Global Maternity Care Eliminated in 2027

Critical Billing Changes for Midwives & Maternity Providers Updated February 2026

1. Introduction

This bulletin provides essential guidance on upcoming changes in maternity billing practices for providers in Alaska, effective January 1, 2027. The traditional global obstetric billing model used in the United States is being restructured, and providers must understand how to prepare for the transition to ensure accurate claims and fair reimbursement.

2. What’s Changing in 2027?

End of Global Obstetric Billing

As of January 1, 2027, the American Medical Association (AMA) CPT Editorial Panel will implement significant revisions to the CPT code set that eliminate most traditional global maternity codes that bundle antepartum care, delivery, and postpartum services into a single charge. 

Shift to Itemized Billing

• Instead of bundled global codes (such as CPT 59400, 59510, and 59610), providers will bill prenatal and postpartum visits separately, generally using Evaluation and Management (E/M) CPT codes (e.g., 99202–99499) with appropriate pregnancy modifiers. 

• Existing delivery-only codes (like 59409 for vaginal delivery only) will continue but apply only to the delivery event itself. 

• Complex labor management spanning multiple days may require inpatient E/M codes to ensure full reimbursement. 

Why the Change?

The traditional global coding structure was designed decades ago, when care was less frequent and less comprehensive. Modern maternity care includes more counseling, screenings, chronic condition management, and care coordination that the bundled codes did not accurately reflect. (ACOG)

3. Immediate Actions for Alaska Providers

Update Documentation Practices

All prenatal and postpartum visits should be documented as discrete clinical encounters (history, exam, medical decision-making) to support itemized billing under E/M codes. 

Revise EHR and Billing Workflows

Work with your practice’s EHR and billing teams to:

• Add new visit templates supporting E/M coding with pregnancy-specific modifiers. (ACOG)

• Train staff on tracking and billing each component of care separately. 

Review Payer Requirements

Medicaid (including Alaska Medicaid) and private insurers may have payer-specific requirements for modifiers or documentation. Proactively reach out to your major payers now so you know how they’ll handle the transition. (ACOG)

4. Billing Scenarios Providers Should Know

Prenatal Care Visits

• Prenatal visits will typically be billed with E/M codes when the global package is no longer available. 

• Modifier placement (e.g., “TH” for pregnancy-related E/M) may be required depending on payer policies. (ACOG)

Delivery Charges

• Delivery remains separately coded, and may still follow specific delivery-only CPT codes. 

Postpartum Care

• Postpartum visits are billed separately as distinct encounters. 

(Note: Exact 2027 CPT code numbers and descriptions will be released in the official AMA CPT Professional Code book in late 2026. Practices should plan to purchase or subscribe to stay current.) 

5. Impact for Alaska Midwives

Alaska has a diverse health care environment with a mix of Medicaid, private payers, and rural provider models. These billing changes will affect:

⦿ Reimbursement consistency — itemized billing better reflects complexity of care. ⦿ Revenue cycle operations — billing staff will need training on new coding protocols. ⦿ Patient education — patients may see more detailed charges on their Explanation of Benefits. 

6. Frequently Asked Questions (FAQ)

Q1: When do the billing changes take effect?

A: January 1, 2027. The CPT code set reflecting these changes will be included in the official 2027 CPT Professional Code book, published in late 2026. 

Q2: Will the traditional global maternity codes still work after 2026?

A: No. Most global maternity codes will be deleted and replaced with itemized reporting structures. 

Q3: What codes replace the global package?

A: Providers will use existing and new E/M codes (e.g., 99202–99499) with modifiers for prenatal/postpartum visits, plus delivery-only codes where applicable. The final 2027 CPT code set will define the specific new codes. 

Q4: How does this affect Medicaid billing in Alaska?

A: Providers must follow Alaska Medicaid’s CPT requirements. Many Medicaid agencies already allow separate E/M billing; the 2027 changes will likely align Medicaid and commercial payer rules with the unbundled structure. Verify specifics with Alaska Medicaid before January 2027. (ACOG)

Q5: Should providers educate pregnant patients about billing differences?

A: Yes — patients will see more detailed claims and may have different copay/deductible impacts when services are unbundled. 

Q6: What steps can my practice take now?

A:

• Update documentation and EHR templates. 

• Train providers and staff on itemized billing. 

• Contact payers to understand modifier and documentation rules. (ACOG)

7. Conclusion

The transition from a global maternity billing model to one that itemizes prenatal, delivery, and postpartum care represents a major shift in U.S. obstetric billing practice. Alaska providers — including midwives — should begin early preparation now to align clinical, billing, and patient education processes before January 1, 2027.

You will start to see changes to the VOB structure for EDDs in 2027. The difficult part about estimates will be that the level and frequency of visits can drastically change the overall cost of care. Estimates would be based on a routine schedule with a disclaimer about the fluctuation of cost due to the visits individual needs.