OB/GYN BILLING & CODING LIBRARY

Every payer we track for OB/GYN billing

National commercial plans, Blue Cross Blue Shield plans, Medicaid managed care and government programs, each with its 2027 maternity billing status.

All payers 152 National 12 State Medicaid 20 Regional 21 Medicaid managed care 46 Medicaid parents 8 Blue Cross Blue Shield 37 Government 5 Other 3

2027 status: ● Final rules● Announced or proposed● No notice yet

National commercial plans · 12 payers

Same policy in every state unless a state plan says otherwise

Aetna All states2027: announced 1 guideline

Ambetter (Centene) FL2027: no notice yet Guide coming soon

Anthem / Elevance CA, CO, CT, GA, IN, KY, ME, MO, NV, NH, NY, OH, VA, WI2027: announced Guide coming soon

Anthem / Elevance Health IN, KY, MO, NV, OH and more2027: announced Guide coming soon

BCBS Federal Employee Program All states2027: not yet reviewed Guide coming soon

Cigna All states2027: keeping global for now Guide coming soon

HCSC IL, MT, NM, OK, TX2027: not yet reviewed Guide coming soon

Humana All states2027: no notice yet Guide coming soon

Kaiser Permanente CA, CO, DC, GA, HI, MD, OR, VA, WA2027: no notice yet Guide coming soon

