January 1, 2027.
• Set up claim scrubber edits so every prenatal and postpartum E/M claim carries modifier TH with the correct U1 to U4 modifier, since a missing U modifier will be denied.
• Since the IHCP already accepts prenatal E/M billing with TH and trimester modifiers for DOS on or after October 1, 2026, start billing prenatal visits this way now to test your workflow early.
• Check high-risk pregnancy claims to confirm a qualifying diagnosis code is included for visits beyond 14, as the $10 add-on will no longer apply.
• Update provider documentation templates to capture gestational age, labor day and complexity, and full visit complexity so new maternity claims go out clean.
   
• Watch the IHCP bulletin page: the agency says more guidance, training material and updated reference modules are coming.

Need a second set of eyes on your Indiana Medicaid maternity claims?

BillingFreedom's COBGC-certified OB/GYN coders review every maternity and gynecology claim before it goes out. Email info@billingfreedom.com, call (855) 415-3472, or request a free OB/GYN billing audit.
 

Source: Indiana Health Coverage Programs (IHCP), IHCP Announces Updates to Maternity Codes Due to Nationally Recognized Changes, Bulletin BT2026180, published October 27, 2026.