Update: Changes to billing for global maternity services effective January 1, 2027

In May 2026, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) issued a provider notice to communicate alignment with new American Medical Association (AMA) requirements for maternity services billing.

Currently, maternity care is reported mainly under one ‘global’ code representing nine months of care as a single bundled service. This simplifies billing but does not recognize variations or levels of complexity in care.

To enable more accurate and transparent reporting of care, the American College of Obstetricians and Gynecologists (ACOG) and the AMA successfully advocated for the deletion of the global maternity care and delivery codes to be replaced with new CPT® codes, effective January 1, 2027.

The new code set allows for care to be reported separately at the service level by classifying maternity care into four phases: antepartum (prenatal), labor management, delivery care, and postpartum care, which will allow for services to be reported more granularly at the service level.

New Billing Guidance Effective September 1, 2026

In anticipation of the transition from the global obstetric codes to the new 2027 maternity services codes, for dates of service on or after September 1, 2026, for deliveries anticipated to occur in 2027, claims for the first prenatal visit after confirmation of pregnancy and subsequent antepartum visits must be billed with:

• An appropriate Evaluation & Management (E&M) code (99202-99205, 99211-99215) appended with modifier -TH to differentiate the visits as maternity care, and
• An appropriate ICD-10-CM code Z34.XX to verify the gestation of the pregnancy or with an appropriate pregnancy diagnosis code O09.XX.

Claims are subject to E&M coding rules, and medical record documentation must support medical decision making or the time consistent with current CPT® guidelines for the billing of an E&M code.

Claims for prenatal care for dates of services on or before August 31, 2026, should be billed with the current antepartum codes 59425 (4-6 visits) or 59426 (7 or more visits).

For resources on the coding changes, visit the AMA CPT® 2027 Maternity Care Services Code Changes page and view the AMA CPT® 2027 Maternity Care Services Code Guidelines (PDF).

We will continue to keep you updated as we learn more, and we encourage all physicians and practitioners, coders, and billing professionals to evaluate clinical documentation and claims workflows to ensure readiness for these significant coding changes.