Starting January 1, 2027, providers will no longer bill obstetric services through a single global Current Procedural Terminology code covering approximately nine to ten months of care.
The overhaul replaces 17 legacy codes with 12 new and six revised codes, organised across the distinct phases of the pregnancy continuum.
The changes result from a multi-year collaboration involving the CPT Editorial Panel, the American College of Obstetricians and Gynecologists, the American Medical Association, and the American Academy of Family Physicians.
Under the new structure, each prenatal encounter will be reported individually through standard evaluation and management codes based on the patient’s location at the time of service.
New labor management codes will be reported daily, divided into initial day and subsequent day categories, with two complexity levels designated as straightforward and complex.
Delivery coding will introduce separate codes for vaginal delivery, vaginal birth after caesarean, and primary versus repeat caesarean, as well as codes covering third- and fourth-degree laceration repair and hysterectomy following caesarean delivery.
The collaborators acknowledged that the global code, introduced in the 1990s, no longer reflects modern obstetric practice, where patients are frequently managed by multiple unaffiliated clinicians across different facilities.
The new codes are designed to allow payers and providers to “reliably assess quality, risk, and birthing outcomes” and “improve the ability of all parties to analyze care patterns, understand drivers of maternal morbidity and mortality, and design payment models that reward high-quality care.”
Patients are not expected to see significant changes to their health plan benefits or cost-sharing responsibilities as a result of the restructuring.
However, providers should develop targeted staff training and update billing and clinical workflows ahead of the January 2027 implementation date.
Providers are also advised to work with their electronic health record and practice management vendors to confirm systems can support the new phase-specific and daily billing structures.
The American College of Obstetricians and Gynecologists recommends providers assess whether clinical notes clearly support the phases of care reported, whether physicians, coders, and billers share a common understanding of the new structure, and whether EHR templates reflect the 2027 model.
ACOG is hosting a live webinar on August 3, 2026, to discuss the new code structure and set forth guidance for operationalising the upcoming changes.
For hospitals with labour and delivery units, the overhaul will require operational adjustments beyond those facing physician practices, particularly around postpartum inpatient care charge capture.
Hospitals are encouraged to work with revenue cycle teams, clinical departments, and community physicians to prepare, as the granular data produced by the new framework is expected to support quality improvement initiatives related to maternal outcomes.