Today, maternity care is largely billed using a "global" code. Beginning January 1, 2027, CPT revisions will allow care to be reported more granularly at the service level. January 1 is the CPT effective date, but each payer might choose to transition billing on their own timeline.
The 2027 Substrate Maternity Resource Center tracks which of your payers are moving off global maternity billing, so you can adapt proactively. For more background, see the AMA CPT 2027 maternity care services update.
AMA CPT 2027 retires global maternity packages (59400, 59510, 59610, 59618) in favor of itemized prenatal, delivery, and postpartum billing. Each payer sets its own timing.
The five statuses above, with these meanings: Confirmed 2027 guidance means the payer published final instructions. Proposed—not final means draft or announced, may change, don't bill on it yet. Pending payer guidance means the payer has not published instructions. Awareness notice only means the payer acknowledged the change without operational detail. Current policy only means the payer states global billing continues.
Transition starts is when the payer begins the changeover. Billing starts is the first date of service that must be billed the new way.
Current as of October 2026. Verify against the linked payer source before submitting claims.
State results include exact state records and clearly labeled national commercial guidance. National guidance does not confirm a state-plan, Medicaid, or Medicare Advantage policy.
The 5Star Life healthcare indemnity page describes a cash benefit that may include newborn baby care and says supplemental medical does not replace health insurance. No obstetric code, global package, or 2027 transition is stated.
Published
Not stated in source
Transition starts
Not stated in cited page
Billing starts
No obstetric billing date stated
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
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Source excerpt
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Scope: 5Star Life Insurance Company catalog ID ending 146230. Life and worksite indemnity. Not the sibling catalog ID.
Transition: No 2027 transition is stated.
Global billing: No global obstetric package is stated.
Do not add this page as an obstetric billing policy. The sibling catalog ID stays separate.
The same 5Star Life healthcare indemnity page says supplemental medical does not replace health insurance. It describes cash indemnity, not an obstetric billing policy. This catalog ID has no separate website of its own.
Published
Not stated in source
Transition starts
Not stated in cited page
Billing starts
No obstetric billing date stated
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: 5STAR LIFE INSURANCE COMPANY catalog ID ending 963d7d. Kept separate from payer_98a8dfc6a0a56f146230.
Transition: No 2027 transition is stated for this catalog ID.
Global billing: No global obstetric package is stated.
Same product page as the other 5Star Life catalog ID. This decision applies only to the ID ending 963d7d.
The No Surprises Act page says patients who are pregnant and undergoing a course of treatment for the pregnancy may continue treatment with a terminated provider. No obstetric code or reimbursement rule is stated.
Published
Not stated in source
Transition starts
Not stated in cited page
Billing starts
No obstetric billing date stated
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
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Scope: 6 Degrees Health. Repricing and payment-integrity vendor page. Not a health-plan obstetric policy.
Transition: No maternity transition date is stated.
Global billing: No global obstetric billing rule is stated.
Do not add this page as a maternity billing policy.
No AARP-specific maternity billing rule was read. The October 2026 UnitedHealthcare commercial reimbursement bulletin does not apply to this supplemental row. Do not import that bulletin's obstetric reporting rules onto AARP UnitedHealthCare Insurance Company.
Published
Not stated in source
Transition starts
Not published for this row
Billing starts
Not published
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
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Scope: AARP UnitedHealthCare Insurance Company supplemental products, payer ID 36273. This row is not the unitedhealthcare record, and that bulletin is not imported here.
Transition: No AARP transition date was read.
Global billing: No AARP global-package or 2027 obstetric reporting rule was read.
Approving this item records the exclusion. Keep this row distinct from the unitedhealthcare commercial record.
AblePay says members can save on out-of-pocket expenses that come with pregnancy and delivery, including deductibles, coinsurance, and copays, when a provider partners with AblePay. No claim-coding rule is stated.
Published
Not stated in source
Transition starts
Not stated in cited page
Billing starts
No obstetric billing date stated
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: AblePay Health patient payment program. Not an insurer obstetric policy.
Transition: No maternity coding transition is stated.
Global billing: No claim-coding or global obstetric rule is stated.
WI · Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
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Scope: Corporate medical maternity template; adoption and effective date for Advantage by Managed Health Services in Wisconsin are unverified.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
This PDF does not document adoption by Advantage by Managed Health Services. Application is subject to coverage documents, applicable plan-level policies and state and federal requirements.
National commercial guidance — verify the member's plan applicability.
For Aetna commercial and Medicare members, the announced CPT framework replaces global maternity codes with service-level coding across antepartum, labor management, delivery and postpartum care beginning 2027-01-01; operational and claims-processing details remain forthcoming. For qualifying patients expected to deliver in 2027, bill preventive prenatal visits on or after 2026-09-01 with the applicable E/M code, modifier TH and pregnancy diagnosis code(s), subject to the stated visit-count rule.
Published
2026-09
Transition starts
September 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
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Scope: Aetna commercial and Medicare medical maternity services. This article does not establish applicability to Medicaid, dental, vision or separately identified affiliates and products.
Transition: For patients expected to deliver in 2027, preventive prenatal visits on or after 2026-09-01 should be billed with the applicable E/M code, TH and pregnancy diagnosis code(s) when three or fewer visits are provided before 2027-01-01. Once four prenatal visits have occurred in 2026, follow current antepartum coding guidelines. The article does not specify a preventive E/M code family.
Global billing: The article directs current antepartum coding once four prenatal visits occur in 2026; it does not grant blanket permission to continue global maternity billing. Global maternity codes are announced for retirement on 2027-01-01, with implementation details forthcoming.
For fully insured plans written in Texas, the maternity changes apply only if consistent with applicable regulatory requirements; other plans follow the article. Routine prenatal and postpartum office E&M visits are described as preventive with no member cost-share and require TH plus an appropriate diagnosis; TH alone does not establish preventive status. Non-routine visits should not use TH and should be billed for the medical reason for the encounter.
Aetna Better Health of Florida announces the elimination of traditional global maternity CPT codes effective January 1, 2027 and summarizes a replacement itemized framework, including prenatal and postpartum visit-level reporting primarily using E/M codes. Additional coding guidance and claims-editing rules were not finalized at early release; this notice does not provide detailed payer submission or transition instructions.
Published
2026-09
Transition starts
No 2026 transition specified
Billing starts
January 1, 2027
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
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Source excerpt
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Scope: Aetna Better Health of Florida medical obstetric billing; the notice does not establish dental, vision, or other Aetna product applicability.
Transition: No September 2026 start date, EDD or visit-count thresholds, TH modifier instruction, or pregnancy diagnosis requirement is specified.
Global billing: The notice announces elimination of traditional global maternity CPT codes effective January 1, 2027. It does not specify a 2026 global-billing allowance or transition pathway.
This is a payer-specific advance notice summarizing the coding change. Additional coding guidance and claims-editing rules were not finalized at early release.
MI · Transition: Not stated in the approved quotes
The plan letter says that effective January 1, 2027 the AMA CPT Editorial Panel is deleting global maternity CPT codes such as 59400, 59510, and 59620. It points providers to proposed MDHHS policy 2623-Practitioner and says MDHHS accepted comments through October 1, 2026. It does not state a plan claim rule.
Published
Not stated in source
Transition starts
Not stated in the approved quotes
Billing starts
No plan billing date stated
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Aetna Better Health of Michigan Medicaid. Not Aetna commercial.
Transition: Not stated in the approved quotes
Global billing: The letter says the global maternity CPT codes are being deleted effective January 1, 2027. That statement is the AMA change as relayed, not a confirmed plan edit.
Do not treat this as confirmed_2027. Do not copy the commercial OfficeLink update onto this row.
No Aetna Better Health Maryland 2027 implementation date was found. Continue the plan's current Maryland Medicaid maternity workflow until a plan-specific update is issued.
Published
Not stated in source
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-09-04
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
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Not published
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Scope: exact plan manual plus Maryland Medicaid program
Transition: No 2027 transition or grace period was located.
Global billing: Follow Maryland Medicaid's current separate-delivery rules; do not apply Aetna commercial OfficeLink guidance to this Medicaid plan.
The manual includes H1003 enriched-maternity billing and referral/documentation requirements. Prior parent-Aetna matching was rejected; this row now uses Maryland-plan sources only.
For new maternity patients beginning prenatal care on or after September 1, 2026, prenatal visits may be billed using E/M codes with modifier TH and a pregnancy diagnosis. Existing global maternity coding guidance remains applicable for qualifying pregnancies and deliveries occurring in 2026. Beginning January 1, 2027, maternity care is reported across antepartum, labor management, delivery, and postpartum.
Published
Not stated as a single calendar date
Transition starts
September 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Aetna Better Health of Oklahoma. Not Aetna commercial or other Aetna Better Health states.
Transition: The September 1 transition does not eliminate global maternity billing for 2026 deliveries.
Global billing: Existing global maternity coding guidance remains applicable for qualifying pregnancies and deliveries occurring in 2026.
Commercial OfficeLink rules are not this plan. The Summer 2026 newsletter quotes are included only where this finding stores them.
No corporate 2027 start date found. The current template supports global maternity billing and code-audit review, but it is effective only when adopted by a specific Centene health plan on that plan's own date.
Published
Not stated in source
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Centene corporate template; state-plan adoption must be verified
Transition: No 2027 transition or grace period located in the cited current policy unless stated in the billing summary.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
The upstream index is an example adopting-plan index (Ambetter PA), not a universal Centene provider-policy index. Medicaid rules and plan-level policies can supersede the corporate template. Match applied from payer family/program metadata; confirm the exact member product before submission.
UnitedHealthcare Community Plan of New York hosts a New York State Medicaid deck that directs all Medicaid providers to bill routine antepartum care with E/M codes plus modifier TH for individuals initiating antepartum services on or after June 1, 2026, or with an estimated due date on or after January 1, 2027. The initial antepartum visit also carries category II CPT 0500F. The deck says all global and bundled obstetric codes are deleted as of January 1, 2027. The plan publishes the deck and states no plan-specific rule.
Published
2026-04-22
Transition starts
June 1, 2026
Billing starts
Plan billing date not established. The state deck says bundled codes are deleted as of January 1, 2027.
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
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Scope: UnitedHealthcare Community Plan of New York (Medicaid). The catalog entry uses the legacy AmeriChoice name. The document relays New York State Medicaid requirements.
Transition: The deck's cohort is antepartum services initiated on or after June 1, 2026 and/or an estimated due date on or after January 1, 2027. UHC Community Plan NY does not state its own claim-edit behavior.
Global billing: The deck says all global and bundled billing codes for obstetric services will be deleted as of January 1, 2027. That is the state directive, not a stated plan rule.
Do not duplicate the New York State rule as a UnitedHealthcare claim rule. medicaid-new-york already records the state requirement.
AmeriHealth Caritas Delaware's August 7, 2026 provider alert says beginning January 1, 2027, bundled prenatal and postpartum CPT codes are retired and replaced with revised and new phase-specific codes. The notice says the update deletes 17 codes, adds 12, and revises six, and that the listed bundled codes should not be reported for dates of service on or after January 1, 2027. It does not state a reimbursement method or how a pregnancy spanning 2026 and 2027 should be billed.
Published
2026-08-07
Transition starts
No 2026 transition date stated
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: AmeriHealth Caritas Delaware Medicaid professional claims. Not Next, VIP Care, or other AmeriHealth Caritas plans.
Transition: No instruction is given for 2026 antepartum care with a 2027 delivery.
Global billing: Bundled prenatal, delivery, and postpartum CPT codes, 17 codes including 59400, 59510, 59610, 59618, 59425, 59426, and 59430, should not be reported for dates of service on or after January 1, 2027. They are replaced by 12 new phase-specific codes, 59080-59083, 59431-59434, 59502-59504, and 59623, with six revised codes.
The notice is a coding and PPC quality-measure update. It asks providers to update systems. It does not state reimbursement methodology.
The AmeriHealth Caritas New Hampshire Maternity Codes FAQ says bundled prenatal and postpartum CPT codes are retired for dates of service on or after January 1, 2027 and replaced with revised and new phase-specific codes. It says 35 codes changed: 17 deleted, 12 new, and six revised. Retired codes should not be reported on or after that date. The FAQ has no publication date and does not list the codes.
Published
Not stated in source
Transition starts
No 2026 transition date stated
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: AmeriHealth Caritas New Hampshire Medicaid. FAQ page only; the code tables it references were not on the page. Catalog id payer_19444353d5e9581d8f11, kept separate from the sibling New Hampshire id.
Transition: No 2026-2027 pregnancy-span instruction is given.
Global billing: Bundled prenatal and postpartum CPT codes are retired for dates of service on or after January 1, 2027. The FAQ does not name the individual codes.
This row is only catalog id payer_19444353d5e9581d8f11. The FAQ does not state a reimbursement method.
The AmeriHealth Caritas New Hampshire Maternity Codes FAQ says bundled prenatal and postpartum CPT codes are retired for dates of service on or after January 1, 2027 and replaced with revised and new phase-specific codes. It says 35 codes changed: 17 deleted, 12 new, and six revised. Retired codes should not be reported on or after that date. The FAQ has no publication date and does not list the codes.
Published
Not stated in source
Transition starts
No 2026 transition date stated
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: AmeriHealth Caritas New Hampshire Medicaid. FAQ page only; the code tables it references were not on the page. Catalog id payer_dcbc7d84282b26503f52, kept separate from the sibling New Hampshire id.
Transition: No 2026-2027 pregnancy-span instruction is given.
Global billing: Bundled prenatal and postpartum CPT codes are retired for dates of service on or after January 1, 2027. The FAQ does not name the individual codes.
This row is only catalog id payer_dcbc7d84282b26503f52. The FAQ does not state a reimbursement method.
The September 22, 2026 AmeriHealth Caritas Next notice for Delaware says beginning January 1, 2027, bundled prenatal and postpartum CPT codes are retired and replaced with revised and new phase-specific codes. The notice says the update deletes 17 codes, adds 12, and revises six, and that the listed bundled codes should not be reported for dates of service on or after January 1, 2027. It does not state a reimbursement method or how a pregnancy spanning 2026 and 2027 should be billed.
Published
2026-09-22
Transition starts
No 2026 transition date stated
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: AmeriHealth Caritas Next marketplace plan, Delaware. Not the AmeriHealth Caritas Medicaid plan in the same state. This is the Next Delaware catalog row, not the Delaware Medicaid plan.
Transition: No instruction is given for 2026 antepartum care with a 2027 delivery.
Global billing: Bundled prenatal, delivery, and postpartum CPT codes, 17 codes including 59400, 59510, 59610, 59618, 59425, 59426, and 59430, should not be reported for dates of service on or after January 1, 2027. They are replaced by 12 new phase-specific codes, 59080-59083, 59431-59434, 59502-59504, and 59623, with six revised codes.
The notice is a coding and PPC quality-measure update. Sibling catalog IDs stay separate.
The September 22, 2026 AmeriHealth Caritas Next notice for Florida says beginning January 1, 2027, bundled prenatal and postpartum CPT codes are retired and replaced with revised and new phase-specific codes. The notice says the update deletes 17 codes, adds 12, and revises six, and that the listed bundled codes should not be reported for dates of service on or after January 1, 2027. It does not state a reimbursement method or how a pregnancy spanning 2026 and 2027 should be billed.
