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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.

207Tracked Payers
63confirmed 2027 guidance
43proposed but not final
26pending payer guidance
16awareness notice only
59policies unchanged

Current As Of October 2026

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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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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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How to read this

AMA CPT 2027 retires global maternity packages (59400, 59510, 59610, 59618) in favor of itemized prenatal, delivery, and postpartum billing. Each payer sets its own timing.

The five statuses above, with these meanings: Confirmed 2027 guidance means the payer published final instructions. Proposed—not final means draft or announced, may change, don't bill on it yet. Pending payer guidance means the payer has not published instructions. Awareness notice only means the payer acknowledged the change without operational detail. Current policy only means the record reflects current policy or reference material. It does not by itself confirm that global billing continues.

Transition starts is when the payer begins the changeover. Billing starts is the first date of service that must be billed the new way.

Current as of October 2026. Verify against the linked payer source before submitting claims.

Source: Substrate AI Maternity Resource Center — https://www.substrateai.com/payers/2027-substrate-maternity-resource-center. Not billing or legal advice.

Interactive policy explorer

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State results include exact state records and clearly labeled national commercial guidance. National guidance does not confirm a state-plan, Medicaid, or Medicare Advantage policy.

Showing 1 of 207 • All states • All statuses

Confirmed 2027 guidance

Healthfirst

NYTransition starts June 1, 2026

For routine prenatal visits when antepartum services start on or after June 1, 2026 or the estimated due date is on or after January 1, 2027, providers must bill the appropriate E/M code with modifier TH and a pregnancy-related O or Z ICD-10 diagnosis. The named lines are Child Health Plus, Essential Plan, IB-Dual, Medicaid Advantage Plus/MAP, Medicaid Managed Care, Qualified Health Plan, HARP, and Medicare Advantage. Starting January 1, 2027, the listed bundled and global CPT codes must not be billed, and 59425 and 59426 are no longer available. Pregnancies not subject to the June 1, 2026 transition still use 59425 for 4-6 antepartum visits, 59426 for 7 or more, and an E/M code for 1-3 visits. MMC and HARP continue informational 0500F or 0503F reporting, which is not reimbursed.

Published
Not stated in source
Transition starts
June 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-10-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published

Scope: Child Health Plus (CHP); Essential Plan (EP); Integrated Benefit Dual Plan (IB-Dual); Medicaid Advantage Plus/MAP (CompleteCare); Medicaid Managed Care (MMC); Qualified Health Plan (QHP); Personal Wellness Plan (HARP); Medicare Advantage

Transition: The June 1 rule applies when antepartum services are initiated on or after that date or the estimated due date is on or after January 1, 2027. Either condition triggers the updated prenatal requirements.

Global billing: Listed bundled and global CPT codes, including 59400, 59510, 59610, 59618, 59425, and 59426, must not be billed for service dates on or after January 1, 2027.

New obstetrical management procedure codes are described as forthcoming. This record does not invent those code numbers.

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One tailored PDF guide: a cover summary, background on the 2027 change, source links to every payer policy in this mix, the selected payers and states, the evaluation rubric, and one page per policy document with verbatim payer guidance.

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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 one PDF guide for that payer mix. It opens with background on the 2027 change, links to every cited payer policy, and each policy gets its own page with the verbatim payer guidance and source links. The source documents remain on each payer's website.

Which bundled maternity CPT codes are retired on January 1, 2027?

The following bundled CPT codes will be retired and should not be reported for dates of service on or after January 1, 2027: 59050, 59400, 59409, 59410, 59425, 59426, 59430, 59510, 59514, 59515, 59525, 59610, 59612, 59614, 59618, 59620, and 59622.

Which maternity CPT codes are revised effective January 1, 2027?

The following CPT codes have revised descriptions or reporting requirements effective January 1, 2027: 59412, 59051, 59414, 59300, 59898, and 59899.

Which new maternity CPT codes take effect on January 1, 2027?

The following new CPT codes take effect January 1, 2027: 59080, 59081, 59082, 59083, 59431, 59432, 59433, 59434, 59502, 59503, 59504, and 59623. They cover labor management, vaginal and cesarean delivery, laceration repair, hysterectomy after cesarean delivery, and uterine tamponade. Routine prenatal and separately reportable postpartum visits use the appropriate evaluation and management (E/M) codes.

How many codes were changed in total?

35 total codes were changed, including 17 deleted codes, 12 new codes and 6 revised codes.

Why are these updates being made?

The updates align with CMS guidance and support more accurate, consistent reporting of prenatal and postpartum care. Phase-specific coding helps identify services at the appropriate stage of care and supports quality measurement. More details can be found from the AMA here: https://www.ama-assn.org/practice-management/cpt/cpt-2027-maternity-care-services-code-changes

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.

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