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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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.

Showing 1 of 207 • All states • All statuses

SelectConfirmed 2027 guidance

Healthfirst (Health Insurance for New Yorkers)

NYTransition starts June 1, 2026

Beginning June 1, 2026, apply Healthfirst's updated routine prenatal billing requirements when antepartum care begins on or after that date or the estimated due date is January 1, 2027 or later. Bill affected routine prenatal visits with the appropriate E/M code for the setting, patient status and documented service, modifier TH, and pregnancy-related O or Z ICD-10 diagnoses. For MMC and HARP, report 0500F for the initial prenatal visit and 0503F for postpartum care on separate, real-time, no-charge informational claims, not bundled with payment claims.

Published: 2026-04
Transition starts: June 1, 2026
Billing starts: June 1, 2026
Evidence checked: 2026-08-28

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: Healthfirst plan-specific reimbursement policy for professional obstetrical services in its expressly listed medical lines of business, including MMC and HARP. This record is supported for the applicable medical Medicaid product, not dental services.

Transition: Care initiated before June 1, 2026 is not automatically exempt: a 2027 estimated due date also triggers the updated requirements in the applicability section and examples. Qualifying pre-June starts with 2026 EDD/delivery may retain legacy billing when all package requirements are met. The policy does not clearly reconcile its Q4 2026 legacy example with postpartum services extending into 2027; obtain clarification for such episodes.

Global billing: Legacy global billing remains conditional for qualifying 2026 episodes. The policy states that listed deleted codes are unavailable when service dates include January 1, 2027 or later; a 2026 delivery alone should not be treated as authorization for a global episode extending into 2027.

Direct support comes from Healthfirst PO-RE-132v4, last approved May 18, 2026, rather than an inferred statewide managed-care alignment requirement. Reconcile the record's state-article citation metadata with this supplied source. Verify the member's listed medical product, benefits and provider contract. The explicit Category II section limits mandatory reporting to MMC/HARP, although page 8 uses broader language; seek clarification rather than extending that requirement to other products.

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