Published
2026-09-22
Transition starts
No 2026 transition date stated
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: AmeriHealth Caritas Next marketplace plan, Florida. Not the AmeriHealth Caritas Medicaid plan in the same state. This is catalog ID ending 596906, kept separate from the sibling Florida Next ID.
Transition: No instruction is given for 2026 antepartum care with a 2027 delivery.
Global billing: Bundled prenatal, delivery, and postpartum CPT codes, 17 codes including 59400, 59510, 59610, 59618, 59425, 59426, and 59430, should not be reported for dates of service on or after January 1, 2027. They are replaced by 12 new phase-specific codes, 59080-59083, 59431-59434, 59502-59504, and 59623, with six revised codes.
The notice is a coding and PPC quality-measure update. Sibling catalog IDs stay separate.
The September 22, 2026 AmeriHealth Caritas Next notice for Louisiana says beginning January 1, 2027, bundled prenatal and postpartum CPT codes are retired and replaced with revised and new phase-specific codes. The notice says the update deletes 17 codes, adds 12, and revises six, and that the listed bundled codes should not be reported for dates of service on or after January 1, 2027. It does not state a reimbursement method or how a pregnancy spanning 2026 and 2027 should be billed.
Published
2026-09-22
Transition starts
No 2026 transition date stated
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: AmeriHealth Caritas Next marketplace plan, Louisiana. Not the AmeriHealth Caritas Medicaid plan in the same state. This is the Next Louisiana catalog row, kept separate from the sibling Louisiana Next product ID.
Transition: No instruction is given for 2026 antepartum care with a 2027 delivery.
Global billing: Bundled prenatal, delivery, and postpartum CPT codes, 17 codes including 59400, 59510, 59610, 59618, 59425, 59426, and 59430, should not be reported for dates of service on or after January 1, 2027. They are replaced by 12 new phase-specific codes, 59080-59083, 59431-59434, 59502-59504, and 59623, with six revised codes.
The notice is a coding and PPC quality-measure update. Sibling catalog IDs stay separate.
The September 22, 2026 AmeriHealth Caritas Next notice for North Carolina says beginning January 1, 2027, bundled prenatal and postpartum CPT codes are retired and replaced with revised and new phase-specific codes. The notice says the update deletes 17 codes, adds 12, and revises six, and that the listed bundled codes should not be reported for dates of service on or after January 1, 2027. It does not state a reimbursement method or how a pregnancy spanning 2026 and 2027 should be billed.
Published
2026-09-22
Transition starts
No 2026 transition date stated
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: AmeriHealth Caritas Next marketplace plan, North Carolina. Not the AmeriHealth Caritas Medicaid plan in the same state. This is the Next North Carolina catalog row, not the North Carolina Medicaid plan.
Transition: No instruction is given for 2026 antepartum care with a 2027 delivery.
Global billing: Bundled prenatal, delivery, and postpartum CPT codes, 17 codes including 59400, 59510, 59610, 59618, 59425, 59426, and 59430, should not be reported for dates of service on or after January 1, 2027. They are replaced by 12 new phase-specific codes, 59080-59083, 59431-59434, 59502-59504, and 59623, with six revised codes.
The notice is a coding and PPC quality-measure update. Sibling catalog IDs stay separate.
The September 22, 2026 AmeriHealth Caritas Next notice for Florida says beginning January 1, 2027, bundled prenatal and postpartum CPT codes are retired and replaced with revised and new phase-specific codes. The notice says the update deletes 17 codes, adds 12, and revises six, and that the listed bundled codes should not be reported for dates of service on or after January 1, 2027. It does not state a reimbursement method or how a pregnancy spanning 2026 and 2027 should be billed.
Published
2026-09-22
Transition starts
No 2026 transition date stated
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: AmeriHealth Caritas Next marketplace plan, Florida. Not the AmeriHealth Caritas Medicaid plan in the same state. This is the sibling Florida Next catalog ID ending b227e0, kept separate from the ID ending 596906.
Transition: No instruction is given for 2026 antepartum care with a 2027 delivery.
Global billing: Bundled prenatal, delivery, and postpartum CPT codes, 17 codes including 59400, 59510, 59610, 59618, 59425, 59426, and 59430, should not be reported for dates of service on or after January 1, 2027. They are replaced by 12 new phase-specific codes, 59080-59083, 59431-59434, 59502-59504, and 59623, with six revised codes.
The notice is a coding and PPC quality-measure update. Sibling catalog IDs stay separate.
The September 22, 2026 AmeriHealth Caritas Next notice for Louisiana says beginning January 1, 2027, bundled prenatal and postpartum CPT codes are retired and replaced with revised and new phase-specific codes. The notice says the update deletes 17 codes, adds 12, and revises six, and that the listed bundled codes should not be reported for dates of service on or after January 1, 2027. It does not state a reimbursement method or how a pregnancy spanning 2026 and 2027 should be billed.
Published
2026-09-22
Transition starts
No 2026 transition date stated
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: AmeriHealth Caritas Next marketplace plan, Louisiana. Not the AmeriHealth Caritas Medicaid plan in the same state. This is the sibling Louisiana Next catalog ID, kept separate from amerihealth-caritas-next-louisiana.
Transition: No instruction is given for 2026 antepartum care with a 2027 delivery.
Global billing: Bundled prenatal, delivery, and postpartum CPT codes, 17 codes including 59400, 59510, 59610, 59618, 59425, 59426, and 59430, should not be reported for dates of service on or after January 1, 2027. They are replaced by 12 new phase-specific codes, 59080-59083, 59431-59434, 59502-59504, and 59623, with six revised codes.
The notice is a coding and PPC quality-measure update. Sibling catalog IDs stay separate.
AmeriHealth Caritas North Carolina's September 3, 2026 alert says beginning January 1, 2027, bundled prenatal and postpartum CPT codes are retired and replaced with revised and new phase-specific codes. The notice says the update deletes 17 codes, adds 12, and revises six, and that the listed bundled codes should not be reported for dates of service on or after January 1, 2027. It does not state a reimbursement method or how a pregnancy spanning 2026 and 2027 should be billed. Beginning September 1, 2026, the notice says NC Medicaid Direct and NC Medicaid Managed Care providers are encouraged to bill E/M 99202-99215 with modifier TH for first prenatal visits after confirmation and for antepartum visits where delivery or the postpartum visit is expected after January 1, 2027, with an ICD-10-CM code including weeks of gestation.
Published
2026-09-03
Transition starts
September 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: AmeriHealth Caritas North Carolina Medicaid managed care. The transition instruction is attributed to NC Medicaid Direct and Managed Care.
Transition: The September 1, 2026 transition is described as encouraged, not as a statement that global codes are rejected before 2027. No separate instruction is given for 2026 antepartum care with a 2027 delivery beyond that encouraged E/M plus TH path.
Global billing: Bundled prenatal, delivery, and postpartum CPT codes, 17 codes including 59400, 59510, 59610, 59618, 59425, 59426, and 59430, should not be reported for dates of service on or after January 1, 2027. They are replaced by 12 new phase-specific codes, 59080-59083, 59431-59434, 59502-59504, and 59623, with six revised codes.
The notice is a coding and PPC quality-measure update. It does not publish fee-schedule or claim-edit behavior. Keep the encouraged wording.
Effective January 1, 2027, the commercial policy says antepartum care is reported per encounter with the applicable E/M code and modifier TH, for up to 13 routine visits per pregnancy episode per TIN, with a Z3A weeks-of-gestation code on the first prenatal visit. Labor management is reported with 59080-59083, one per calendar date per setting at the highest level. Delivery is reported with 59431, 59432, 59502, or 59503 and a Z3A code. Postpartum care is per-encounter E/M with modifier TH, up to 3 routine visits within 12 weeks (16 combined). Visit limits do not apply to high-risk or complication E/M services. No Colorado exemption is stated. This catalog entry is an encounters routing ID, not a member-facing product.
Published
2026-09-09
Transition starts
No 2026 transition date stated
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Anthem Blue Cross and Blue Shield commercial professional claims, Colorado. Catalog entry is an encounters routing ID, not a member-facing product. No Colorado exemption is stated.
Transition: No 2026-2027 pregnancy-span instruction is stated. The delayed exemption in the policy history names California and Virginia, not Colorado.
Global billing: The September 9, 2026 review replaces the global obstetric care package with service-level reimbursement effective January 1, 2027. This row stays the Colorado encounters catalog ID and is not a substitute for a member-facing Colorado plan record.
Kept separate from other Anthem Colorado catalog entries. The finding identifies this row as a WGS encounters routing ID.
NY · Transition: No separate transition date. Policy effective 2027-01-01
Commercial reimbursement policy C-19004, last approved 09/09/2026 and effective 01/01/2027, names In these same counties, Anthem Blue Cross and Blue Shield HP is the trade name of Anthem HP, LLC. Antepartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 13 routine office or other outpatient visits per pregnancy episode under the same TIN. The first prenatal E/M visit must include an ICD-10-CM code from category Z3A. Labor management must be reported with CPT codes 59080–59083. Delivery must be reported with 59431, 59432, 59502, or 59503, plus a Z3A code. Postpartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 3 routine visits within 12 weeks after delivery under the same TIN. Policy history adds a California and Virginia exemption effective TBD. This plan is Anthem HP, LLC in those New York counties, which that exemption does not name.
Published
2026-09-09
Transition starts
No separate transition date. Policy effective 2027-01-01
Billing starts
January 1, 2027
Evidence checked
2026-10-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Commercial; Anthem HP, LLC, trade name Anthem Blue Cross and Blue Shield HP, in 17 southeastern New York counties
Transition: Policy history adds a California and Virginia exemption effective TBD. This plan is Anthem HP, LLC in those New York counties, which that exemption does not name. added California and Virginia exemption effective TBD due to delayed implementation
Global billing: The policy replaces global obstetric reporting with per-encounter antepartum and postpartum E/M codes, labor-management codes 59080-59083, and delivery codes 59431, 59432, 59502, or 59503.
California and Virginia are the plans named in the exemption. This record does not apply that exemption here.
No 2027 implementation date was published. Current HealthKeepers Plus Medicaid policy still reimburses global obstetrical codes for complete same-TIN care.
Published
Not stated in source
Transition starts
Not published
Billing starts
October 23, 2025
Evidence checked
2026-09-04
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: exact HealthKeepers Plus Medicaid policy; commercial 2027 notice not found
Transition: No 2027 transition or grace period was located.
Global billing: Yes under the current HealthKeepers Plus Medicaid policy when the same TIN provides the complete obstetric package.
The located maternity policy is Anthem HealthKeepers Plus Medicaid, last approved 10/23/2025, and is not a 2027 commercial implementation notice. Do not apply another Anthem state's 2027 article to Virginia commercial claims.
CA · Transition: California exemption effective TBD
Commercial policy C-19004, approved September 9, 2026, describes January 1, 2027 service-level maternity reimbursement, including E/M plus modifier TH. Its policy history adds a California exemption effective TBD due to delayed implementation. For California commercial professional claims, that effective date is not established, so the 2027 service-level rules are not confirmed.
Published
2026-09-09
Transition starts
California exemption effective TBD
Billing starts
Not published. The California exemption effective date is TBD.
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Anthem Blue Cross commercial professional claims in California. The policy exempts California with an effective date TBD.
Transition: The only California timing in the retrieved text is the policy-history line: California and Virginia exemption effective TBD due to delayed implementation. The exemption body text was not in the retrieved PDF text.
Global billing: The policy says it replaces the global obstetric package with service-level reimbursement, and the same history line delays that change for California. Do not apply the service-level rules as confirmed California billing instructions.
Pending because of the delayed California exemption. Do not publish a California billing date. The policy number in the document is C-19004.
CO · Transition: No separate transition date. Policy effective 2027-01-01
Commercial reimbursement policy C-19004, last approved 09/09/2026 and effective 01/01/2027, names In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. Antepartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 13 routine office or other outpatient visits per pregnancy episode under the same TIN. The first prenatal E/M visit must include an ICD-10-CM code from category Z3A. Labor management must be reported with CPT codes 59080–59083. Delivery must be reported with 59431, 59432, 59502, or 59503, plus a Z3A code. Postpartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 3 routine visits within 12 weeks after delivery under the same TIN. Policy history adds a California and Virginia exemption effective TBD. Colorado is not named in that exemption.
Published
2026-09-09
Transition starts
No separate transition date. Policy effective 2027-01-01
Billing starts
January 1, 2027
Evidence checked
2026-10-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Commercial; Rocky Mountain Hospital and Medical Service, Inc. in Colorado. HMO products underwritten by HMO Colorado, Inc.
Transition: Policy history adds a California and Virginia exemption effective TBD. Colorado is not named in that exemption. added California and Virginia exemption effective TBD due to delayed implementation
Global billing: The policy replaces global obstetric reporting with per-encounter antepartum and postpartum E/M codes, labor-management codes 59080-59083, and delivery codes 59431, 59432, 59502, or 59503.
California and Virginia are the plans named in the exemption. This record does not apply that exemption here.
GA · Transition: No separate transition date. Policy effective 2027-01-01
Commercial reimbursement policy C-19004, last approved 09/09/2026 and effective 01/01/2027, names In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Antepartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 13 routine office or other outpatient visits per pregnancy episode under the same TIN. The first prenatal E/M visit must include an ICD-10-CM code from category Z3A. Labor management must be reported with CPT codes 59080–59083. Delivery must be reported with 59431, 59432, 59502, or 59503, plus a Z3A code. Postpartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 3 routine visits within 12 weeks after delivery under the same TIN. removed Georgia exemption The California and Virginia exemption effective TBD does not name Georgia.
Published
2026-09-09
Transition starts
No separate transition date. Policy effective 2027-01-01
Billing starts
January 1, 2027
Evidence checked
2026-10-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Commercial; Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.
Transition: removed Georgia exemption The California and Virginia exemption effective TBD does not name Georgia. added California and Virginia exemption effective TBD due to delayed implementation
Global billing: The policy replaces global obstetric reporting with per-encounter antepartum and postpartum E/M codes, labor-management codes 59080-59083, and delivery codes 59431, 59432, 59502, or 59503.
California and Virginia are the plans named in the exemption. This record does not apply that exemption here.
IN · Transition: No separate transition date. Policy effective 2027-01-01
Commercial reimbursement policy C-19004, last approved 09/09/2026 and effective 01/01/2027, names In Indiana: Anthem Insurance Companies, Inc. Antepartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 13 routine office or other outpatient visits per pregnancy episode under the same TIN. The first prenatal E/M visit must include an ICD-10-CM code from category Z3A. Labor management must be reported with CPT codes 59080–59083. Delivery must be reported with 59431, 59432, 59502, or 59503, plus a Z3A code. Postpartum care must be reported per encounter with the applicable E/M code and modifier TH, up to 3 routine visits within 12 weeks after delivery under the same TIN. Policy history adds a California and Virginia exemption effective TBD. Indiana is not named in that exemption.
