Checked October 2, 2026.
| Payer | What they published | Date | What to bill now | Source |
|---|---|---|---|---|
| Molina Healthcare of Florida (Medicaid and Marketplace) | Global codes denied for dates of service after March 1, 2026. The guide still names some codes CPT deletes in 2027. | March 1, 2026 | Bill individual maternity services. | Molina Florida provider guide |
| Arkansas Blue Cross (Commercial) | Phase 1 May 15, 2026; phase 2 July 15, 2026; post–September 1 instructions pending. | May 15, 2026; July 15, 2026 | 59426 from May 15, 2026 through July 14, 2026. 59425 from July 15, 2026 through September 1, 2026. | Arkansas Blue Cross maternity coding PDF |
| Independent Health (all products in the June 2026 SCOPE: commercial, Medicare Advantage, Medicaid/Essential, and self-funded) | Each prenatal encounter uses office E/M 99202–99215 plus modifier TH and a pregnancy diagnosis. 0500F on the initial visit. Nonroutine E/M omits TH. 59425 and 59426 deny. | June 1, 2026 | Office E/M 99202–99215 + modifier TH + pregnancy diagnosis for each prenatal encounter. 0500F on the initial visit. Omit TH on nonroutine E/M. Do not bill 59425 or 59426. | Independent Health June 2026 SCOPE |
| New York Medicaid (fee-for-service and managed care) | Each prenatal service: office E/M + TH + pregnancy diagnosis. 0500F for the initial visit. | June 1, 2026 | Office E/M + modifier TH + pregnancy diagnosis for each prenatal service. 0500F on the initial visit. | New York Medicaid Update, April 2026 |
| Aetna commercial, and the same OfficeLink article applies to Medicare members | September 1, 2026 crossover for preventive prenatal visits, and January 1, 2027 code retirement. The October OfficeLink restates the September 1 rule. | September 1, 2026 | For patients expected to deliver in 2027, preventive prenatal visits on or after September 1, 2026: applicable E/M + modifier TH + pregnancy diagnosis only while three or fewer visits are provided before January 1, 2027. Once four prenatal visits have occurred in 2026, follow current antepartum coding guidelines. TH alone does not make a service preventive. Non-routine prenatal or postpartum office E/M: do not use TH; those visits are subject to cost-share. Texas fully insured: only if consistent with Texas regulatory requirements. | Aetna OfficeLink, September 2026 Aetna OfficeLink, October 2026 |
| Blue Cross Blue Shield of Vermont | August notice: first prenatal visit after confirmation and subsequent antepartum visits. October 2026 newsletter adds a spanning-pregnancy visit table (59426 / 59425 / E/M + TH). The August notice still requires E/M + TH for dates of service on or after September 1. | September 1, 2026 | Dates of service on or after September 1: E/M + modifier TH + Z34.XX or O00–O9A. Dates of service on or before August 31: E/M or 59425/59426. Also use the October newsletter visit table for 2026–2027 pregnancies. | BCBS Vermont August 2026 notice BCBS Vermont October 2026 newsletter |
| Blue Cross NC | The September 16, 2026 update supersedes the May advance notice. September 1 applies for 2027 deliveries. | September 1, 2026 | For 2027 deliveries: E/M + modifier TH and Z34.XX or O09.XX. | Blue Cross NC September 16, 2026 update |
| Blue KC | September 2026 BlueSpeak. Encouraged E/M from September 1 for 2027 deliveries, with a 59425 / 59426 / E/M split and modifier TH. | September 1, 2026 | Encouraged: E/M from September 1 for 2027 deliveries, using the published 59425 / 59426 / E/M split and modifier TH. | Blue KC BlueSpeak, September 2026 |
| NC Medicaid (Direct and managed care) | Beginning September 1, providers are encouraged to use 99202–99215 + TH for prenatal care that will span January 1, 2027. Mandatory January 1, 2027 details are pending. | September 1, 2026 encouraged; January 1, 2027 mandatory details pending | Encouraged for cross-year prenatal care: 99202–99215 + modifier TH. Mandatory 2027 details are not published yet. | NC Medicaid July 10, 2026 bulletin |
| MassHealth | Bulletin 419. Setting-appropriate E/M + TH. | September 1, 2026 | Setting-appropriate E/M + modifier TH. | MassHealth All Provider Bulletin 419 |
| MaineCare | Append TH to maternity E/M. | September 1, 2026 | Append modifier TH to maternity E/M. | MaineCare TH modifier bulletin |
