New CPT Code Structure & E/M Coding Requirements
Effective Date: January 1, 2027
Effective January 1, 2027, the American Medical Association (AMA) will delete the existing global obstetrical package codes and certain related maternity care codes from the CPT code set. These codes will no longer be valid for dates of service on or after January 1, 2027.
Maternity services must be billed separately using the appropriate E/M, labor management, delivery, or other applicable CPT code. See the Quick Reference below for the deleted and replacement codes.
Claims using deleted codes for dates of service on or after January 1, 2027, will be denied.
Definition: Global OB package codes combine prenatal care, delivery, and postpartum care into one CPT code.
Quick Reference: How to Bill Maternity Services in 2027
| Service | How to Bill Beginning January 1, 2027 |
|---|---|
| Routine Prenatal visits* Deleted: 59425, 59426 | Bill all three components:
|
| Labor management | Bill one code per calendar day:
Do not report a labor management code for a planned cesarean delivery without labor. |
| Vaginal delivery Deleted: 59400, 59409, 59410, 59610, 59612, 59614 |
Bill prenatal and postpartum services separately. |
| Cesarean delivery Deleted: 59510, 59514, 59515, 59618, 59620, 59622 |
Bill prenatal and postpartum services separately. |
| Routine Postpartum visits* Deleted: 59430 | Bill all three components below:
|
| Hysterectomy after cesarean delivery Deleted: 59525 | Bill 59504 |
*All three components are necessary for the commercial plans’ routine prenatal and postpartum visit benefit.
How to Choose a Labor Management Code
Straightforward—all of the following must apply:
- Singleton vertex presentation
- Routine maternal/fetal monitoring
- Fetal monitoring (eg, heart rate) not requiring physician or other QHP intervention
- Normal progression of labor or routine labor induction or augmentation
- Stable medical conditions (eg, well-controlled hypertension, diet-controlled diabetes) not requiring additional management during labor
- No previous cesarean delivery
Complex—any labor management that is not explicitly defined as straightforward:
Examples:
- More than one fetus
- Fetal monitoring (eg, heart rate) abnormalities requiring a change in management, requiring physician or other QHP intervention
- Prolonged first or second stage of labor
- Labor complications (eg, intra-amniotic infection and/or inflammation, preeclampsia)
- One or more severe maternal morbidity indicator(s) (eg, acute renal failure, eclampsia)
- Maternal medical conditions (eg, hypertension, diabetes, morbid obesity) requiring additional medical management during labor
- Previous cesarean delivery
Pregnancies That Begin in 2026 and Continue into 2027
Use the table below when prenatal care begins in 2026 and delivery occurs in 2027.
For 2026 claims using 59425 or 59426: Use the date of the last prenatal visit included in the code.
| If This Happens | Bill for 2026 | Bill for 2027 |
|---|---|---|
| Delivery occurs in 2026 | Use the current global OB package code. | Bill applicable postpartum visits in 2027. |
| 7 or more prenatal visits occur in 2026; delivery occurs in 2027 | Bill 59426 for the 2026 prenatal visits. | Bill the delivery and postpartum services. Do not bill prenatal visits already included in 59426. |
| 4–6 prenatal visits occur in 2026; delivery occurs in 2027 | Bill 59425 for the 2026 prenatal visits. | Bill the delivery and postpartum services. Beginning with the 7th prenatal visit, bill each additional visit using the appropriate E/M code, diagnosis code, and modifier TH. |
| 3 or fewer prenatal visits occur in 2026; delivery occurs in 2027 | Bill each 2026 prenatal visit using the appropriate E/M code. | Bill all 2027 maternity services using the new coding structure. |