Published
2026-09-09
Transition starts
No separate transition date. Policy effective 2027-01-01
Billing starts
January 1, 2027
Evidence checked
2026-10-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Commercial; Anthem Insurance Companies, Inc. in Indiana
Transition: Policy history adds a California and Virginia exemption effective TBD. Indiana is not named in that exemption. added California and Virginia exemption effective TBD due to delayed implementation
Global billing: The policy replaces global obstetric reporting with per-encounter antepartum and postpartum E/M codes, labor-management codes 59080-59083, and delivery codes 59431, 59432, 59502, or 59503.
California and Virginia are the plans named in the exemption. This record does not apply that exemption here.
ME · Transition: Not stated in the approved quotes
Anthem's September 9, 2026 review of commercial policy C-19004, effective January 1, 2027, replaces the global obstetric care package with service-level reimbursement. Antepartum care is an E/M code with modifier TH. The California and Virginia exemption in the same PDF does not name Maine. Maine DHHS guidance stays on maine-medicaid.
Published
2026-09-09
Transition starts
Not stated in the approved quotes
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Anthem Blue Cross and Blue Shield commercial professional claims in Maine. Not Maine Medicaid.
Transition: Not stated in the approved quotes
Global billing: The review replaces the global obstetric care package with service-level reimbursement guidance.
Same PDF as California and Colorado encounters. This row uses the Maine reading, which has no state exemption.
Anthem's New York Medicaid article announces maternity coding restructuring effective January 1, 2027. It directs NYS Medicaid-enrolled maternity providers to use the restructured system for services to individuals initiating prenatal care on or after June 1, 2026, and/or having an estimated due date on or after January 1, 2027. Antepartum and postpartum care are reported per encounter using E/M codes; labor management and delivery are reported separately. The article refers providers to the April 2026 NYS Medicaid Update for additional billing guidance.
Scope: New York Medicaid maternity medical services; coverage identified as Anthem Blue Cross and Blue Shield HP, trade name of Anthem HP, LLC. Applicability to commercial, Medicare, dental, or vision products is not established.
Transition: The patient criteria are prenatal-care initiation on or after June 1, 2026, and/or an estimated due date on or after January 1, 2027. This article does not state a grandfathering exception through December 31 or a rule for global claims spanning January 1.
Global billing: The article describes a January 1, 2027 move away from legacy global maternity codes toward phase-specific reporting. It does not specify which 2026 global claims remain permissible or provide a global-claim date-span rule.
This is an Anthem New York Medicaid provider article, updated June 18, 2026. It references the April 2026 NYS Medicaid Update, but that separate document was not supplied. TH, pregnancy-diagnosis and 0500F requirements, and an express managed-care alignment deadline cannot be verified from this article.
For Arkansas Blue Cross members, follow the recommended maternity billing phases based on the date of the initial prenatal visit for confirmation of pregnancy. The first non-global phase begins May 15, 2026; complete 2027 billing instructions are not supplied here.
Published
2026-05-04
Transition starts
May 15, 2026
Billing starts
Initial prenatal confirmation-visit cohorts beginning May 15, 2026
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Maternity medical billing for Arkansas Blue Cross members; specific commercial and Medicare product applicability is not identified.
Transition: For initial prenatal visits for confirmation of pregnancy: until May 15, 2026, global obstetric codes still may be used; May 15–July 14, use 59426 + delivery only; July 15–September 1, use 59425 + delivery. Further guidance is promised for visits on or after September 1, creating an unresolved overlap on that date.
Global billing: Global obstetric codes still may be used for the initial-visit cohort described as 'Until May 15, 2026.' Subsequent listed cohorts use 59426 + delivery only, then 59425 + delivery. These recommendations do not establish a blanket cutoff for all global claims.
This document supplies recommended 2026 transition phases ahead of the January 1, 2027 CPT changes. It does not identify product-level applicability or establish whether later guidance was subsequently issued. The supplied files do not substantiate the archive-provenance or August 28 search-history assertions. Clarify the September 1 boundary and the July phase's delivery wording before applying them.
AZ · Transition: Not stated in the approved quotes
AZ Blue's Medicaid newsletter says current global maternity care codes will be replaced by codes that separately identify antepartum care, labor management, delivery, and postpartum care. Four to six antepartum visits bill CPT 59425. Seven or more bill CPT 59426. Fewer than four continue current 2026 CPT coding. The stored quotes do not state a calendar effective date.
Published
Not stated in source
Transition starts
Not stated in the approved quotes
Billing starts
Not stated as a calendar date in the stored quotes
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: AZ Blue Medicaid provider newsletter. Not a commercial AZ Blue rule.
Transition: Not stated in the approved quotes
Global billing: Global maternity care codes will be replaced by codes that separately identify the phases of care. The stored quotes do not date that replacement.
Visit-count rows use only the stored quotes. No January 1 date was in those quotes.
MI · Transition: Not stated in the approved quotes
The American Medical Association will discontinue global bundled prenatal, delivery, and postpartum codes on Jan. 1, 2027 and replace them with individual E/M or designated obstetric procedure codes. These interim requirements apply only to prenatal visits for members expected to deliver on or after Jan. 1, 2027. The TH modifier is a prerequisite for processing prenatal claims that use the designated E/M codes.
Published
Not stated in source
Transition starts
Not stated in the approved quotes
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Blue Cross Blue Shield of Michigan commercial, Blue Care Network commercial, Medicare Plus Blue, and BCN Advantage. This catalog ID is separate from the sibling IDs.
Transition: Not stated in the approved quotes
Global billing: Global bundled prenatal, delivery, and postpartum codes are discontinued on Jan. 1, 2027.
The approved finding names all four products in one notice. This record is only this catalog ID.
ND · Transition: Not stated in the approved quotes
BCBSND says maternity global coding changes will take effect Jan. 1, 2027. The page says to watch for final guidance and education materials in December. It does not give claim codes.
Published
Not stated in source
Transition starts
Not stated in the approved quotes
Billing starts
No code-level billing date; final guidance is promised in December
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: BCBSND catalog ID bcbs-north-dakota-72dc21. The sibling ID is a separate record.
Transition: Not stated in the approved quotes
Global billing: The page says maternity global reporting will change. It does not give the replacement codes.
pending_guidance because the claim instructions are not published. Do not mark confirmed_2027.
ND · Transition: Not stated in the approved quotes
BCBSND says maternity global coding changes will take effect Jan. 1, 2027. The page says to watch for final guidance and education materials in December. It does not give claim codes.
Published
Not stated in source
Transition starts
Not stated in the approved quotes
Billing starts
No code-level billing date; final guidance is promised in December
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: BCBSND catalog ID bcbs-north-dakota-cb1b6a. The sibling ID is a separate record.
Transition: Not stated in the approved quotes
Global billing: The page says maternity global reporting will change. It does not give the replacement codes.
pending_guidance because the claim instructions are not published. Do not mark confirmed_2027.
CT; IL; NM; TX; UT · Transition: Not stated in RP044
RP044 is effective 2026-05-22 and describes current professional-provider maternity reimbursement. It permits global billing for complete care under specified provider/location/TIN conditions and describes separate billing for partial or transferred care. This document does not state a 2027 CPT implementation date or transition rules.
Published
Not stated in source
Transition starts
Not stated in RP044
Billing starts
May 22, 2026
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: BCBSTX professional-provider obstetrical maternity claims. Specific member-product and program applicability is not identified in the document; this is not 2027 implementation guidance.
Transition: RP044 does not address the 2027 maternity CPT deletion or state a transition or grace period. Its silence does not establish whether other payer guidance exists.
Global billing: RP044 permits global billing when antepartum, delivery, and postpartum care are provided by the same QHP or another QHP at the same location under the same TIN. It also describes component billing, including a separate-billing option for providers at the same location/same TIN. Claims must use valid code combinations; the document does not authorize continued use of deleted codes pending a payer notice.
Plan documents and provider contracts govern conflicts with this policy. Confirm applicability to the member's product; the document does not identify commercial, Medicare, Medicaid, or STAR/CHIP applicability. The supplied PDF does not state the reimbursement-index rule about out-of-network policies becoming effective when posted.
For a first visit after confirmation of pregnancy on or after September 1, 2026, bill the appropriate E/M code appended with modifier -TH and an appropriate Z34.XX or O00-O9A diagnosis code. Global maternity care and delivery codes are deleted effective January 1, 2027. A vaginal or cesarean delivery in 2026 uses the appropriate current global obstetrics codes. Seven or more antepartum visits in 2026 with delivery in 2027 use CPT 59426. Four to six use CPT 59425.
Published
2026-06
Transition starts
September 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Blue Cross and Blue Shield of Vermont obstetric claims. The August notice remains the upstream edition.
Transition: Apply the transition by date of service, not by the date of the initial prenatal visit. Prenatal services on or before August 31, 2026 should use an appropriate E/M code or antepartum code 59425 (4-6 visits) or 59426 (7 or more visits). Services on or after September 1, 2026 follow the E/M, -TH, and diagnosis instructions.
Global billing: The notice permits 59425/59426 as alternatives to appropriate E/M for qualifying prenatal dates of service through August 31, 2026. It does not authorize continued global billing for other services; antepartum dates of service on or after September 1 follow the specified E/M requirements.
The August 2026 notification, updated July 30, 2026, announces January 1, 2027 maternity code replacement and supplies September 1, 2026 antepartum transition instructions. It does not provide detailed billing instructions for the full 2027 code set. Confirm applicability to the member's specific product.
MI · Transition: Not stated in the approved quotes
The American Medical Association will discontinue global bundled prenatal, delivery, and postpartum codes on Jan. 1, 2027 and replace them with individual E/M or designated obstetric procedure codes. These interim requirements apply only to prenatal visits for members expected to deliver on or after Jan. 1, 2027. The TH modifier is a prerequisite for processing prenatal claims that use the designated E/M codes.
Published
Not stated in source
Transition starts
Not stated in the approved quotes
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Blue Cross Blue Shield of Michigan commercial, Blue Care Network commercial, Medicare Plus Blue, and BCN Advantage. This catalog ID is separate from the sibling IDs.
Transition: Not stated in the approved quotes
Global billing: Global bundled prenatal, delivery, and postpartum codes are discontinued on Jan. 1, 2027.
The approved finding names all four products in one notice. This record is only this catalog ID.
MI · Transition: Not stated in the approved quotes
The American Medical Association will discontinue global bundled prenatal, delivery, and postpartum codes on Jan. 1, 2027 and replace them with individual E/M or designated obstetric procedure codes. These interim requirements apply only to prenatal visits for members expected to deliver on or after Jan. 1, 2027. The TH modifier is a prerequisite for processing prenatal claims that use the designated E/M codes.
Published
Not stated in source
Transition starts
Not stated in the approved quotes
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Blue Cross Blue Shield of Michigan commercial, Blue Care Network commercial, Medicare Plus Blue, and BCN Advantage. This catalog ID is separate from the sibling IDs.
Transition: Not stated in the approved quotes
Global billing: Global bundled prenatal, delivery, and postpartum codes are discontinued on Jan. 1, 2027.
The approved finding names all four products in one notice. This record is only this catalog ID.
For deliveries expected on or after 2027-01-01, BCBSWY says not to bill global maternity codes; bill antepartum, labor, delivery, and postpartum services separately.
Published
2026-06-19
Transition starts
No early transition date stated
Billing starts
January 1, 2027
Evidence checked
2026-09-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: BCBSWY provider-manual notice. The notice does not identify a commercial, Medicare Advantage, or other line of business.
Transition: No prenatal visit-count, modifier, diagnosis, or cross-year grace-period detail was located in the public notice.
Global billing: Continue the applicable global package for deliveries expected through 2026-12-31 when responsible for the complete package. Do not use global codes for deliveries expected on or after 2027-01-01.
Do not automatically apply this brand-level notice to a separately identified Medicare Advantage record without plan confirmation.
NC · Transition: Beginning mid-May 2026; exact date and billing steps unspecified
Blue Cross NC announces maternity billing-process changes beginning mid-May 2026 to support services performed on or after January 1, 2027. Detailed billing guidance is forthcoming.
Published
2026-05-26
Transition starts
Beginning mid-May 2026; exact date and billing steps unspecified
Billing starts
January 1, 2027
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Blue Cross NC maternity medical-services billing; specific insurance products and commercial-only scope are not identified.
Transition: The notice says providers will need to change how maternity services are billed beginning mid-May 2026. It gives no exact transition date or claim instructions and promises additional guidance.
Global billing: Changes to global maternity billing are announced, but the notice does not specify codes, claim methods, or handling of episodes spanning January 1, 2027.
Advance notice only. Do not infer an exact May transition date, a claim-submission method, or applicability to every Blue Cross NC product. Dental and vision applicability is not established.
CA · Transition: Not stated in the approved quotes
Effective January 1, 2027, Blue Shield of California will require maternity services to be billed with a phase-of-care methodology rather than a global obstetrical package. Patients with one to three antepartum visits by September 1, 2026 should have continuing antepartum visits billed with E/M codes when those visits are anticipated to continue past January 1, 2027. Patients with four or more visits as of September 1, 2026 stay on the global structure when they deliver by December 31, 2026.
Published
Not stated in the stored quotes
Transition starts
Not stated in the approved quotes
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Blue Shield of California. Not the Washington HCA FAQ and not Promise Health Plan.
Transition: Not stated in the approved quotes
Global billing: Four or more visits as of September 1, 2026 continue under the global CPT structure for deliveries by December 31, 2026.
This catalog ID does not inherit the Washington Medicaid FAQ that previously listed it as unpublished.
The cited guide does not state a 2027 implementation date. It describes global maternity billing when the same physician/group provides all components; its claims tips specify four or more antepartum visits, delivery and postpartum care. For separately reportable care, it lists E&M for 1–3 antepartum-only visits, 59425 for 4–6, 59426 for 7 or more, and 59430 for postpartum-only care. The guide instructs providers to submit the most current codes.
Published
Not stated in source
Transition starts
Not stated in cited guide
Billing starts
Not stated in cited guide
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: BCBS Alabama medical maternity coding reference; specific Commercial and Medicare products are not identified, and Dental/Vision applicability is not established. Not 2027 implementation guidance.
Transition: No 2027 transition or grace period is stated in this guide. This document alone cannot establish whether other payer guidance exists.
Global billing: The guide describes global billing for complete same-physician/group care, but instructs providers to consult the CPT manual for current updates and submit the most current codes. It does not authorize continued use of listed codes until a payer-specific 2027 update is posted.
Informational reference only; verify member eligibility, benefits and exact product applicability before applying its guidance. The source does not discuss 2027 code deletions. Its different-practice antepartum/postpartum sentence conflicts with Scenario A about which provider reports those services.
Reimbursement policy FP-01.011, Obstetrical Maternity Services, goes into effect September 1, 2026 and prepares providers for the 2027 move away from global obstetric codes toward visit-based reporting. Before September 1, 2026, the first prenatal visit after confirmation of pregnancy continues to use bundled codes. On or after September 1, 2026, that first prenatal visit requires an E/M code with modifier TH and ICD-10-CM Z3A.XX for weeks of gestation. FP-01.011 also addresses obstetrics and maternity services transitioning from global-based billing to visit/service-based billing effective January 1, 2027.
