Preparing for 2027: The End of OB Global Billing and What It Means for Your Practice

Beginning January 1, 2027, obstetric billing as we know it will fundamentally change. The AMA CPT Editorial Panel has approved the deletion of 16 global obstetric codes, the revision of 6 codes, and the introduction of 12 new maternity care codes. For OB-GYN practices and L&D units, this represents the most significant shift in maternity care reimbursement in decades.

For many practices, this transition is an opportunity, a chance to finally be paid for the comprehensive care they provide. But it also requires preparation, documentation excellence, and the right technology infrastructure. Here’s what you need to know.

Why Global Payments Are Being Eliminated

The traditional global obstetric model bundles all prenatal visits, delivery, and postpartum care into a single payment. According to ACOG, this model was built for a different era of prenatal care, one with fewer screenings, fewer chronic conditions, and far less patient counseling.

“The global obstetric codes no longer reflect the standard of care occurring today. Current payment methodologies no longer reflect the care occurring today.”

— American College of Obstetricians and Gynecologists

Modern obstetrics looks very different. Consider the changes over the past two decades:

• Increased use of telehealth and remote monitoring
• More comprehensive screening requirements (depression, SDOH, genetic)
• Higher rates of chronic conditions requiring additional management
• Extended postpartum care recommendations (up to 12 weeks)
• Complex care coordination between multiple providers and facilities
• Transfer protocols between rural facilities and tertiary care centers

What’s Changing in 2027

The new model will unbundle maternity care, allowing physicians to bill separately for:

• Each prenatal visit using appropriate E/M codes (99202-99499)
• Delivery services including labor management
• Postpartum visits as separate encounters
• Ancillary services like screening administration, counseling, and education
• Complications management including hemorrhage, cardiac conditions, and mental health

Codes Being Deleted

Global OB Codes Being Retired (January 2027)

Code	Description
59400	Vaginal delivery global
59510	Cesarean delivery global
59610	VBAC global
59618	Cesarean after VBAC global
59425	Antepartum care (4-6 visits)
59426	Antepartum care (7+ visits)
59410	Delivery + postpartum only
59515	C-section + postpartum only

What Will Be Billable

Under the new model, practices will use individual E/M codes for each encounter, with ACOG recommending the HCPCS modifier “TH” be appended to differentiate prenatal/postpartum visits. The delivery-only codes (59409, 59514, 59612, 59620) will remain, covering labor management through delivery completion.

The Documentation Challenge

The shift to unbundled billing creates a significant documentation burden. Every prenatal visit must now justify a separate E/M code with clear documentation of:

• History and physical examination findings
• Medical decision-making complexity
• Time spent in direct patient care
• All diagnoses and conditions addressed
• Screening results and interventions

For high-volume L&D units, this means exponentially more documentation, and exponentially more opportunity for revenue leakage if codes are missed or under-documented.

How Birth Model Prepares You for 2027

Birth Model’s AI-powered platform was built to address exactly this challenge. Our Automatic Diagnosis Capture feature continuously monitors patient data throughout labor and delivery, identifying and documenting billable diagnoses in real-time:

Sample Automated ICD-10 Capture

Code	Description
Z3A.39	39 Weeks Gestation
O99.824	GBS Carrier Complicating Childbirth
O24.424	Gestational Diabetes, Insulin Controlled
O14.14	Severe Preeclampsia in Childbirth
O41.123	Chorioamnionitis, Third Trimester
O72.1	Immediate Postpartum Hemorrhage

Sample Automated CPT Capture

Code	Description
59409	Vaginal Delivery Only
96365	IV Infusion, Initial Hour
96366	IV Infusion, Additional Hour
96372	IM Injection (Hemabate)
59160	Postpartum Curettage
59899	Bakri Balloon Tamponade

Preparing Your Practice Now

Even though the 2027 codes aren’t finalized until the CPT Manual is released in late 2026, there are several steps you can take today:

1. Audit your current documentation to identify gaps in E/M documentation
2. Implement real-time coding support to capture all billable services
3. Train staff on documentation requirements for individual E/M visits
4. Update EHR workflows to support unbundled billing
5. Model revenue impact to understand how the transition will affect your practice

The Opportunity Ahead

For practices already providing comprehensive, high-touch maternal care, the 2027 changes represent a significant opportunity. The unbundled model will finally allow reimbursement for the complex care you’ve been providing all along, care that was never adequately captured under global billing.

ACOG has made it clear: the goal is accuracy, fairness, and transparency in reimbursement. With the right preparation and technology, your practice can be ready to thrive under the new model.

For more information on the 2027 coding changes, visit ACOG’s Payment for Obstetric Services resource page.