| Cigna Healthcare commercial | No early transition authorized. Article updated September 14, 2026. Continue existing contract billing. | No early transition (article updated September 14, 2026) | Keep current contract billing. Do not adopt early E/M solely because the first prenatal visit is on or after September 1, 2026. | Cigna Healthcare maternity coding update |
| Highmark PA, DE, NY (communications hub), and WV | September 28, 2026 notice. October 1, 2026 for due dates in 2027, with an ACOG visit-count split through December 31. | October 1, 2026 | For due dates in 2027, follow the October 1, 2026 notice, including the ACOG visit-count split through December 31. | Highmark maternity coding guidance |
| Highmark Western New York public programs only (MMC, HARP, Child Health Plus, Essential Plan) | Separate from the Highmark commercial notice above. Effective January 1, 2027. | January 1, 2027 | E/M + modifier TH, 13 routine antepartum visits, and Z3A on the first prenatal visit. | Highmark Western New York public programs PDF |
| Community First Health Plans (Texas Medicaid and CHIP) | Advance notice. Code-level detail is pending. | January 1, 2027 | No code-level billing instruction is published yet. Watch for the plan’s follow-up. | Community First August 3, 2026 notice |
| Michigan Medicaid | Use existing global codes through 2026. | January 1, 2027 | Keep existing global codes through 2026. | Michigan Medicaid July 15, 2026 alert |
| Apple Health (Washington Medicaid) | Current billing through 2026. Individual services beginning 2027. | January 1, 2027 | Current billing through 2026. Individual services beginning in 2027. | Apple Health pregnancy-related billing FAQ |
| Original Medicare | Proposed only. The CY 2027 Physician Fee Schedule proposed rule was published July 14, 2026. CMS is considering Medicare-specific global maternity HCPCS G-codes (discussed as GMAT1–GMAT15). The final rule was not published as of October 2, 2026. The comment deadline of September 14 has passed. | Proposed for CY 2027; final rule not published | Do not bill from the proposed rule. No final Medicare instruction is published as of October 2, 2026. | CY 2027 Medicare Physician Fee Schedule proposed rule |
| UnitedHealthcare Commercial and Individual Exchange | January 1, 2027, conditional on the CMS final rule. Medicare Advantage and Community Plan are not covered by this bulletin. | January 1, 2027, if the CMS final rule is published as proposed | If G-codes are finalized as proposed, follow those. Otherwise use 2026 CPT through December 31 and E/M + modifier TH after. | UnitedHealthcare Commercial reimbursement policy update, October 2026 UnitedHealthcare Individual Exchange reimbursement policy update, October 2026 |
| Virginia Medicaid | January 1, 2027 is the mandatory date. Early E/M is a recommendation, and the bulletin also says to keep current requirements until more guidance. September 16, 2026 is the bulletin timestamp, not an edit effective date. | January 1, 2027 | Mandatory date is January 1, 2027. Early E/M is only a recommendation. Keep current requirements until more guidance is published. | Virginia Medicaid bulletin |
| TennCare | The January 1, 2027 memo is about value-based perinatal episode performance. It is not claim-coding guidance. | January 1, 2027 memo; not a claim-coding date | Obtain billing instructions from the member’s MCO. Do not treat this memo as a coding change. | TennCare perinatal performance memo |
| Geisinger Health Plan (all lines of business) | Awareness only. No contract or reimbursement-methodology change announced. | January 1, 2027 awareness only | No billing-method change is announced. Continue the current contract method. | Geisinger Health Plan May 27, 2026 update |
| BlueCare Tennessee | The public maternity page still describes the current bundled incentive path (0500F with E/M if applicable; postpartum 0503F with 59430). This is not a verified 2027 unbundling bulletin. | No verified 2027 unbundling date | The page describes the current bundled incentive path. It does not publish a 2027 unbundling rule. | BlueCare Tennessee maternity quality page |
Summary image of the same dates. The table above is the text version.
CPT 2027
CPT 2027 deletes 17 codes, adds 12, and revises 6, effective January 1, 2027. AMA notice: CPT 2027 maternity care services code changes.
Crossover dates still have to be applied on the claim. Payment posting is where those paid lines land.
Disclaimer
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.
Not legal, coding, or payer-contract advice.