Published
Not stated in source
Transition starts
September 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-10-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Capital Blue Cross reimbursement policy FP-01.011. The maternity sentences do not name a narrower product line.
Transition: A different notice retires NR-30.029 effective August 31, 2026. That retirement date is not the maternity billing date.
Global billing: Global-based billing transitions to visit/service-based billing effective January 1, 2027. The notice sentence does not list the January 1 code numbers.
The September 1, 2026 code-removal sentences for other policies do not name the maternity codes, so those codes are not copied here.
Capital Blue Cross begins visit-based prenatal billing on 2026-09-01 after pregnancy confirmation. Its stated 2027 policy moves labor management, delivery, and postpartum care to component reporting on 2027-01-01.
Published
2026-07-01
Transition starts
September 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-09-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Capital Blue Cross bulletin expressly lists CHIP, EPO, FEP PPO, HMO, Medicare Advantage HMO/PPO, POS, PPO, and Traditional and Comprehensive products.
Transition: For first prenatal visits after pregnancy confirmation on or after 2026-09-01, use E/M + TH + appropriate ICD-10-CM including Z3A.XX. A September bulletin says the policy is further updated effective 2026-11-01: append TH to all maternity-related procedure codes.
Global billing: Before the September transition, the bulletin identifies 59425 for 4–6 visits and 59426 for 7+ visits. Component reporting applies from 2027-01-01 as stated.
The July bulletin gives labor-management and delivery-frequency rules. The later September bulletin changes the TH requirement; use the latest policy when submitting claims.
AZ · Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Corporate template for medical maternity services; Care1st Arizona Medicaid adoption and effective date are unverified. No dental billing application is established.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
This PDF does not document Care1st Arizona adoption. Conflicting state Medicaid coverage provisions take precedence; applicable coverage documents and plan-level policies must also be checked.
No 2027 start date found. The BlueChoice manual still refers providers to the current global obstetrical payment policy.
Published
Not stated in source
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-09-04
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: exact BlueChoice product manual
Transition: No 2027 transition or grace period was located.
Global billing: Yes under current CareFirst policy when complete package requirements are met.
The manual also requires delivery-facility notification and additional authorization for preterm labor/complications; some ultrasound and genetic-testing rules are BlueChoice-specific. The canonical payer inventory has no separate BlueChoice record, so this label maps to the CareFirst Maryland policy owner.
This chapter directs providers to follow CPT maternity reporting guidelines, including non-global services, and refers to Medical Policy 4.01.006A and Payment Policy PP CO 080.01. It states no implementation date for the 2027 maternity CPT deletion.
Published
Not stated in source
Transition starts
Not stated in this chapter
Billing starts
Not stated in this chapter
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Applicable local CareFirst BlueCross BlueShield medical business, subject to member contract. NASCO/FEP policies may differ. This chapter does not independently establish NCA-specific or GA applicability or maternity guidance for dental and vision products.
Transition: This chapter does not address the 2027 maternity CPT deletion, transition arrangements, or a grace period.
Global billing: Follow CPT guidelines for maternity reporting, including separate antepartum, delivery and/or postpartum services when appropriate under those guidelines. Consult 4.01.006A, PP CO 080.01, and the member contract; this chapter provides no 2027 continuation or conversion instructions.
The referenced policies are not reproduced in the supplied chapter, and portal-access requirements are not established. Verify the governing member product and account rules. Silence in this chapter does not establish that CareFirst has published no other 2027 guidance.
No public 2027 start date found. The February 2026 CareFirst CHPMD provider manual follows the Maryland HealthChoice maternity workflow and is not a 2027 implementation notice.
Published
Not stated in source
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-09-04
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: exact CareFirst Community Health Plan Maryland Medicaid manual
Transition: No 2027 transition or grace period located in the cited current policy unless stated in the billing summary.
Global billing: Follow Maryland Medicaid unbundled/separate-delivery rules; do not apply CareFirst commercial global obstetrical payment policies.
The plan-specific Medicaid manual requires H1000 for the prenatal risk assessment and allows H1003 for enriched maternity services. Do not treat CareFirst commercial Chapter 9, Medical Policy 4.01.006A, or PP CO 080.01 as controlling this product.
DE · Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Corporate template for medical maternity services; Celtic Delaware product adoption and effective date are unverified. No dental billing application is established.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
This PDF does not identify an adopting Celtic product. Application is subject to coverage documents, applicable plan-level policies and state and federal requirements.
No corporate 2027 start date found. The current template supports global maternity billing and code-audit review, but it is effective only when adopted by a specific Centene health plan on that plan's own date.
Published
Not stated in source
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Centene corporate template; state-plan adoption must be verified
Transition: No 2027 transition or grace period located in the cited current policy unless stated in the billing summary.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
The upstream index is an example adopting-plan index (Ambetter PA), not a universal Centene provider-policy index. Medicaid rules and plan-level policies can supersede the corporate template. Match applied from payer family/program metadata; confirm the exact member product before submission.
NATIONAL · Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Centene corporate template for medical maternity services; individual health-plan adoption and effective dates require verification. No dental or vision billing application is established.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
The header effective date is 01/01/2013 and the last review date is 10/28/2025; neither is a 2027 implementation date. Application is subject to coverage documents, applicable plan-level policies and state and federal requirements.
National commercial guidance — verify the member's plan applicability.
No new billing start was announced. Cigna says to continue current contracts and reimbursement policies and not begin the proposed prenatal E/M approach on September 1, 2026.
Published
2026-08-24
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-09-04
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: exact Cigna commercial notice; Great West product applicability not explicit
Transition: No 2027 transition or grace period was located.
Global billing: Yes under current contracts until Cigna publishes replacement guidance.
The source is conclusive for Cigna Healthcare commercial. Great West appears in the canonical inventory under Cigna, but the notice does not name Great West; verify the member product before applying it.
TX · Transition: Plan transition not specified; AMA revisions effective January 1, 2027
Community First's advance awareness notice summarizes AMA maternity coding revisions effective January 1, 2027: appropriate E/M codes for antepartum and postpartum care, new inpatient labor-management codes, separate delivery reporting, and deletion of numerous global maternity package codes. Community First is reviewing the revisions; detailed payer billing, reimbursement and implementation guidance remains pending.
Published
2026-08-03
Transition starts
Plan transition not specified; AMA revisions effective January 1, 2027
Billing starts
Plan billing implementation guidance pending
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Advance provider awareness notice on Community First's Texas Medicaid/CHIP-facing site; commercial and Medicare applicability is not established.
Transition: This notice does not specify transition handling or a grace period. Providers are instructed to monitor future communications for implementation and reimbursement guidance.
Global billing: The notice states that numerous existing global maternity package codes will be deleted under the AMA revisions. It does not establish a blanket payer rule ending global billing for all 2027 dates of service.
Do not infer product-wide implementation requirements from website navigation or payer-family metadata. Confirm the member's product and consult applicable payer policies and subsequent Community First guidance.
NY · Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Corporate template for medical maternity services; adoption and effective date for the exact Fidelis Care New York product are unverified. No dental billing application is established.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
This PDF does not identify an adopting Fidelis Care product or establish its program. Application is subject to coverage documents, applicable plan-level policies and state and federal requirements.
FL · Transition: 2026 antepartum services for 2027 deliveries
Florida Blue’s August notice directs a cross-year antepartum transition for 2027 deliveries, then individual prenatal, labor, delivery, and postpartum billing from 2027-01-01.
Published
2026-08
Transition starts
2026 antepartum services for 2027 deliveries
Billing starts
January 1, 2027
Evidence checked
2026-09-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Florida Blue notice also expressly names Truli for Health. It does not expressly identify Florida Blue Medicare products.
Transition: For a 2027 delivery, bill 1–3 2026 antepartum visits with E/M, 4–6 with 59425, and 7+ with 59426. From 2027-01-01, bill antepartum and postpartum E/M under CPT guidance; Florida Blue says TH is not required for routine prenatal E/M but is encouraged.
Global billing: For the stated 2027-delivery cohort, use the notice’s 2026 visit-count approach; global obstetric bundles end under the announced 2027 framework.
Florida Blue says affected contracts will be amended and a fuller 2027 policy is forthcoming. Do not use this notice for the separately listed Florida Blue Medicare record without a product-specific source.
GHP is preparing for the 2027 maternity CPT changes. Continue current maternity billing until formally notified by GHP. The notice states that the coding updates do not change provider contracts or reimbursement methodologies; it does not specify a GHP implementation date.
Published
2026-05-15
Transition starts
See guidance
Billing starts
Not announced
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: GHP medical maternity services; GHP expects consistent application across all its plan offerings once implemented. This notice does not establish dental or vision billing requirements.
Transition: Geisinger promises reasonable grace periods but gives no dates.
Global billing: Continue current billing until formal notification.
GHP promises advance communication, education, operational support and grace periods. Further operational details and billing guidance will follow. The notice does not describe assessment, configuration or testing phases.
GHP is preparing for the 2027 maternity CPT changes and expects consistent application across its plan offerings once implemented. Continue current maternity billing until formally notified by GHP. Contracts and reimbursement methodologies are unchanged by these coding updates; no Gold-specific implementation date is announced.
Published
2026-05-15
Transition starts
See guidance
Billing starts
Not announced
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Geisinger Gold Medicare Advantage medical maternity services, within GHP's stated expectation of consistent application across all plan offerings once implemented. No separate dental or vision billing applicability is established.
Transition: Geisinger promises reasonable grace periods but gives no dates.
Global billing: Continue current billing until formal notification.
The source explicitly identifies Geisinger Gold Medicare Advantage HMO, PPO and HMO D-SNP plans as offered by GHP/Geisinger Indemnity Insurance Company. GHP promises advance communication, education, operational support and grace periods, with further billing guidance to follow; it does not describe assessment, configuration or testing phases.
MD; VA; DC · Transition: Not stated in this chapter
The supplied chapter directs CPT maternity reporting, including non-global services, and refers to Medical Policy 4.01.006A and Payment Policy PP CO 080.01. It states no implementation date for the 2027 maternity CPT deletion.
Published
Not stated in source
Transition starts
Not stated in this chapter
Billing starts
Not stated in this chapter
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Applicable local medical business of Group Hospitalization and Medical Services, Inc., operating as CareFirst BlueCross BlueShield, subject to member contract. NASCO/FEP policies may differ.
Transition: This chapter does not address the 2027 maternity CPT deletion, transition arrangements, or a grace period.
Global billing: Follow CPT maternity reporting guidelines, including non-global reporting, and consult 4.01.006A, PP CO 080.01, and the member contract. The chapter gives no instruction to continue existing global billing through a 2027 transition or until a separate payer notice.
The entity mapping is explicit in the chapter's footer. The referenced policies are not reproduced, and portal-access requirements are not established. The absence of 2027 instructions in this chapter does not establish the absence of other public payer guidance.
IL · Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Corporate medical maternity template; adoption and effective date for Harmony's Illinois Medicare product are unverified.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
This PDF does not document Harmony Medicare adoption. For Medicare members, review all applicable NCDs and LCDs before applying the policy, together with relevant coverage documents and plan-level requirements.
CO · Transition: No transition date in this manual. OM26-056 is referenced for pregnancies beginning 2026-09-01
Health First Colorado uses global obstetric codes when one practitioner or the same group provides prenatal care of four or more visits, labor and delivery, and postpartum care. The complete global codes are 59400, 59510, 59610, and 59618, and the claim reports the date of delivery. Partial global codes for labor, delivery, and postpartum without that prenatal care are 59410, 59515, 59614, and 59622, each with 0503F. For new pregnancies beginning on dates of service September 1, 2026 and after, the manual says to reference Maternity Services Billing Operational Guidance Memo OM26-056 and does not restate it.
Published
2026-08-25
Transition starts
No transition date in this manual. OM26-056 is referenced for pregnancies beginning 2026-09-01
Billing starts
Not published in this manual
Evidence checked
2026-10-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Health First Colorado obstetrical billing manual.
Transition: Exceptions include transfer, referral, termination, insurer change, and pregnancies that meet OM26-056. The memo's billing steps are not in this manual.
Global billing: Bill 59400, 59510, 59610, or 59618 when prenatal care of four or more visits, labor and delivery, and postpartum care are all provided by one practitioner or the same group.
Approved status is pending_guidance because the September 1, 2026 operational memo is cited and not reproduced.
CA; OR · Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Corporate template for medical maternity services; Health Net adoption and effective dates must be verified separately for each California or Oregon product. No dental or vision billing application is established.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
This PDF does not identify adopting Health Net products in either state. Application is subject to coverage documents, applicable plan-level policies and state and federal requirements.
For routine prenatal visits when antepartum services start on or after June 1, 2026 or the estimated due date is on or after January 1, 2027, providers must bill the appropriate E/M code with modifier TH and a pregnancy-related O or Z ICD-10 diagnosis. The named lines are Child Health Plus, Essential Plan, IB-Dual, Medicaid Advantage Plus/MAP, Medicaid Managed Care, Qualified Health Plan, HARP, and Medicare Advantage. Starting January 1, 2027, the listed bundled and global CPT codes must not be billed, and 59425 and 59426 are no longer available. Pregnancies not subject to the June 1, 2026 transition still use 59425 for 4-6 antepartum visits, 59426 for 7 or more, and an E/M code for 1-3 visits. MMC and HARP continue informational 0500F or 0503F reporting, which is not reimbursed.
Published
Not stated in source
Transition starts
June 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-10-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Child Health Plus (CHP); Essential Plan (EP); Integrated Benefit Dual Plan (IB-Dual); Medicaid Advantage Plus/MAP (CompleteCare); Medicaid Managed Care (MMC); Qualified Health Plan (QHP); Personal Wellness Plan (HARP); Medicare Advantage
Transition: The June 1 rule applies when antepartum services are initiated on or after that date or the estimated due date is on or after January 1, 2027. Either condition triggers the updated prenatal requirements.
Global billing: Listed bundled and global CPT codes, including 59400, 59510, 59610, 59618, 59425, and 59426, must not be billed for service dates on or after January 1, 2027.
New obstetrical management procedure codes are described as forthcoming. This record does not invent those code numbers.
Beginning June 1, 2026, apply Healthfirst's updated routine prenatal billing requirements when antepartum care begins on or after that date or the estimated due date is January 1, 2027 or later. Bill affected routine prenatal visits with the appropriate E/M code for the setting, patient status and documented service, modifier TH, and pregnancy-related O or Z ICD-10 diagnoses. For MMC and HARP, report 0500F for the initial prenatal visit and 0503F for postpartum care on separate, real-time, no-charge informational claims, not bundled with payment claims.
Published
2026-04
Transition starts
June 1, 2026
Billing starts
June 1, 2026
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Healthfirst plan-specific reimbursement policy for professional obstetrical services in its expressly listed medical lines of business, including MMC and HARP. This record is supported for the applicable medical Medicaid product, not dental services.
Transition: Care initiated before June 1, 2026 is not automatically exempt: a 2027 estimated due date also triggers the updated requirements in the applicability section and examples. Qualifying pre-June starts with 2026 EDD/delivery may retain legacy billing when all package requirements are met. The policy does not clearly reconcile its Q4 2026 legacy example with postpartum services extending into 2027; obtain clarification for such episodes.
