Beginning January 1, 2027, the American Medical Association (AMA) will implement significant revisions to the Current Procedural Terminology (CPT) code set for maternity care services. These changes move maternity care away from broad global billing and toward a structure that separately identifies antepartum care, labor management, delivery care, and postpartum care. The AMA released this information early to help CPT users prepare, but practices should confirm final language in the CPT 2027 professional code book when it becomes available.
Reasons for Change
The biggest reason for the update is that maternity care is now often delivered across multiple settings and care teams. For example, a patient may receive prenatal care in one setting, transfer to another facility for higher-risk labor or delivery, and then complete postpartum follow-up through a different provider or care team. The revised codes are meant to better reflect how care is actually provided and to make reporting more accurate and transparent.
Challenges, impacts, and risks for providers and billers
All OBGYN practices, including managers, physicians, and billing teams, will be significantly affected by these billing changes, with billers expected to feel the impact most acutely.
The main challenges will include the changeover period for existing pregnant patients, financial forecasting, and tracking payments with new codes and charges, as well as the risks of not staying informed during the transition. Practices may also need to adjust how they track visits across the full pregnancy timeline, since services that were previously bundled may now need to be documented and billed at the encounter or service level.
One major operational change is that labor management will have its own codes and will be reported once per calendar date. These codes will be divided into initial and subsequent day services, with straightforward and complex levels based on the condition of the patient and fetus or fetuses, the care required, and the medical decision-making involved. This distinction is important because the length of labor alone does not determine complexity; the level depends on the clinical circumstances and management required.
Delivery care will also be reported more separately from labor management. Same-day postpartum care is included in delivery care, while postpartum care on later calendar dates will generally be reported with the appropriate evaluation and management (E/M) code. This means teams will need to pay close attention to the date of service and whether postpartum work occurred on the delivery date or after it.
The AMA summary notes that 17 codes are being deleted, 12 codes are being added, and six codes are being revised. Practices should pay close attention to deleted global maternity codes and the new codes for labor management, delivery care, laceration repair, cesarean delivery, and postpartum procedures.
Workflow and Preparation Advice
The best preparation strategy is to begin education and workflow planning before the January 2027 effective date. Teams should review AMA guidance, keep an eye out for AMA updates, monitor additional CPT education, and follow relevant EHR-specific resources, such as athenahealth’s Women’s Health User Group for athena users, to stay aware of practical updates and peer discussion.
Teams should also make sure final reporting instructions are verified once the official CPT 2027 codebook is released. This preparation should include both coding education and practical workflow review, so staff understand how the new phase-based structure will affect documentation, claims, and internal handoffs.
Billers and revenue cycle teams should also prepare for patients whose maternity care overlaps the old and new billing structures. This may require extra attention to documentation, payer communication, connecting with major payers on allowable updates, EHR updates, charge capture, and payment tracking during the transition. Teams should also set a reminder to update fee and allowable schedules once payer and AMA guidance is finalized.
Organizations should also discuss how they plan to adjust financial projections and roll out these changes to team members. Having these conversations early can help managers, providers, and billing teams align expectations before the new codes take effect.
Summary of Known Changes And What to Investigate
The known changes are mostly centered on separating maternity care into four reportable areas: antepartum care, labor management, delivery care, and postpartum care. This is a shift from using broad maternity packages to reporting care in a way that better reflects where, when, and how services are performed.
Antepartum care: Antepartum care includes pregnancy management before labor begins and will generally be reported with the appropriate E/M code for the setting. This may include office, outpatient, telemedicine, hospital, home, or other applicable care settings, depending on where the service is performed.
Labor management: Labor management will be reported using new initial and subsequent day codes, with straightforward and complex levels. Straightforward labor generally reflects routine maternal and fetal monitoring, while complex labor may involve factors such as multiple gestation, abnormal fetal monitoring requiring intervention, prolonged labor, preeclampsia, or a previous cesarean delivery.
Delivery care: Delivery care will be separated from labor management and will include updated reporting for vaginal delivery, VBAC, primary cesarean delivery, repeat cesarean delivery, and certain laceration repairs.
Postpartum care: Postpartum care after the delivery date will generally be reported with the appropriate E/M code, and a new postpartum procedure code is being added for uterine tamponade. Same-day postpartum care remains part of delivery care, so the timing of postpartum services will be important for accurate reporting.