Molina Marketplace Multi-state2027: no notice yet Guide coming soon

Oscar Health FL2027: no notice yet Guide coming soon

UnitedHealthcare All states2027: announced Guide coming soon

State Medicaid programs · 20 payers

State fee-for-service Medicaid programs

AmeriHealth Caritas New Hampshire NH2027: no notice yet 1 guideline

Arizona Medicaid (AHCCCS) AZ2027: no notice yet 1 guideline

California Medi-Cal CA2027: announced 2 guidelines

Florida Medicaid FL2027: no notice yet Guide coming soon

Health First Colorado (Colorado Medicaid) CO2027: no notice yet 1 guideline

Indiana Medicaid (IHCP) IN2027: no notice yet 1 guideline

Kansas Medicaid (KMAP) KS2027: no notice yet 1 guideline

Kentucky Medicaid KY2027: not yet reviewed Guide coming soon

MaineCare (Maine Medicaid) ME2027: no notice yet 1 guideline

Maryland Medicaid MD2027: no notice yet 1 guideline

Michigan Medicaid MI2027: announced 1 guideline

Mississippi Medicaid MS2027: no notice yet 3 guidelines

Nebraska Medicaid NE2027: final rules 1 guideline

Nevada Medicaid NV2027: no notice yet 2 guidelines

North Carolina Medicaid NC2027: not yet reviewed 1 guideline

Oklahoma Medicaid (OHCA / SoonerCare) OK2027: not yet reviewed 1 guideline

Oregon Medicaid OR2027: announced 1 guideline

South Dakota Medicaid SD2027: no notice yet 1 guideline

Texas Medicaid (TMHP) TX2027: no notice yet 1 guideline

Virginia Medicaid VA2027: announced 1 guideline

Regional commercial plans · 21 payers

Operate in a limited set of states

AvMed FL2027: not yet reviewed Guide coming soon

Banner|Aetna AZ2027: not yet reviewed Guide coming soon

Baylor Scott & White Health Plan TX2027: not yet reviewed Guide coming soon

Community Health Choice Marketplace TX2027: not yet reviewed Guide coming soon

EmblemHealth NY2027: not yet reviewed Guide coming soon

Fidelis Care NY2027: not yet reviewed Guide coming soon

FirstCare Health Plans TX2027: not yet reviewed Guide coming soon

Florida Health Care Plans FL2027: not yet reviewed Guide coming soon

Health Net CA2027: not yet reviewed Guide coming soon

Health Plan of Nevada NV2027: in research Guide coming soon

Healthfirst NY2027: not yet reviewed Guide coming soon

Hometown Health NV2027: not yet reviewed Guide coming soon

Medical Mutual of Ohio OH2027: not yet reviewed Guide coming soon

NC State Health Plan NC2027: not yet reviewed Guide coming soon

PacificSource ID, MT, OR, WA2027: not yet reviewed Guide coming soon

Point32Health ME, MA, NH2027: not yet reviewed 1 guideline

Priority Health MI2027: not yet reviewed Guide coming soon

Prominence Health Plan NV2027: not yet reviewed Guide coming soon

SelectHealth CO, ID, NV, UT2027: not yet reviewed Guide coming soon

Sharp Health Plan CA2027: not yet reviewed Guide coming soon

UPMC Health Plan PA2027: not yet reviewed Guide coming soon

Medicaid managed care plans · 46 payers

Follow the state Medicaid manual plus plan bulletins

Absolute Total Care SC2027: not yet reviewed Guide coming soon

Aetna Better Health of Florida FL2027: not yet reviewed Guide coming soon

Aetna Better Health of Kentucky KY2027: not yet reviewed Guide coming soon

AmeriHealth Caritas North Carolina NC2027: not yet reviewed Guide coming soon

Arizona Complete Health AZ2027: not yet reviewed Guide coming soon

Banner University Family Care AZ2027: not yet reviewed Guide coming soon

CalOptima CA2027: not yet reviewed Guide coming soon

CareSource Nevada NV2027: not yet reviewed Guide coming soon

Carolina Complete Health NC2027: not yet reviewed Guide coming soon

Community Care Health Plan of Nevada NV2027: not yet reviewed Guide coming soon

Community First Health Plans TX2027: not yet reviewed 1 guideline

Community Health Choice TX2027: not yet reviewed Guide coming soon

First Choice by Select Health SC2027: not yet reviewed Guide coming soon

Health Net (Medi-Cal) CA2027: not yet reviewed Guide coming soon

Health Plan of Nevada (Medicaid) NV2027: not yet reviewed Guide coming soon

Healthy Blue North Carolina NC2027: not yet reviewed Guide coming soon

Healthy Blue South Carolina SC2027: not yet reviewed Guide coming soon

Humana Healthy Horizons in Kentucky KY2027: not yet reviewed Guide coming soon

Humana Medical Plan FL2027: not yet reviewed Guide coming soon

Inland Empire Health Plan CA2027: not yet reviewed Guide coming soon

L.A. Care CA2027: not yet reviewed Guide coming soon

Magnolia Health MS2027: not yet reviewed Guide coming soon

Mercy Care AZ2027: not yet reviewed Guide coming soon

Molina Healthcare of California CA2027: not yet reviewed Guide coming soon

Molina Healthcare of Mississippi MS2027: not yet reviewed Guide coming soon

Molina Healthcare of Nevada NV2027: not yet reviewed Guide coming soon

Molina Healthcare of South Carolina SC2027: not yet reviewed Guide coming soon

Molina Healthcare of Texas TX2027: not yet reviewed Guide coming soon

Passport by Molina KY2027: not yet reviewed Guide coming soon

Peach State Health Plan Georgia2027: no notice yet Guide coming soon

SilverSummit Healthplan NV2027: not yet reviewed Guide coming soon

Simply Healthcare Florida2027: no notice yet Guide coming soon

Simply Healthcare Plans FL2027: not yet reviewed Guide coming soon

Sunshine Health FL2027: not yet reviewed 1 guideline

Superior HealthPlan TX2027: not yet reviewed Guide coming soon

Texas Children's Health Plan TX2027: not yet reviewed Guide coming soon

TrueCare MS2027: not yet reviewed Guide coming soon

UHC Community Plan of Arizona AZ2027: not yet reviewed Guide coming soon

UHC Community Plan of Florida FL2027: not yet reviewed Guide coming soon

UHC Community Plan of Kentucky KY2027: not yet reviewed Guide coming soon

UHC Community Plan of Mississippi MS2027: not yet reviewed Guide coming soon

UHC Community Plan of North Carolina NC2027: not yet reviewed Guide coming soon

UHC Community Plan of Texas TX2027: not yet reviewed Guide coming soon

WellCare of Kentucky KY2027: not yet reviewed Guide coming soon

Wellpoint (Amerigroup) TX, FL, MD and more2027: no notice yet Guide coming soon

Wellpoint Texas TX2027: not yet reviewed Guide coming soon

Medicaid parent companies · 8 payers

National Medicaid managed care organizations

Aetna Better Health Multi-state2027: not yet reviewed Guide coming soon

AmeriHealth Caritas Multi-state2027: not yet reviewed Guide coming soon

CareSource Multi-state2027: not yet reviewed Guide coming soon

Centene Medicaid plans Multi-state2027: not yet reviewed Guide coming soon

Elevance / Wellpoint Medicaid Multi-state2027: not yet reviewed Guide coming soon