Global billing: Legacy global billing remains conditional for qualifying 2026 episodes. The policy states that listed deleted codes are unavailable when service dates include January 1, 2027 or later; a 2026 delivery alone should not be treated as authorization for a global episode extending into 2027.
Direct support comes from Healthfirst PO-RE-132v4, last approved May 18, 2026, rather than an inferred statewide managed-care alignment requirement. Reconcile the record's state-article citation metadata with this supplied source. Verify the member's listed medical product, benefits and provider contract. The explicit Category II section limits mandatory reporting to MMC/HARP, although page 8 uses broader language; seek clarification rather than extending that requirement to other products.
For pregnant members with due dates on or after Jan. 1, 2027, providers should begin transitioning on Oct. 1, 2026 by using E/M codes with the TH modifier only. Current global maternity codes are retired on Jan. 1, 2027, when labor and delivery CPT codes become available. Seven or more antepartum visits bill CPT 59426, 4-6 bill CPT 59425, and fewer than 4 bill E/M codes with the TH modifier.
Published
2026-09-28
Transition starts
October 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Highmark professional and facility notice. Sibling Highmark catalog IDs are not on this row.
Transition: Not published.
Global billing: Patients who initiate maternity care on or after Oct. 1 are not eligible for global maternity billing.
Addressed to professional and facility providers. Highmark promises operational or administrative updates in Provider News and the Provider Resource Center before January 1, 2027. Do not infer applicability to every affiliated product from regional navigation or family metadata.
Highmark reports an industry-wide maternity coding model effective January 1, 2027 and is reviewing implementation. This notice gives no Highmark-specific claim-submission rules and does not separately establish applicability to NY Commercial and Medicare Advantage products.
Published
2026-07-01
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Regional Highmark Blue Cross Blue Shield awareness notice; WNY is named in site navigation. Commercial and Medicare Advantage applicability is not expressly specified.
Transition: Not published.
Global billing: The source describes current global maternity billing but does not authorize its continuation pending further guidance or provide a product-specific stop/start date.
Highmark promises updates in Provider News and the Provider Resource Center before January 1, 2027. Verify each product's applicability; the WNY regional selector is not proof of implementation for both Commercial and Medicare Advantage.
For this record, the notice applies to MMC and CHPlus maternity services. It announces CPT maternity restructuring effective January 1, 2027 and directs all NYS Medicaid-enrolled providers of antepartum, postpartum, labor and delivery services to use the restructured system for individuals initiating prenatal care on or after June 1, 2026 and/or having an estimated due date on or after January 1, 2027.
Published
2026-07-01
Transition starts
June 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Highmark BCBS MMC and CHPlus medical maternity services within this record; the notice also names HARP and EP but does not establish payer-family applicability.
Transition: Preserve the source's 'and/or' between prenatal-initiation and estimated-due-date criteria. The article does not detail 2026 claim handling or cross-year episode billing; it refers providers to NYS Medicaid Update – April 2026 Volume 42 – Number 5.
Global billing: The notice moves away from legacy global maternity codes toward separate antepartum, labor-management, delivery and postpartum reporting. Antepartum and postpartum care use encounter-based E/M reporting; routine postpartum care on the delivery date is included in the delivery care code.
This is a program-specific coding notice, not merely an awareness article or evidence of an ongoing Highmark implementation review. Confirm the member's covered program and consult the referenced NYS Medicaid billing guidance for implementation details.
For this record, the notice applies to MMC and CHPlus maternity services, not to dental or vision benefits. It announces CPT maternity restructuring effective January 1, 2027 and directs all NYS Medicaid-enrolled providers of antepartum, postpartum, labor and delivery services to use the restructured system for individuals initiating prenatal care on or after June 1, 2026 and/or having an estimated due date on or after January 1, 2027.
Published
2026-07-01
Transition starts
June 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: MMC and CHPlus medical maternity services within this record. No dental, vision or payer-family implementation scope is established.
Transition: The prenatal-initiation and estimated-due-date criteria are joined by 'and/or.' The article does not detail 2026 claim handling or cross-year episode billing and directs providers to NYS Medicaid Update – April 2026 Volume 42 – Number 5.
Global billing: The notice replaces legacy global maternity reporting with phase-specific reporting, including encounter-based antepartum and postpartum E/M services, separate labor management and delivery-only codes. Routine postpartum care on the delivery date remains included in the delivery care code.
The source is an explicit program-limited coding notice, not evidence that Highmark is still reviewing implementation. Confirm the member's MMC or CHPlus product and consult the referenced NYS Medicaid guidance for additional billing details.
This notice is limited to Highmark BCBS MMC, HARP, CHPlus and EP maternity services; it is not commercial or Medicare guidance. It states a January 1, 2027 CPT restructuring effective date and directs all NYS Medicaid-enrolled providers of the listed maternity services to use the restructured system for individuals initiating prenatal care on or after June 1, 2026 and/or having an estimated due date on or after January 1, 2027.
Published
2026-07-01
Transition starts
June 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Only the medical maternity portion of this record corresponding to MMC, HARP, CHPlus or EP. This source does not establish commercial, Medicare, dental, vision or other Highmark-market implementation.
Transition: Preserve both cohort criteria and the source's 'and/or.' The article does not explain 2026 claim handling or cross-year episodes; consult the referenced NYS Medicaid Update – April 2026 Volume 42 – Number 5 for additional billing guidance.
Global billing: The notice moves from legacy global maternity codes to phase-specific antepartum, labor-management, delivery and postpartum reporting. It does not instruct providers to continue current global billing while awaiting a Highmark implementation decision.
Entity identity does not establish adoption by every product. Confirm the member is in one of the four expressly named programs before applying this notice.
Highmark reports an industry-wide maternity coding model effective January 1, 2027 and is reviewing its policies, procedures, and systems. This notice does not provide Highmark billing implementation instructions or establish applicability to every Delaware product.
Published
2026-07-01
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: General maternity-services awareness notice associated with the Highmark Blue Cross Blue Shield Delaware regional brand. Commercial, Medicare, and Medicaid applicability is not separately specified; Dental and Vision policies are not addressed.
Transition: Not published.
Global billing: Current global maternity billing is background information, not an instruction to continue it pending further guidance. No Highmark stop/start date is supplied.
Highmark promises updates in Provider News and the Provider Resource Center before January 1, 2027. Regional branding does not establish adoption by every Delaware program or affiliated plan.
Highmark reports an industry-wide maternity coding model effective January 1, 2027 and is reviewing implementation. This notice supplies no Highmark-specific claim-submission rules or payer billing implementation date.
Published
2026-07-01
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: General maternity-services awareness notice associated with Highmark Blue Cross Blue Shield West Virginia. Individual medical products are not enumerated; Dental and Vision policies are not addressed.
Transition: Not published.
Global billing: The source describes current global maternity billing but does not instruct providers to continue it pending further guidance or specify a Highmark stop/start date.
Highmark promises updates in Provider News and the Provider Resource Center before January 1, 2027. Do not extend regional-brand context to other West Virginia subsidiaries or products without verification.
For this record, apply the notice only to matching MMC, HARP, CHPlus or EP medical maternity services. The article announces CPT restructuring effective January 1, 2027 and directs all NYS Medicaid-enrolled providers of antepartum, postpartum, labor and delivery services to use the restructured system for individuals initiating prenatal care on or after June 1, 2026 and/or having an estimated due date on or after January 1, 2027.
Published
2026-07-01
Transition starts
June 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Highmark BCBS MMC, HARP, CHPlus and EP medical maternity services only. No commercial, Medicare, dental, vision or Highmark Group-wide adoption is established.
Transition: The source joins prenatal-initiation and estimated-due-date criteria with 'and/or.' It refers providers to NYS Medicaid Update – April 2026 Volume 42 – Number 5 and does not itself detail pre-2027 claims or cross-year episode handling.
Global billing: The notice moves away from legacy global maternity coding toward separate reporting by phase of care. Antepartum and postpartum reporting uses E/M encounters, labor management is separate, and delivery codes are delivery-only, with routine same-day postpartum care included.
This is a program-specific coding instruction, not evidence of an unresolved Highmark implementation review. Confirm the member's program; do not inherit this directive across other products or the payer group.
Highmark reports an industry-wide maternity coding model effective January 1, 2027 and is reviewing its policies, procedures, and systems. This notice does not specify Highmark claim-submission rules or a payer billing implementation date.
Published
2026-07-01
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: General Highmark Blue Cross Blue Shield West Virginia medical-provider awareness notice; individual products and subsidiaries are not enumerated.
Transition: Not published.
Global billing: Current global maternity billing is described as background. The notice does not instruct providers to continue it pending further guidance or supply a Highmark stop/start date.
Addressed to professional and facility providers. Highmark promises operational or administrative updates in Provider News and the Provider Resource Center before January 1, 2027. Regional navigation is not evidence of every subsidiary's adoption.
Highmark reports an industry-wide maternity coding model effective January 1, 2027 and is reviewing its policies, procedures, and systems. This notice provides no Highmark-specific claim-submission instructions or payer billing implementation date.
Published
2026-07-01
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: General Highmark Blue Shield medical-provider awareness notice; individual products and subsidiaries are not enumerated.
Transition: Not published.
Global billing: The article describes current global maternity billing as background but does not direct its continuation pending further guidance or establish a Highmark stop/start date.
Highmark promises updates in Provider News and the Provider Resource Center before January 1, 2027. The named regional brands provide site context, not evidence that every affiliated product has adopted an implementation policy.
Highmark reports an industry-wide maternity coding model effective January 1, 2027 and is reviewing implementation. This notice supplies no Highmark-specific claim-submission rules and does not separately establish applicability to NY Commercial and Medicare Advantage products.
Published
2026-07-01
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Regional Highmark Blue Shield awareness notice; NENY is named in site navigation. Commercial and Medicare Advantage applicability is not expressly specified.
Transition: Not published.
Global billing: The source describes current global maternity billing but does not authorize its continuation pending further guidance or provide a product-specific stop/start date.
Highmark promises updates in Provider News and the Provider Resource Center before January 1, 2027. Verify each product's applicability; regional and Medicare navigation are not product-adoption statements.
Medicaid products of this Highmark brand (MMC, HARP, CHPlus, EP) follow the NYS Medicaid directive: members who initiate prenatal care on/after 2026-06-01 and/or have an EDD on/after 2027-01-01 -> prenatal visits billed E/M + modifier TH with pregnancy O/Z diagnoses; full AMA 2027 code set from 2027-01-01. For commercial and Medicare Advantage members Highmark has announced only a review (2026-07-01 notice) and no operational change.
Published
2026-07-01
Transition starts
June 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Split by product: NYS Medicaid cohort rules for MMC/HARP/CHPlus/EP only; commercial and Medicare Advantage remain under Highmark's awareness notice
Transition: Transition 2026-06-01 per NYS cohort; billing 2027-01-01. Article defers detail to NYS Medicaid Update April 2026.
Global billing: Per NYS Medicaid: unavailable when the service span includes dates on/after 2027-01-01; established prenatal patients before 2026-06-01 may continue current billing through 2026-12-31.
Advance notice only; monitor each market's bulletins and reimbursement policies. Match applied from payer family/program metadata; confirm the exact member product before submission.
Highmark reports an industry-wide maternity coding model effective January 1, 2027 and is reviewing its policies, procedures, and systems. This notice gives no Highmark-specific claim-submission rules or payer billing implementation date.
Published
2026-07-01
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: General maternity-services awareness notice associated with the Pennsylvania Highmark regional brands shown on the provider site. Individual products are not enumerated; Dental and Vision policies are not addressed.
Transition: Not published.
Global billing: The article describes current global maternity billing as background but does not direct its continuation pending further guidance or establish a Highmark stop/start date.
Highmark promises updates in Provider News and the Provider Resource Center before January 1, 2027. Pennsylvania regional navigation does not establish adoption by every affiliated entity or product.
Highmark's 2026-07-01 notice says it is conducting a comprehensive review of policies, procedures and systems for the 2027 CPT maternity changes and will formally notify providers of any claim-submission changes. No operational billing change, transition date or billing start has been published; continue current billing until Highmark notifies you.
Published
2026-07-01
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: payer-family guidance across named Highmark markets
Transition: Not published.
Global billing: Current billing remains in place; the notice announces a review, not a change.
Advance notice only; monitor each market's bulletins and reimbursement policies. Match applied from payer family/program metadata; confirm the exact member product before submission.
Highmark reports an industry-wide maternity coding model effective January 1, 2027 and is reviewing its policies, procedures, and systems. This notice does not provide Highmark-specific claim-submission instructions or a payer billing implementation date.
Published
2026-07-01
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: General medical-provider awareness notice associated with the Highmark Blue Shield CPA/SEPA regional brand; individual Southeastern Pennsylvania products are not enumerated.
Transition: Not published.
Global billing: The notice describes current global maternity billing but does not direct providers to continue it pending further guidance or specify a Highmark stop/start date.
Highmark promises updates in Provider News and the Provider Resource Center before January 1, 2027. Retain this as regional-brand awareness information, not evidence of every product's adoption.
Highmark reports an industry-wide maternity coding model effective January 1, 2027 and is reviewing implementation. This notice supplies no Highmark-specific claim-submission rules or payer billing implementation date.
Published
2026-07-01
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: General maternity-services awareness notice associated with the Highmark Blue Cross Blue Shield WPA/NEPA regional brand. Individual Western Pennsylvania medical products are not enumerated; Dental policies are not addressed.
Transition: Not published.
Global billing: Current global maternity billing is background information, not an instruction to continue it pending further guidance. No Highmark stop/start date is supplied.
Highmark promises updates in Provider News and the Provider Resource Center before January 1, 2027. Regional branding does not establish adoption by every affiliated product.
Highmark's 2026-07-01 notice says it is conducting a comprehensive review of policies, procedures and systems for the 2027 CPT maternity changes and will formally notify providers of any claim-submission changes. No operational billing change, transition date or billing start has been published; continue current billing until Highmark notifies you.
Published
2026-07-01
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: payer-family guidance across named Highmark markets
Transition: Not published.
Global billing: Current billing remains in place; the notice announces a review, not a change.
Advance notice only; monitor each market's bulletins and reimbursement policies. Match applied from payer family/program metadata; confirm the exact member product before submission.
Highmark's 2026-07-01 notice says it is conducting a comprehensive review of policies, procedures and systems for the 2027 CPT maternity changes and will formally notify providers of any claim-submission changes. No operational billing change, transition date or billing start has been published; continue current billing until Highmark notifies you.
Published
2026-07-01
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: payer-family guidance across named Highmark markets
Transition: Not published.
Global billing: Current billing remains in place; the notice announces a review, not a change.
Advance notice only; monitor each market's bulletins and reimbursement policies. Match applied from payer family/program metadata; confirm the exact member product before submission.
Applicability to the Hill Physicians UnitedHealthcare PPO arrangement is unverified. For plans governed by this policy, report global OB care when the same group provides antepartum, delivery and postpartum care. Follow the specified component-itemization rules and separately report excluded services only when permitted. This document states no 2027 transition date.
