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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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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.

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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

Medicaid Washington

WATransition starts January 1, 2027

Effective January 1, 2027, HCA will remove deleted global obstetrics codes from Apple Health billing guides and fee schedules; providers will use new and revised CPT codes aligned with updated Apple Health clinical policy. Beginning January 1, 2027, bill the first prenatal visit with the appropriate E/M code and CPT 0500F. The E/M code is reimbursable; 0500F is billed at $0.01 and pays zero.

Published
2026-05
Transition starts
January 1, 2027
Billing starts
January 1, 2027
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: Washington Apple Health (Medicaid) pregnancy-related professional/clinical services in hospital and out-of-hospital settings. This is direct state-program guidance, not evidence of named managed-care plan adoption or requirements for commercial, Medicare, dental or vision products.

Transition: HCA anticipates a clean transition between December 31, 2026 and January 1, 2027, with no period accepting both global and itemized coding. HCA does not plan September 2026 implementation under ACOG's recommendation or prorated payments for global OB codes. Instructions for pregnancy care spanning 2026 and 2027 remain forthcoming. Current modifier guidance remains effective through December 31, 2026; updated modifier and encounter-billing instructions will follow.

Global billing: Current global OB coding is to end with the anticipated December 31, 2026–January 1, 2027 transition. HCA will remove deleted global OB codes effective January 1, 2027; cross-year billing instructions remain pending.

Reimbursement rates will be available by January 1, 2027; amounts remain undetermined pending CMS values. The changes affect professional services, not birth center facility-fee or home-birth-kit policy and reimbursement, or birth doula coverage and billing. A replacement birth center facility-fee code will be identified separately. The FAQ does not establish whether additional named-plan guidance exists.

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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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