2027 Substrate Maternity Resource Center

Global billing for maternity is ending.

Today, maternity care is largely billed using a "global" code. Beginning January 1, 2027, CPT revisions will allow care to be reported more granularly at the service level. January 1 is the CPT effective date, but each payer might choose to transition billing on their own timeline.

The 2027 Substrate Maternity Resource Center tracks which of your payers are moving off global maternity billing, so you can adapt proactively. For more background, see the AMA CPT 2027 maternity care services update.

197Tracked Payers

54confirmed 2027 guidance

43proposed but not final

25pending payer guidance

16awareness notice only

59policies unchanged

Current As Of October 2026

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What to bill, by payer

Visit-date and EDD triggers, visit-count rules, codes to bill, modifiers, diagnosis and Category II requirements, cost share, and payer contacts, each tied to the verbatim source passage.

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Encounter billing calculator

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Enter the state, payer or plan, date of service, delivery date or EDD, visit number, and service phase to get that payer's own maternity billing instruction with its source.

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SelectConfirmed 2027 guidance

Capital Blue Cross of Pennsylvania

PATransition starts September 1, 2026

Capital Blue Cross begins visit-based prenatal billing on 2026-09-01 after pregnancy confirmation. Its stated 2027 policy moves labor management, delivery, and postpartum care to component reporting on 2027-01-01.

Published: 2026-07-01
Transition starts: September 1, 2026
Billing starts: January 1, 2027
Evidence checked: 2026-09-08

Billing notes and scope

Scope: Capital Blue Cross bulletin expressly lists CHIP, EPO, FEP PPO, HMO, Medicare Advantage HMO/PPO, POS, PPO, and Traditional and Comprehensive products.

Transition: For first prenatal visits after pregnancy confirmation on or after 2026-09-01, use E/M + TH + appropriate ICD-10-CM including Z3A.XX. A September bulletin says the policy is further updated effective 2026-11-01: append TH to all maternity-related procedure codes.

Global billing: Before the September transition, the bulletin identifies 59425 for 4–6 visits and 59426 for 7+ visits. Component reporting applies from 2027-01-01 as stated.

The July bulletin gives labor-management and delivery-frequency rules. The later September bulletin changes the TH requirement; use the latest policy when submitting claims.

Frequently asked questions

What you need to know

Is global billing for maternity ending everywhere at once?

No. CPT revisions take effect January 1, 2027, but that is not each payer's billing date. Search tracked payers to see who published a transition date, whose guidance is still proposed, and whose policies are unchanged.

What is changing about maternity billing in 2027?

Today, maternity care is largely reported using a global code. Beginning January 1, 2027, CPT revisions will allow care to be reported more granularly at the service level. Whether and when a payer moves off global billing depends on that payer's own policy.

How do I see what’s changing by payer in my market?

Search the 2027 Substrate Maternity Resource Center by payer, then open the primary policy. Confirm the transition and billing dates, and recheck the source before submitting claims. This is policy intelligence, not coding or legal advice.

Can I download policies for multiple payers?

Yes. Select payer cards and download an offline source packet containing the policy summary plus links to the maternity policy and the payer policy homepage. The source documents remain on each payer's website.

Turn payer policy into billing instructions

What to bill, by payer

Check a single encounter

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Capital Blue Cross of Pennsylvania

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What you need to know