Published
Not stated in source
Transition starts
Not stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: UHC Commercial and Individual Exchange professional maternity claims on CMS-1500 or its equivalent/successor; applicability to the Hill Physicians arrangement requires verification.
Transition: The cited policy states no 2027 transition date, grace period or cross-year pregnancy rule. This does not establish whether other public guidance exists.
Global billing: For plans governed by this policy, report 59400, 59510, 59610 or 59618 for complete antepartum, delivery and postpartum care provided by the same group reporting the same federal tax identification number.
Confirm the exact benefit plan and applicable provider contract before applying this policy to the Hill Physicians arrangement. Contracts, benefit documents and other policies may affect reimbursement. The source does not discuss the 2027 code deletion or require a replacement policy by a specified date.
Horizon encourages prenatal claims after pregnancy confirmation to use existing E/M codes with modifier -TH and the appropriate maternity diagnosis for dates of service on or after 2026-09-01. Its notice identifies the AMA component-based model as beginning 2027-01-01.
Published
2026-08-25
Transition starts
September 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-09-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Exact Horizon Blue Cross Blue Shield of New Jersey provider notice. No product line is identified; it is not mapped to Horizon NJ Health, Braven Health, dental, or federal-program routing records.
Transition: After the initial pregnancy-confirmation visit and for DOS on/after 2026-09-01, Horizon encourages existing E/M + -TH + appropriate maternity diagnosis. The notice provides no visit-count, delivery, postpartum, ultrasound, prior-authorization, or grace-period rule.
Global billing: The notice reports that the AMA will retire global maternity CPT codes on 2027-01-01, but it does not independently state Horizon’s 2027 global-code claim edit or a payer-specific exception.
Treat the September 2026 action as an encouragement, not a published requirement. Confirm member product and obtain a detailed Horizon billing policy before inferring component-code, delivery, or postpartum claim handling.
NATIONAL · Transition: Not stated in supplied index
The supplied Humana medical claims-payment index contains no 2027 global OB CPT-deletion instruction or implementation date. Medicaid applicability is policy-specific; this source does not establish a nationally applicable maternity billing method or whether separate guidance exists.
Published
Not stated in source
Transition starts
Not stated in supplied index
Billing starts
Not stated in supplied index
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Humana medical claims-payment index with Medicaid listings; state and policy applicability vary. Dental and vision applicability is not established.
Transition: The supplied index does not state a 2027 global OB transition or grace period. Guidance elsewhere is unverified.
Global billing: No 2027 global OB billing method is specified in this index.
The index includes a Kentucky Medicaid postpartum LARC policy listing, not a 2027 global OB deletion policy. Linked policy texts and separate code-edit announcements were not supplied. Verify the specific Medicaid product, state and applicable policy.
Not specified · Transition: Not stated in supplied index
The supplied Humana medical claims-payment index contains no 2027 global OB CPT-deletion instruction or implementation date. It does not establish whether separate maternity guidance exists or specify a current global OB billing method.
Published
Not stated in source
Transition starts
Not stated in supplied index
Billing starts
Not stated in supplied index
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Humana medical claims-payment index; individual policies have their own program and sometimes state limitations.
Transition: The supplied index does not state a 2027 global OB transition or grace period. Guidance elsewhere is unverified.
Global billing: No 2027 global OB billing method is specified in this index.
A Kentucky Medicaid postpartum LARC policy is listed, so this is not evidence that Humana has no maternity-related public policy. Linked policy texts and separate code-edit announcements were not supplied. Member-plan terms and provider contracts may affect claims.
The cited Humana medical claims-payment index does not identify Humana (KV) - JVHL or provide 2027 global OB CPT-deletion instructions. Applicability to this record and the existence of separate product guidance remain unverified.
Published
Not stated in source
Transition starts
Not established for this record
Billing starts
Not established for this record
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: General Humana medical claims-payment index; KV/JVHL entity and product applicability are unresolved.
Transition: No KV/JVHL-specific 2027 global OB transition or grace period is established by the supplied index.
Global billing: This source does not establish a global OB billing method for Humana (KV) - JVHL.
The retrieved page is a general policy index, not a 2027 maternity policy. Verify the KV/JVHL relationship and exact member product before attributing Humana policies to this record. Separate code-edit announcements were not supplied.
Not specified · Transition: Not established for this record
The supplied Humana medical claims-payment index does not identify Humana Behavioral Health or establish its role in maternity claims. It contains no 2027 global OB CPT-deletion instruction; record-specific guidance remains unverified.
Published
Not stated in source
Transition starts
Not established for this record
Billing starts
Not established for this record
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: General Humana medical claims-payment index; applicability to Humana Behavioral Health and maternity benefits is unresolved.
Transition: No 2027 global OB transition or grace period for this record is established by the supplied index.
Global billing: This source does not establish a global OB billing method for Humana Behavioral Health.
The retrieved page is not a 2027 maternity policy. Verify whether this record represents a product or administrator responsible for maternity medical claims before attributing a global OB directive. Separate code-edit announcements were not supplied.
NATIONAL · Transition: Not established for this record
National commercial guidance — verify the member's plan applicability.
The supplied Humana medical claims-payment index does not identify Humana Encounters or provide 2027 global OB CPT-deletion instructions. Its commercial-policy listings do not establish applicability to this record or whether separate guidance exists.
Published
Not stated in source
Transition starts
Not established for this record
Billing starts
Not established for this record
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: General Humana medical claims-payment index; applicability to Humana Encounters and its listed dental line is unverified.
Transition: No Humana Encounters-specific 2027 global OB transition or grace period is established by the supplied index.
Global billing: This source does not establish a global OB billing method for Humana Encounters.
The retrieved page is a general index, not a 2027 maternity policy. Verify the meaning of the Encounters designation and the underlying member product. Separate code-edit announcements were not supplied.
The supplied Humana medical claims-payment index contains no 2027 global OB CPT-deletion instruction and does not identify Humana Health Plan Ohio. The plan's program, applicable policies and any separate maternity guidance require verification.
Published
Not stated in source
Transition starts
Not established for this record
Billing starts
Not established for this record
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Humana family-level medical claims-payment index; applicability to Humana Health Plan Ohio is unverified.
Transition: No Humana Health Plan Ohio-specific 2027 global OB transition or grace period is established by the supplied index.
Global billing: This source does not establish a global OB billing method for Humana Health Plan Ohio.
The retrieved page is not a 2027 maternity policy. Verify the exact legal entity, program and member product; do not equate this record with another Ohio Humana product without evidence. Separate code-edit announcements were not supplied.
The supplied Humana medical claims-payment index contains no 2027 global OB CPT-deletion instruction for Humana Healthy Horizons in Ohio. General Medicaid listings and a Kentucky postpartum LARC listing do not establish this Ohio product's maternity billing requirements or whether separate guidance exists.
Published
Not stated in source
Transition starts
Not established for this record
Billing starts
Not established for this record
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Humana medical claims-payment index; Ohio Healthy Horizons maternity applicability and dental or vision applicability are unverified.
Transition: No Ohio Healthy Horizons-specific 2027 global OB transition or grace period is established by the supplied index.
Global billing: This source does not establish a global OB billing method for Humana Healthy Horizons in Ohio.
The retrieved page is not a 2027 maternity policy. The postpartum LARC listing explicitly concerns Kentucky Medicaid, not Ohio. Verify Ohio product-specific policies; linked policy texts and separate code-edit announcements were not supplied.
NATIONAL · Transition: Not established for this record
National commercial guidance — verify the member's plan applicability.
The supplied Humana medical claims-payment index does not identify Humana Long-Term Care or establish its maternity claims scope. It contains no 2027 global OB CPT-deletion instruction; product-specific requirements and any separate guidance remain unverified.
Published
Not stated in source
Transition starts
Not established for this record
Billing starts
Not established for this record
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: General Humana medical claims-payment index; applicability to this commercial long-term-care record and its dental line is unresolved.
Transition: No Humana Long-Term Care-specific 2027 global OB transition or grace period is established by the supplied index.
Global billing: This source does not establish a global OB billing method for Humana Long-Term Care.
The retrieved page is not a 2027 maternity policy. Verify the exact product, program and maternity benefit responsibility. The Indiana PathWays entry concerns Medicaid DME and does not identify this record. Separate code-edit announcements were not supplied.
The supplied Humana medical claims-payment index contains no 2027 global OB CPT-deletion instruction and does not identify a Puerto Rico product. Applicability to Humana Puerto Rico and the existence of separate product guidance remain unverified.
Published
Not stated in source
Transition starts
Not established for this record
Billing starts
Not established for this record
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Humana family-level medical claims-payment index; Puerto Rico product and dental applicability are unverified.
Transition: No Humana Puerto Rico-specific 2027 global OB transition or grace period is established by the supplied index.
Global billing: This source does not establish a global OB billing method for Humana Puerto Rico.
The retrieved page is not a 2027 maternity policy. Verify the Puerto Rico entity, program and exact member product before applying an individual indexed policy. Linked policy texts and separate code-edit announcements were not supplied.
Transition begins 2026-06-01. Report each prenatal encounter with office E/M 99202-99215, TH, and pregnancy diagnosis; report 0500F on the initial visit.
Published
2026-06
Transition starts
June 1, 2026
Billing starts
June 1, 2026
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: payer-specific all-product guidance
Transition: Members established before 2026-06-01 may remain under current 2026 billing; detailed examples require portal access.
Global billing: Limited during transition; 59425 and 59426 deny for the affected cohort.
All-product bulletin. Some implementation examples are behind the provider portal. Match applied from payer family/program metadata; confirm the exact member product before submission.
No 2027 date was published. Current EHP policy requires global obstetric package codes for complete care.
Published
Not stated in source
Transition starts
Not published
Billing starts
August 1, 2024
Evidence checked
2026-09-04
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: exact EHP policy
Transition: No 2027 transition or grace period was located.
Global billing: Required for complete maternity care under RPC.029; otherwise the claim may deny.
EHP shares payer ID 52189 with Priority Partners, but their maternity policies conflict: EHP uses global billing while Priority Partners requires individual billing. Product identification is essential.
Priority Partners already requires individual prenatal E/M and delivery billing; no new 2027 transition date was published.
Published
Not stated in source
Transition starts
Not published
Billing starts
July 15, 2024
Evidence checked
2026-09-04
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: exact Priority Partners policy
Transition: No 2027 transition or grace period was located.
Global billing: No. RPC.008 says not to use 59400, 59425, 59426, 59510, 59610, or 59618.
Use pregnancy ICD-10 codes on prenatal E/M claims, bill delivery separately, and follow MPRA/HCPCS requirements. The shared 52189 canonical record also routes EHP, whose policy is different; product identity is mandatory.
No public 2027 maternity billing start date found. Use the applicable Northern California provider agreement/manual and authorization until Kaiser posts claim-level maternity instructions.
Published
Not stated in source
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Northern California provider manual; exact region/product must be verified
Transition: No 2027 transition or grace period located in the cited current policy unless stated in the billing summary.
Global billing: The public manual covers general coding, claims, and payment rules but does not provide a public 2027 maternity transition.
Kaiser product and referral arrangements vary; many services are integrated rather than submitted like an open-network commercial claim. The manual is not maternity-specific. Match applied from payer family/program metadata; confirm the exact member product before submission.
MS · Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Corporate template for medical maternity services; adoption and effective date for the exact Magnolia Mississippi product are unverified. No dental billing application is established.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
This PDF does not identify an adopting Magnolia product or its program. Application is subject to coverage documents, applicable plan-level policies and state and federal requirements.
Transition begins 2026-09-01. Use expected delivery and remaining visits to move from global/bundled care to encounter E/M; append TH to all maternity E/M.
Published
2026-08-06
Transition starts
September 1, 2026
Billing starts
September 1, 2026
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: state Medicaid guidance; plan-specific operational guidance not located
Transition: Providers must adjust no later than before 9/1 based on EDD and expected remaining care; no fixed grace end stated.
Global billing: Only when consistent with the transition calculation and current policy; individualized E/M is required for transitioned care.
MaineCare explicitly operationalizes an early transition but leaves some episode arithmetic to the provider. Match applied from payer family/program metadata; confirm the exact member product before submission.
Maryland Medicaid already requires delivery to be billed separately from prenatal care; no additional 2027 MPC transition date was published.
Published
Not stated in source
Transition starts
Not published
Billing starts
January 1, 2026
Evidence checked
2026-09-04
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: exact plan billing page plus controlling Maryland Medicaid manual
Transition: No 2027 transition or grace period was located.
Global billing: No for Maryland Medicaid global delivery-package codes identified by the current state manual.
MPC directs providers to state/CMS billing guidance. Use H1000 for the prenatal risk assessment and follow current H1003/enriched-maternity rules; recheck MPC notices for 2027 replacement-code mapping.
Starting November 1, 2026, Medi-Cal encourages obstetrical providers to submit prenatal and postpartum claims using E/M selected by time and complexity with TH. Prenatal visits require gestational-age diagnosis coding; postpartum visits require a relevant listed diagnosis and actual subcodes. CPSP providers and doulas must continue local Z1032, Z1034 and Z1038 until further notice. The article does not establish individual managed-care-plan adoption.
Published
2026-09-18
Transition starts
November 1, 2026
Billing starts
November 1, 2026
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
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Scope: California Medi-Cal program; obstetrical providers. The article does not expressly distinguish FFS and managed care or identify individual managed-care plans.
Transition: No EDD, actual-delivery or care-initiation cohort stated. No grace period or mandatory conversion date supplied. CPSP/doula exception continues until further notice.
Global billing: CPSP providers and doulas must retain local Z1032, Z1034 and Z1038 until further notice. Global-code continuation/retirement for other providers is not stated in this article.
Pending human review. Native Exa returned the complete article and eight-row table; direct HTTP/web and browser yielded a shell without the article. Origin freshness and later revisions remain unverified. The table repeats 99213 descriptions for 99214; do not propagate those descriptions as validated CPT descriptors. Prior pregnancy manual has not been reread/reconciled in this focused intake.
Provider Bulletin 2026-44 keeps two antepartum delivery timings. Effective for dates of service September 1, 2026 and forward, with a delivery date anticipated after December 31, 2026, all antepartum visits must be billed with the appropriate E/M procedure code. Starting in September, antepartum care will be billed with one of the applicable E/M codes for all deliveries that are anticipated to occur prior to December 31, 2026. Modifier TH must be listed on the antepartum detail for dates of service September 1, 2026 and forward. Maternity care providers will continue to bill existing procedure codes for labor, delivery, and postpartum care when delivery occurs prior to January 1, 2027. Phase 2, effective January 1, 2027, says new labor management and delivery codes will be added to fee schedules and does not list them. Maternity bundle participants continue PB 2025-66.
Published
August 2026
Transition starts
September 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-10-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Connecticut Medical Assistance Program providers named in Provider Bulletin 2026-44, including physicians, physician assistants, APRNs, certified nurse-midwives, family planning clinics, FQHCs, and outpatient hospitals.