Humana Healthy Horizons Multi-state2027: not yet reviewed Guide coming soon

Molina Healthcare Multi-state2027: not yet reviewed Guide coming soon

UHC Community Plan Multi-state2027: not yet reviewed Guide coming soon

Blue Cross Blue Shield plans · 37 payers

Each Blue plan sets its own policy

Arkansas BCBS AR2027: not yet reviewed Guide coming soon

AZ Blue AZ2027: not yet reviewed Guide coming soon

BCBS of Alabama AL2027: not yet reviewed Guide coming soon

BCBS of Kansas KS2027: not yet reviewed Guide coming soon

BCBS of Louisiana LA2027: not yet reviewed Guide coming soon

BCBS of Massachusetts MA2027: not yet reviewed Guide coming soon

BCBS of Michigan MI2027: not yet reviewed Guide coming soon

BCBS of Minnesota MN2027: not yet reviewed Guide coming soon

BCBS of Mississippi MS2027: not yet reviewed 1 guideline

BCBS of Nebraska NE2027: not yet reviewed Guide coming soon

BCBS of North Dakota ND2027: not yet reviewed Guide coming soon

BCBS of Rhode Island RI2027: not yet reviewed Guide coming soon

BCBS of South Carolina SC2027: not yet reviewed Guide coming soon

BCBS of Tennessee TN2027: not yet reviewed Guide coming soon

BCBS of Vermont VT2027: not yet reviewed Guide coming soon

BCBS of Wyoming WY2027: not yet reviewed Guide coming soon

Blue Cross Blue Shield of Alabama Alabama2027: no notice yet Guide coming soon

Blue Cross Blue Shield of Illinois Illinois2027: no notice yet Guide coming soon

Blue Cross Blue Shield of Michigan Michigan2027: no notice yet Guide coming soon

Blue Cross Blue Shield of Texas Texas2027: no notice yet Guide coming soon

Blue Cross NC NC2027: not yet reviewed 1 guideline

Blue Cross of Idaho ID2027: not yet reviewed Guide coming soon

Blue KC KS, MO2027: not yet reviewed Guide coming soon

Blue Shield of California CA2027: not yet reviewed Guide coming soon

Capital Blue Cross PA2027: not yet reviewed Guide coming soon

CareFirst BCBS DC, MD, VA2027: not yet reviewed Guide coming soon

Excellus BCBS NY2027: not yet reviewed Guide coming soon

Florida Blue FL2027: not yet reviewed Guide coming soon

Highmark DE, NY, PA, WV2027: not yet reviewed Guide coming soon

HMSA HI2027: not yet reviewed Guide coming soon

Horizon BCBS NJ2027: not yet reviewed Guide coming soon

Horizon BCBS of New Jersey New Jersey2027: no notice yet Guide coming soon

Independence Blue Cross PA2027: not yet reviewed Guide coming soon

Premera Blue Cross AK, WA2027: not yet reviewed Guide coming soon

Regence ID, OR, UT, WA2027: not yet reviewed Guide coming soon

Triple-S Salud PR2027: not yet reviewed Guide coming soon

Wellmark BCBS IA, SD2027: not yet reviewed Guide coming soon

Government programs · 5 payers

Medicare, Medicare Advantage, TRICARE and federal programs

CHAMPVA All states2027: not yet reviewed Guide coming soon

Medicare (CMS) All states2027: proposed rule 3 guidelines

Medicare Advantage All states2027: no notice yet Guide coming soon

Tricare All states2027: no notice yet Guide coming soon

VA Community Care All states2027: not yet reviewed Guide coming soon

Other payers · 3 payers

All other state Medicaid programs 45 more · see States2027: varies by state Guide coming soon

Florida Medicaid (AHCA) Florida2027: no notice yet 3 guidelines

Medicare Advantage plans Nationwide2027: no notice yet Guide coming soon

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