When does Anthem Blue Cross Blue Shield of Georgia change OB/GYN billing?
Confirmed 2027 guidance
Transition
No separate transition date. Policy effective January 1, 2027
Billing
January 1, 2027
Published
September 9, 2026
Commercial reimbursement policy C-19004, last approved 09/09/2026 and effective 01/01/2027, names In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Antepartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 13 routine office or other outpatient visits per pregnancy episode under the same TIN. The first prenatal E/M visit must include an ICD-10-CM code from category Z3A. Labor management must be reported with CPT codes 59080–59083. Delivery must be reported with 59431, 59432, 59502, or 59503, plus a Z3A code. Postpartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 3 routine visits within 12 weeks after delivery under the same TIN. The California and Virginia exemption effective TBD does not name Georgia.
The California and Virginia exemption effective TBD does not name Georgia.
The policy replaces global obstetric reporting with per-encounter antepartum and postpartum E/M codes, labor-management codes 59080-59083, and delivery codes 59431, 59432, 59502, or 59503.
Commercial; Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.
Questions about Anthem Blue Cross Blue Shield of Georgia
When does Anthem Blue Cross Blue Shield of Georgia change OB/GYN billing?
Anthem Blue Cross Blue Shield of Georgia has published 2027 OB/GYN billing guidance. Transition: No separate transition date. Policy effective January 1, 2027. Billing: January 1, 2027. Commercial reimbursement policy C-19004, last approved 09/09/2026 and effective 01/01/2027, names In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Antepartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 13 routine office or other outpatient visits per pregnancy episode under the same TIN. The first prenatal E/M visit must include an ICD-10-CM code from category Z3A. Labor management must be reported with CPT codes 59080–59083. Delivery must be reported with 59431, 59432, 59502, or 59503, plus a Z3A code. Postpartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 3 routine visits within 12 weeks after delivery under the same TIN. The California and Virginia exemption effective TBD does not name Georgia. The California and Virginia exemption effective TBD does not name Georgia.
What do I bill Anthem Blue Cross Blue Shield of Georgia for prenatal visits in 2027?
Commercial reimbursement policy C-19004, last approved 09/09/2026 and effective 01/01/2027, names In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Antepartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 13 routine office or other outpatient visits per pregnancy episode under the same TIN. The first prenatal E/M visit must include an ICD-10-CM code from category Z3A. Labor management must be reported with CPT codes 59080–59083. Delivery must be reported with 59431, 59432, 59502, or 59503, plus a Z3A code. Postpartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 3 routine visits within 12 weeks after delivery under the same TIN. The California and Virginia exemption effective TBD does not name Georgia. The policy replaces global obstetric reporting with per-encounter antepartum and postpartum E/M codes, labor-management codes 59080-59083, and delivery codes 59431, 59432, 59502, or 59503. The California and Virginia exemption effective TBD does not name Georgia.
Has Anthem Blue Cross Blue Shield of Georgia published 2027 maternity guidance?
Yes. Anthem Blue Cross Blue Shield of Georgia has published 2027 maternity guidance. Last checked October 8, 2026. Source: Commercial Reimbursement Policy C-19004: Maternity Services - Professional.
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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