Transition: The billing guidance updates will happen in two phases: • Phase 1: Effective for dates of service September 1, 2026 and forward, with a delivery date anticipated after December 31, 2026, all antepartum visits must be billed with the appropriate evaluation/management (E/M) procedure code. Starting in September, antepartum care will be billed with one of the applicable E/M codes for all deliveries that are anticipated to occur prior to December 31, 2026: CPT Code Range Description 98000-98003 New patient synchronous audio-video visit 98004-98013 Established patient synchronous audio video visit 99202-99205 New patient office or other outpatient visit 99211-99215 Established patient office or other outpatient visit 99221-99223 Initial hospital care with medical decision making 99231-99233 Subsequent hospital care with medical decision making 99234-99236 Hospital inpatient or observation care 99291-99292 Critical care 99341-99345…
Global billing: The bulletin says global maternity care procedure codes are being end dated. For deliveries prior to January 1, 2027, labor, delivery, and postpartum stay on existing procedure codes.
The two delivery-timing sentences are both in Bulletin 2026-44 and are kept as separate instructions.
Effective September 1, 2026, for prenatal services furnished before implementation of the AMA 2027 maternity coding structure, patients whose first prenatal visit following confirmation of pregnancy occurred on or after that date may have services reported using an appropriate E/M code with modifier TH. Use the listed setting-appropriate codes and document the selected E/M level based on medical decision making or total time, consistent with current CPT guidelines.
Published
2026-08
Transition starts
September 1, 2026
Billing starts
September 1, 2026
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
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Source excerpt
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Scope: MassHealth prenatal medical services before implementation of the AMA 2027 maternity coding structure; addressed to all providers participating in MassHealth. The bulletin does not identify individual managed-care plan implementation.
Transition: If the first prenatal visit following confirmation of pregnancy occurred before September 1, 2026, continue 59425/59426 when applicable. If that visit occurred on or after September 1, 2026, providers may report appropriate E/M services with TH. This is a permissive pathway, not a stated universal mandate.
Global billing: The bulletin directs continued use of antepartum-only codes 59425/59426, when applicable, for patients whose first prenatal visit following confirmation occurred before September 1, 2026. It does not establish continued authorization for the entire global OB package or use of deleted codes after January 1, 2027.
MassHealth plans additional billing guidance in 2027 for the AMA 2027 maternity coding structure. This is a direct MassHealth program source; named-plan adoption and the existence or absence of other plan-specific guidance cannot be determined from this document alone.
The MDHHS July 15, 2026 alert remains the confirmed state-program source: keep global maternity coding through December 31, 2026, and use separate reporting for dates of service on or after January 1, 2027. Proposed policy 2623-Practitioner, issued September 1, 2026, adds claim requirements that were still proposed, with comments due October 1, 2026. It does not change the July 15 billing date.
Published
2026-07-15
Transition starts
Not published
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
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Scope: Michigan Medicaid, Healthy Michigan Plan, MI Coordinated Health, Maternity Outpatient Medical Services, and MIChild. Proposed policy 2623-Practitioner is not final. The July 15, 2026 alert remains the confirmed program source.
Transition: No required transition start. Billing date stays 2027-01-01 from the July 15 alert. The September proposed policy does not change that date.
Global billing: Yes through 2026-12-31 under the July 15 alert. The proposed policy says claims with global maternity codes on and after January 1, 2027 are payable only if all dates of service are on or before December 31, 2026. That text is still proposed.
Proposed 2623-Practitioner was the September bulletin this record said to watch. It says providers must append modifier TH and an obstetric ICD-10-CM code for the enhanced rate under MSA 14-32, and that a Z3A weeks-of-gestation code may be reported. The final bulletin after the October 1, 2026 comment period was not located. This does not reopen the MIHP decision.
NV · Transition: Not stated in the approved quotes
Nevada Medicaid, including its managed care organizations, will not adopt the new maternity code structure on January 1, 2027. Providers should continue to use the current bundled code structure until Nevada Medicaid's policy is changed.
Published
Not stated in source
Transition starts
Not stated in the approved quotes
Billing starts
No 2027 billing date; current bundled structure continues
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Nevada Medicaid and its managed care organizations.
Transition: Not stated in the approved quotes
Global billing: Continue the current bundled code structure until the policy changes.
A later public-notice timeline is mentioned for mid-2027. That is not a billing start.
NM · Transition: Not stated in the approved quotes
Effective January 1, 2027, global maternity codes are eliminated and replaced with an unbundled phase-based structure. A delivery prior to January 1, 2027 stays on current guidelines. A first 10-week visit between May 15, 2026 and July 14, 2026 uses 59426 plus delivery only. A first 10-week visit between July 15, 2026 and August 30, 2026 uses 59425 plus delivery only.
Published
2026-05-27
Transition starts
Not stated in the approved quotes
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: New Mexico Medicaid.
Transition: Not stated in the approved quotes
Global billing: Deliveries prior to January 1, 2027 continue under current guidelines.
Effective immediately, NYS Medicaid FFS directs providers to use prenatal E/M CPT codes with TH and pregnancy-related O or Z ICD-10 diagnosis codes for individuals initiating prenatal care on or after June 1, 2026, and/or with an estimated due date on or after January 1, 2027. Initial prenatal visits must also include 0500F. The article separately states that current billing guidance applies through December 31, 2026 for members who established prenatal care before June 1, 2026. MMC plans must prepare systems and provider agreements/contracts for the specified prenatal alignment by June 1, 2026 and full AMA code-change implementation by January 1, 2027.
Published
2026-04
Transition starts
June 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-08-31
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
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Source excerpt
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Scope: NYS Medicaid FFS medical-obstetric services, with express systems and provider agreement/contract requirements for NYS Medicaid Managed Care plans. No applicability to Dental, Vision or other Department of Health programs is established by this article.
Transition: The FFS instruction is stated to be effective immediately for the specified prenatal-initiation and/or estimated-due-date population. June 1, 2026 is both a cohort threshold and the MMC prenatal-alignment deadline. Current guidance is separately retained through December 31, 2026 for members established before June 1; the article does not explain how that provision interacts with an estimated due date on or after January 1, 2027.
Global billing: CPT 59400, 59425, 59426, 59510, 59610 and 59618 will be deleted and unavailable when service dates include any date on or after January 1, 2027. Earlier billing remains subject to the article's prenatal transition instructions and its provision retaining current guidance for members established before June 1, 2026.
This is operational state Medicaid guidance, not merely advance awareness. Further AMA guidance and NYS Medicaid Update articles are expected for additional obstetric code revisions/deletions. The article directs MMC questions to the enrollee's plan; it does not document any individual plan's completed implementation.
Beginning January 1, 2027, Ohio Medicaid fee-for-service discontinues current Maternity Care Services global and bundled codes, and CPT services are separately reportable. For a first prenatal visit after confirmation of pregnancy on or after September 1, 2026, ODM requires E/M codes and ICD-10-CM codes, including weeks of gestation printed as Z23A.
Published
Not stated in the stored quotes
Transition starts
September 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Ohio Department of Medicaid fee-for-service. Not the managed-care catalog entries.
Transition: Not stated in the approved quotes
Global billing: Global and bundled Maternity Care Services codes are discontinued beginning January 1, 2027.
The bulletin prints the gestation category as Z23A. That spelling is kept.
OK · Medicaid · Transition starts September 1, 2026
SoonerCare moves new prenatal patients to its staged 2026 transition on 2026-09-01. For maternity care spanning into 2027, the state says not to use bundled delivery codes and requests TH on antepartum/postpartum E/M claims.
Published
2026-08-10
Transition starts
September 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-09-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
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Scope: Oklahoma Health Care Authority / SoonerCare Medicaid. This does not establish rules for commercial Oklahoma plans or Medicaid managed-care plans without their own instruction.
Transition: From 2026-09-01, use E/M for 1–3 visits; use 59425 for the initial 4–6 visit block and E/M for continuing visits; use 59426 for 7+ visits. Do not bill 59426 and E/M before 2026-12-31. If prenatal care occurs in 2026 and delivery occurs in 2027, bundled delivery codes are not permitted.
Global billing: Delivery before 2027-01-01 may use bundled codes. Prenatal care in 2026 with delivery in 2027 cannot use bundled delivery codes.
The source requests TH on antepartum/postpartum E/M to avoid denials. No unsupported MCO-level mapping is included.
SD · Transition: Not stated in the approved quotes
Global obstetric codes remain valid for dates of service through December 31, 2026. Providers may elect to bill obstetrical services individually before January 1, 2027. Routine prenatal and postpartum E/M uses modifier TH. Labor and delivery may use delivery-only codes 59409, 59514, 59612, or 59620.
Published
2026-09-04
Transition starts
Not stated in the approved quotes
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: South Dakota Medicaid providers.
Transition: Not stated in the approved quotes
Global billing: Global obstetric codes remain valid through December 31, 2026.
VA · Transition: Not stated in the approved quotes
DMAS is recommending providers begin billing. The stored quotes say 0500F on all initial prenatal visits, until additional implementation guidance is issued. They do not state the code range, modifier, or a calendar billing date.
Published
Not stated in source
Transition starts
Not stated in the approved quotes
Billing starts
Not stated in the stored quotes
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Virginia Medicaid catalog ID. The sibling ID is a separate record. Scope and timing were still marked for review.
Transition: Not stated in the approved quotes
Global billing: Not stated in the stored quotes.
The approved candidateStatus was 'confirmed_2027 subject to scope/timing review', which is not a publishable status. The stored quotes do not support the longer billing summary, so this record stays pending_guidance.
VA · Transition: Not stated in the approved quotes
DMAS is recommending providers begin billing. The stored quotes say 0500F on all initial prenatal visits, until additional implementation guidance is issued. They do not state the code range, modifier, or a calendar billing date.
Published
Not stated in source
Transition starts
Not stated in the approved quotes
Billing starts
Not stated in the stored quotes
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Virginia Medicaid catalog ID. The sibling ID is a separate record. Scope and timing were still marked for review.
Transition: Not stated in the approved quotes
Global billing: Not stated in the stored quotes.
The approved candidateStatus was 'confirmed_2027 subject to scope/timing review', which is not a publishable status. The stored quotes do not support the longer billing summary, so this record stays pending_guidance.
Effective January 1, 2027, HCA will remove deleted global obstetrics codes from Apple Health billing guides and fee schedules; providers will use new and revised CPT codes aligned with updated Apple Health clinical policy. Beginning January 1, 2027, bill the first prenatal visit with the appropriate E/M code and CPT 0500F. The E/M code is reimbursable; 0500F is billed at $0.01 and pays zero.
Published
2026-05
Transition starts
January 1, 2027
Billing starts
January 1, 2027
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Washington Apple Health (Medicaid) pregnancy-related professional/clinical services in hospital and out-of-hospital settings. This is direct state-program guidance, not evidence of named managed-care plan adoption or requirements for commercial, Medicare, dental or vision products.
Transition: HCA anticipates a clean transition between December 31, 2026 and January 1, 2027, with no period accepting both global and itemized coding. HCA does not plan September 2026 implementation under ACOG's recommendation or prorated payments for global OB codes. Instructions for pregnancy care spanning 2026 and 2027 remain forthcoming. Current modifier guidance remains effective through December 31, 2026; updated modifier and encounter-billing instructions will follow.
Global billing: Current global OB coding is to end with the anticipated December 31, 2026–January 1, 2027 transition. HCA will remove deleted global OB codes effective January 1, 2027; cross-year billing instructions remain pending.
Reimbursement rates will be available by January 1, 2027; amounts remain undetermined pending CMS values. The changes affect professional services, not birth center facility-fee or home-birth-kit policy and reimbursement, or birth doula coverage and billing. A replacement birth center facility-fee code will be identified separately. The FAQ does not establish whether additional named-plan guidance exists.
OH · Transition: Services follow the date each service is rendered, not the claim billing date
RP-202701, created and initially effective 01/01/2027, reimburses maternity care by the separately reported component, including antepartum care, labor management, delivery, and postpartum care. Antepartum care must be reported with the appropriate E/M code and modifier TH. 0500F is billed on the initial visit with that E/M code, modifier TH, and a pregnancy-related ICD-10 diagnosis, and is not separately reimbursable. Maternity care codes are not eligible for dates of service on or after January 1, 2027. Labor management may be reported once per calendar date and is not separately reimbursable for a scheduled or planned cesarean when labor does not occur. Multiple-gestation vaginal delivery is one appropriate vaginal delivery code per fetus; only one cesarean delivery code is eligible. Immediate maternal postpartum care on the delivery date is included in delivery care. The policy names Medical Mutual of Ohio, Medical Mutual Services, LLC except Mutual Health Services, Medical Health Insuring Corporation of Ohio, and MedMutual Life Insurance Company.
Published
2027-01-01
Transition starts
Services follow the date each service is rendered, not the claim billing date
Billing starts
January 1, 2027
Evidence checked
2026-10-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Commercial and Marketplace (Fully-Insured and Self-Funded), and Medicare Advantage. Medical Mutual of Ohio, Medical Mutual Services, LLC except Mutual Health Services, Medical Health Insuring Corporation of Ohio, and MedMutual Life Insurance Company
Transition: applicable to the date each service is rendered, not the billing date for the service.
Global billing: Maternity care codes are not eligible for reimbursement for dates of service on or after January 1, 2027.
Mutual Health Services is a separate commercial self-funded reading of this policy.
AL · Transition: CY 2027 proposal; transition date not finalized by this source
For CY 2027, CMS proposes maternity CPT work RVUs and separately seeks comment on 15 alternative HCPCS G-codes that would retain the previous MMM global structure instead of adopting the new CPT codes for Medicare payment. This source does not finalize either approach.
Published
2026-07-16
Transition starts
CY 2027 proposal; transition date not finalized by this source
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS proposal for Part B medical maternity services; not dental-product guidance or Alabama-specific MAC instructions.
Transition: The supplied text does not establish a finalized transition date, grace period, or MAC implementation instructions. It cannot verify whether later guidance had been published as of 2026-08-28.
Global billing: Potentially yes under the proposal through alternative HCPCS G codes; not final.
Proposed, not active billing guidance. Table A-D3 is referenced but not reproduced, so the specific G-code identifiers cannot be verified from the supplied text. Confirm finalized Medicare requirements before submission.
AK · Transition: CY 2027 proposal; transition date not finalized by this source
For CY 2027, CMS proposes maternity CPT work RVUs and separately seeks comment on 15 alternative HCPCS G-codes that would retain the previous MMM global structure instead of adopting the new CPT codes for Medicare payment. This source does not finalize either approach.
Published
2026-07-16
Transition starts
CY 2027 proposal; transition date not finalized by this source
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS proposal for Part B medical maternity services; not Alaska-specific MAC instructions.
Transition: The supplied text does not establish a finalized transition date, grace period, or MAC implementation instructions. It cannot verify whether later guidance had been published as of 2026-08-28.
Global billing: Potentially yes under the proposal through alternative HCPCS G codes; not final.
Proposed, not active billing guidance. Table A-D3 is referenced but not reproduced, so the specific G-code identifiers cannot be verified from the supplied text. Confirm finalized Medicare requirements before submission.
AS · Transition: CY 2027 proposal; transition date not finalized by this source
For CY 2027, CMS proposes maternity CPT work RVUs and separately seeks comment on 15 alternative HCPCS G-codes that would retain the previous MMM global structure instead of adopting the new CPT codes for Medicare payment. This source does not finalize either approach.
