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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.

161Tracked Payers
28confirmed 2027 guidance
41proposed but not final
16pending payer guidance
14awareness notice only
62policies unchanged

Current As Of September 2026

Billing tools

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Standardized biller rubric

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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Interactive policy explorer

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1 payer record

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.

Payer results

Matched payer policy cards

Confirmed 2027 guidance

Highmark Blue Cross Blue Shield (Western and Northeastern NY)

NY

This notice is limited to Highmark BCBS MMC, HARP, CHPlus and EP maternity services; it is not commercial or Medicare guidance. It states a January 1, 2027 CPT restructuring effective date and directs all NYS Medicaid-enrolled providers of the listed maternity services to use the restructured system for individuals initiating prenatal care on or after June 1, 2026 and/or having an estimated due date on or after January 1, 2027.

Published
2026-07-01
Transition starts
June 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-08-28
Billing notes and scope

Scope: Only the medical maternity portion of this record corresponding to MMC, HARP, CHPlus or EP. This source does not establish commercial, Medicare, dental, vision or other Highmark-market implementation.

Transition: Preserve both cohort criteria and the source's 'and/or.' The article does not explain 2026 claim handling or cross-year episodes; consult the referenced NYS Medicaid Update – April 2026 Volume 42 – Number 5 for additional billing guidance.

Global billing: The notice moves from legacy global maternity codes to phase-specific antepartum, labor-management, delivery and postpartum reporting. It does not instruct providers to continue current global billing while awaiting a Highmark implementation decision.

Entity identity does not establish adoption by every product. Confirm the member is in one of the four expressly named programs before applying this notice.

Policy packets

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Cover summary, selected payers and states, the evaluation rubric, and one page per policy document with verbatim payer guidance and source links.

Select at least one payer card above to build a guide.

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.

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 — providers should 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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