Preparing for Coordinated Care’s 2027 Obstetric Billing Transition

Coordinated Care announced changes to obstetric billing in its September 2026 provider notice. Beginning January 1, 2027, maternity care will move from global billing codes to separate reporting for individual services. At the time of the announcement, Washington’s Health Care Authority (HCA) was still working on its implementation policy.

OB/GYN practices, maternity providers, birth centers, and billing teams caring for Coordinated Care’s Washington Apple Health members should review their billing processes and follow the latest instructions from HCA and Coordinated Care.

Policy Timeline: What’s in Coordinated Care’s September Update

According to Coordinated Care’s September 2026 newsletter, HCA hadn't finished its clinical policy by October 1, 2026. It planned to share the policy with health plans in late November or early December.

Those dates were estimates. The September notice didn’t confirm when the final policy or claim instructions would become available.

At the time, HCA was also working on rule changes and managed care contract updates, with completion expected by January 1, 2027.

The newsletter mentioned webinar slides, an FAQ that was still being updated, and another planned webinar. CMS decisions on code valuation and payment were also pending.

Washington HCA Rules and Billing Guidance

Washington adopted its maternity care rule amendment on August 6, 2026, effective January 1, 2027.

While the amendment confirms when the rule takes effect, it doesn’t provide every detail needed to submit maternity claims under the new coding structure.

HCA’s October 2026 pregnancy-related services billing guide states that the January 2027 edition will include instructions for the new and revised obstetric codes.

Before submitting claims, practices should check the applicable HCA billing guide and any updated instructions from Coordinated Care.

How Maternity Billing Changes in 2027

The AMA’s 2027 maternity coding overview divides maternity care into four separately reported phases:

• Antepartum care: Evaluation and management services provided before labor begins.
• Labor management: Care provided during labor, which may be billed separately from delivery if CPT requirements are met.
• Delivery: Care provided during vaginal or cesarean birth.
• Postpartum care: Evaluation and management services after delivery. Routine care on the delivery date is included in the delivery code.

These CPT changes explain how maternity services are reported, but they don’t replace HCA coverage policies or Coordinated Care’s claim submission and payment rules.

Practices should check both coding instructions and payer requirements before billing under the new structure.

Reviewing 2026 Maternity Codes Before the Transition

Under the previous global billing system, providers billed routine maternity care as a single package when they handled all required services.

Partial-care billing applied when a provider handled only certain parts of the patient’s maternity care.

BillingFreedom’s CPT 59400 guide explains the earlier global maternity billing approach.

For pregnancies continuing into 2027, don’t assume the previous global codes apply to every service. Check the date of care, review any claims already submitted, and follow HCA and Coordinated Care’s transition billing instructions.

Common Questions About the 2027 Transition

Are Birth Center Facility Fees and Professional Maternity Charges the Same?

No. Washington’s maternity care rule treats birth center facility fees and professional maternity charges separately.

Birth centers should check billing requirements for each service type. Changes to professional maternity codes don’t automatically determine how facility claims should be submitted or paid.

Follow the applicable HCA and Coordinated Care instructions for both.

What Does the 2027 Transition Mean for Your Practice?

OB/GYN practices should review their maternity billing processes before the new coding structure takes effect. Pay particular attention to pregnancies that begin in 2026 and continue into 2027.

Check the following for your practice.

• - Follow HCA and Coordinated Care updates. Assign someone to check billing guides and provider notices. The final policy was expected in late November or early December, but the dates weren't confirmed. Check for the published policy before applying its instructions.
• - Review pregnancies continuing into 2027. Keep a record of prenatal visits, delivery, postpartum care, service dates, and the providers involved. Check payer transition guidelines before selecting codes, and review earlier claims to avoid billing the same services twice.
• Update EHR & billing systems. Update charge lists, documentation templates, and claim edits for antepartum care, labor management, delivery, and postpartum care. Test claims for each service, including provider transfers, against confirmed payer rules.
• Review documentation & payer rules. Check with clinicians and billing staff that medical records support the services billed. Review patient coverage, provider eligibility, payment terms, and claim submission requirements separately from CPT coding rules.
• - Review birth center billing. Check professional and facility claims separately. Washington’s maternity rule distinguishes between these fees, and professional coding changes may not apply to facility claims.

Need Help Preparing for Washington’s 2027 Maternity Billing Changes?

Maternity billing changes can affect how OB/GYN practices document care, select codes, submit claims, and manage payments.

BillingFreedom provides OB/GYN medical billing services to help practices review documentation, check coding, prepare claims, and follow up with payers.

Our team can review your current billing process and identify areas that may need attention before the transition.

Contact BillingFreedom to discuss your Washington practice’s maternity billing needs and prepare for the 2027 changes.

References

• Coordinated Care: September 2026 Provider News
• Washington: Adopted Maternity Care Rule Amendment
• HCA: October 2026 Pregnancy-Related Services Billing Guide
• HCA: Pregnancy Services and Clinical Care Resources
• AMA: CPT 2027 Maternity Care Changes
• CMS: CY 2027 Physician Fee Schedule Proposed Rule