Major maternity billing changes coming in 2027

Beginning January 1, 2027, the health care industry will implement one of the most significant maternity coding updates in decades. The American Medical Association is replacing the traditional global maternity billing model with a more detailed, service-based approach that separately reports prenatal care (antepartum), labor management, delivery services and postpartum care. While this is primarily a billing and reporting change, it has important implications for providers, employers, members, and health plans. 

What is global maternity billing? 

Historically, maternity care has often been billed using a single global code that bundles prenatal care, delivery, and postpartum care into one payment. 

Why it’s changing 

The new structure reflects how maternity care is delivered today. Members often receive care from multiple clinicians across different settings. Often, care plans are tailored to each member’s medical, social, and clinical needs. 

For health plans, the new coding structure is expected to provide greater visibility into maternity care delivery, support improved quality measurement, provide more detailed reporting on maternity services and outcomes and provide greater member support at key points during pregnancy. 

Impact 

Maternity care is not changing; billing is changing. Members will continue to receive the same clinical maternity services they receive today. The primary change is how those services are reported and processed on claims.  

While benefit designs are not changing solely because of this coding update, we know you may have questions about claims, deductibles, cost-sharing, and potential financial impacts. Those impacts are still being evaluated and may vary based on plan design, provider billing patterns, patient risk mix, and final reimbursement values for the new codes.  

What’s next 

Although the new coding structure does not take effect until January 1, 2027, implementation planning is already underway. Premera teams are evaluating operational, financial, and member impacts while working to support a smooth transition for providers, employers, and members. 

On July 14, 2026, the Centers for Medicare & Medicaid Services (CMS) proposed new maternity care codes that would maintain the current global payment structure. CMS is accepting public comments and will consider feedback before deciding whether to finalize the proposal. The American Medical Association (AMA) and the American College of Obstetricians and Gynecologists (ACOG) have expressed concerns that the proposal could create a dual billing system, increase administrative complexity and potentially affecting care equity. At this time, Premera is continuing with implementation of the original AMA coding changes and will evaluate any adjustments needed once CMS issues a final decision. 

Resources 

You can find the American Medical Association announcement here. We will provide more info as it becomes available.