Published
2026-07-16
Transition starts
CY 2027 proposal; transition date not finalized by this source
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS proposal for Part B medical maternity services; not American Samoa-specific MAC instructions.
Transition: The supplied text does not establish a finalized transition date, grace period, or MAC implementation instructions. It cannot verify whether later guidance had been published as of 2026-08-28.
Global billing: Potentially yes under the proposal through alternative HCPCS G codes; not final.
Proposed, not active billing guidance. Table A-D3 is referenced but not reproduced, so the specific G-code identifiers cannot be verified from the supplied text. Confirm finalized Medicare requirements before submission.
AZ · Transition: CY 2027 proposal; transition date not finalized by this source
For CY 2027, CMS proposes maternity CPT work RVUs and separately seeks comment on 15 alternative HCPCS G-codes that would retain the previous MMM global structure instead of adopting the new CPT codes for Medicare payment. This source does not finalize either approach.
Published
2026-07-16
Transition starts
CY 2027 proposal; transition date not finalized by this source
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS proposal for Part B medical maternity services; not dental-product guidance or Arizona-specific MAC instructions.
Transition: The supplied text does not establish a finalized transition date, grace period, or MAC implementation instructions. It cannot verify whether later guidance had been published as of 2026-08-28.
Global billing: Potentially yes under the proposal through alternative HCPCS G codes; not final.
Proposed, not active billing guidance. Table A-D3 is referenced but not reproduced, so the specific G-code identifiers cannot be verified from the supplied text. Confirm finalized Medicare requirements before submission.
AR · Transition: CY 2027 proposal; transition date not finalized by this source
For CY 2027, CMS proposes maternity CPT work RVUs and separately seeks comment on 15 alternative HCPCS G-codes that would retain the previous MMM global structure instead of adopting the new CPT codes for Medicare payment. This source does not finalize either approach.
Published
2026-07-16
Transition starts
CY 2027 proposal; transition date not finalized by this source
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS proposal for Part B medical maternity services; not dental-product guidance or Arkansas-specific MAC instructions.
Transition: The supplied text does not establish a finalized transition date, grace period, or MAC implementation instructions. It cannot verify whether later guidance had been published as of 2026-08-28.
Global billing: Potentially yes under the proposal through alternative HCPCS G codes; not final.
Proposed, not active billing guidance. Table A-D3 is referenced but not reproduced, so the specific G-code identifiers cannot be verified from the supplied text. Confirm finalized Medicare requirements before submission.
CO · Transition: CY 2027 proposal; transition date not finalized by this source
For CY 2027, CMS proposes maternity CPT work RVUs and separately seeks comment on 15 alternative HCPCS G-codes that would retain the previous MMM global structure instead of adopting the new CPT codes for Medicare payment. This source does not finalize either approach.
Published
2026-07-16
Transition starts
CY 2027 proposal; transition date not finalized by this source
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS proposal for Part B medical maternity services; not dental-product guidance or Colorado-specific MAC instructions.
Transition: The supplied text does not establish a finalized transition date, grace period, or MAC implementation instructions. It cannot verify whether later guidance had been published as of 2026-08-28.
Global billing: Potentially yes under the proposal through alternative HCPCS G codes; not final.
Proposed, not active billing guidance. Table A-D3 is referenced but not reproduced, so the specific G-code identifiers cannot be verified from the supplied text. Confirm finalized Medicare requirements before submission.
CT · Transition: CY 2027 proposal; transition date not finalized by this source
For CY 2027, CMS proposes maternity CPT work RVUs and separately seeks comment on 15 alternative HCPCS G-codes that would retain the previous MMM global structure instead of adopting the new CPT codes for Medicare payment. This source does not finalize either approach.
Published
2026-07-16
Transition starts
CY 2027 proposal; transition date not finalized by this source
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS proposal for Part B medical maternity services; not dental-product guidance or Connecticut-specific MAC instructions.
Transition: The supplied text does not establish a finalized transition date, grace period, or MAC implementation instructions. It cannot verify whether later guidance had been published as of 2026-08-28.
Global billing: Potentially yes under the proposal through alternative HCPCS G codes; not final.
Proposed, not active billing guidance. Table A-D3 is referenced but not reproduced, so the specific G-code identifiers cannot be verified from the supplied text. Confirm finalized Medicare requirements before submission.
DE · Transition: CY 2027 proposal; transition date not finalized by this source
For CY 2027, CMS proposes maternity CPT work RVUs and separately seeks comment on 15 alternative HCPCS G-codes that would retain the previous MMM global structure instead of adopting the new CPT codes for Medicare payment. This source does not finalize either approach.
Published
2026-07-16
Transition starts
CY 2027 proposal; transition date not finalized by this source
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS proposal for Part B medical maternity services; not Delaware-specific MAC instructions.
Transition: The supplied text does not establish a finalized transition date, grace period, or MAC implementation instructions. It cannot verify whether later guidance had been published as of 2026-08-28.
Global billing: Potentially yes under the proposal through alternative HCPCS G codes; not final.
Proposed, not active billing guidance. Table A-D3 is referenced but not reproduced, so the specific G-code identifiers cannot be verified from the supplied text. Confirm finalized Medicare requirements before submission.
DC · Transition: CY 2027 proposal; no confirmed transition date in this source
For CY 2027, CMS proposes valuations for restructured maternity CPT codes and seeks comment on creating 15 alternative HCPCS G-codes to preserve the previous MMM global structure for Medicare PFS payment. Neither alternative is established here as a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; no confirmed transition date in this source
Billing starts
Not specified in supplied source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity services paid under the PFS; not dental coverage or District of Columbia-specific MAC instructions.
Transition: The supplied text does not specify an operational transition date or grace period. It cannot establish the status of subsequent final rules or MAC instructions as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would retain current MMM payment conditions and the MMM global period instead of adopting the new CPT codes for Medicare payment. This is not authorization to bill the contemplated G-codes.
Tables A-D2 and A-D3 are referenced but not reproduced in the supplied text; GMAT1-GMAT15 cannot be verified. The source supports no comparative ranking against other payers' approaches.
FL · Transition: CY 2027 proposal; no confirmed transition date in this source
For CY 2027, CMS proposes valuations for restructured maternity CPT codes and seeks comment on creating 15 alternative HCPCS G-codes to preserve the previous MMM global structure for Medicare PFS payment. Neither alternative is established here as a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; no confirmed transition date in this source
Billing starts
Not specified in supplied source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity services paid under the PFS; not dental coverage or Florida-specific MAC instructions.
Transition: The supplied text does not specify an operational transition date or grace period. It cannot establish the status of subsequent final rules or MAC instructions as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would retain current MMM payment conditions and the MMM global period instead of adopting the new CPT codes for Medicare payment. This is not authorization to bill the contemplated G-codes.
Tables A-D2 and A-D3 are referenced but not reproduced in the supplied text; GMAT1-GMAT15 cannot be verified. The source supports no comparative ranking against other payers' approaches.
GA · Transition: CY 2027 proposal; no confirmed transition date in this source
For CY 2027, CMS proposes valuations for restructured maternity CPT codes and seeks comment on creating 15 alternative HCPCS G-codes to preserve the previous MMM global structure for Medicare PFS payment. Neither alternative is established here as a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; no confirmed transition date in this source
Billing starts
Not specified in supplied source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity services paid under the PFS; not dental coverage or Georgia-specific MAC instructions.
Transition: The supplied text does not specify an operational transition date or grace period. It cannot establish the status of subsequent final rules or MAC instructions as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would retain current MMM payment conditions and the MMM global period instead of adopting the new CPT codes for Medicare payment. This is not authorization to bill the contemplated G-codes.
Tables A-D2 and A-D3 are referenced but not reproduced in the supplied text; GMAT1-GMAT15 cannot be verified. The source supports no comparative ranking against other payers' approaches.
ID · Transition: CY 2027 proposal; no confirmed transition date in this source
For CY 2027, CMS proposes valuations for restructured maternity CPT codes and seeks comment on creating 15 alternative HCPCS G-codes to preserve the previous MMM global structure for Medicare PFS payment. Neither alternative is established here as a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; no confirmed transition date in this source
Billing starts
Not specified in supplied source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity services paid under the PFS; not Idaho-specific MAC instructions.
Transition: The supplied text does not specify an operational transition date or grace period. It cannot establish the status of subsequent final rules or MAC instructions as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would retain current MMM payment conditions and the MMM global period instead of adopting the new CPT codes for Medicare payment. This is not authorization to bill the contemplated G-codes.
Tables A-D2 and A-D3 are referenced but not reproduced in the supplied text; GMAT1-GMAT15 cannot be verified. The source supports no comparative ranking against other payers' approaches.
IL · Transition: CY 2027 proposal; no confirmed transition date in this source
For CY 2027, CMS proposes valuations for restructured maternity CPT codes and seeks comment on creating 15 alternative HCPCS G-codes to preserve the previous MMM global structure for Medicare PFS payment. Neither alternative is established here as a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; no confirmed transition date in this source
Billing starts
Not specified in supplied source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity services paid under the PFS; not dental coverage or Illinois-specific MAC instructions.
Transition: The supplied text does not specify an operational transition date or grace period. It cannot establish the status of subsequent final rules or MAC instructions as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would retain current MMM payment conditions and the MMM global period instead of adopting the new CPT codes for Medicare payment. This is not authorization to bill the contemplated G-codes.
Tables A-D2 and A-D3 are referenced but not reproduced in the supplied text; GMAT1-GMAT15 cannot be verified. The source supports no comparative ranking against other payers' approaches.
IN · Transition: CY 2027 proposal; no confirmed transition date in this source
For CY 2027, CMS proposes valuations for restructured maternity CPT codes and seeks comment on creating 15 alternative HCPCS G-codes to preserve the previous MMM global structure for Medicare PFS payment. Neither alternative is established here as a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; no confirmed transition date in this source
Billing starts
Not specified in supplied source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity services paid under the PFS; not dental coverage or Indiana-specific MAC instructions.
Transition: The supplied text does not specify an operational transition date or grace period. It cannot establish the status of subsequent final rules or MAC instructions as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would retain current MMM payment conditions and the MMM global period instead of adopting the new CPT codes for Medicare payment. This is not authorization to bill the contemplated G-codes.
Tables A-D2 and A-D3 are referenced but not reproduced in the supplied text; GMAT1-GMAT15 cannot be verified. The source supports no comparative ranking against other payers' approaches.
IA · Transition: CY 2027 proposal; no confirmed transition date in this source
For CY 2027, CMS proposes valuations for restructured maternity CPT codes and seeks comment on creating 15 alternative HCPCS G-codes to preserve the previous MMM global structure for Medicare PFS payment. Neither alternative is established here as a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; no confirmed transition date in this source
Billing starts
Not specified in supplied source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity services paid under the PFS; not Iowa-specific MAC instructions.
Transition: The supplied text does not specify an operational transition date or grace period. It cannot establish the status of subsequent final rules or MAC instructions as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would retain current MMM payment conditions and the MMM global period instead of adopting the new CPT codes for Medicare payment. This is not authorization to bill the contemplated G-codes.
Tables A-D2 and A-D3 are referenced but not reproduced in the supplied text; GMAT1-GMAT15 cannot be verified. The source supports no comparative ranking against other payers' approaches.
KS · Transition: CY 2027 proposal; no confirmed transition date in this source
For CY 2027, CMS proposes valuations for restructured maternity CPT codes and seeks comment on creating 15 alternative HCPCS G-codes to preserve the previous MMM global structure for Medicare PFS payment. Neither alternative is established here as a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; no confirmed transition date in this source
Billing starts
Not specified in supplied source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity services paid under the PFS; not dental coverage or Kansas-specific MAC instructions.
Transition: The supplied text does not specify an operational transition date or grace period. It cannot establish the status of subsequent final rules or MAC instructions as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would retain current MMM payment conditions and the MMM global period instead of adopting the new CPT codes for Medicare payment. This is not authorization to bill the contemplated G-codes.
Tables A-D2 and A-D3 are referenced but not reproduced in the supplied text; GMAT1-GMAT15 cannot be verified. The source supports no comparative ranking against other payers' approaches.
KY · Transition: CY 2027 proposal; final transition date not established
For CY 2027, CMS proposes maternity CPT work RVUs and seeks comment on creating 15 HCPCS G-codes instead of adopting the new CPT codes for Medicare payment. The G-code alternative would preserve the previous MMM global structure if finalized; this is not a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; final transition date not established
Billing starts
Not established in supplied proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B maternity services paid under the PFS; medical scope only, not a dental-product or Kentucky-specific MAC directive.
Transition: The supplied proposal does not establish transition handling or a grace period. It cannot verify whether later final rules or MAC instructions exist.
Global billing: CMS is seeking comment on 15 HCPCS G-codes that would preserve current MMM coding, payment conditions and global periods if finalized. This text does not adopt that alternative.
The referenced code tables are not reproduced in the supplied text, so specific G-code identifiers cannot be verified. The source does not substantiate a comparative ranking against other approaches or implementation status as of 2026-08-28.
LA · Transition: CY 2027 proposal; final transition date not established
For CY 2027, CMS proposes maternity CPT work RVUs and seeks comment on creating 15 HCPCS G-codes instead of adopting the new CPT codes for Medicare payment. The G-code alternative would preserve the previous MMM global structure if finalized; this is not a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; final transition date not established
Billing starts
Not established in supplied proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B maternity services paid under the PFS; medical scope only, not a dental-product or Louisiana-specific MAC directive.
Transition: The supplied proposal does not establish transition handling or a grace period. It cannot verify whether later final rules or MAC instructions exist.
Global billing: CMS is seeking comment on 15 HCPCS G-codes that would preserve current MMM coding, payment conditions and global periods if finalized. This text does not adopt that alternative.
The referenced code tables are not reproduced in the supplied text, so specific G-code identifiers cannot be verified. The source does not substantiate a comparative ranking against other approaches or implementation status as of 2026-08-28.
ME · Transition: CY 2027 proposal; final transition date not established
For CY 2027, CMS proposes maternity CPT work RVUs and seeks comment on creating 15 HCPCS G-codes instead of adopting the new CPT codes for Medicare payment. The G-code alternative would preserve the previous MMM global structure if finalized; this is not a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; final transition date not established
Billing starts
Not established in supplied proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B maternity services paid under the PFS; medical scope only, not a dental-product or Maine-specific MAC directive.
Transition: The supplied proposal does not establish transition handling or a grace period. It cannot verify whether later final rules or MAC instructions exist.
Global billing: CMS is seeking comment on 15 HCPCS G-codes that would preserve current MMM coding, payment conditions and global periods if finalized. This text does not adopt that alternative.
The referenced code tables are not reproduced in the supplied text, so specific G-code identifiers cannot be verified. The source does not substantiate a comparative ranking against other approaches or implementation status as of 2026-08-28.
MD · Transition: CY 2027 proposal; final transition date not established
For CY 2027, CMS proposes maternity CPT work RVUs and seeks comment on creating 15 HCPCS G-codes instead of adopting the new CPT codes for Medicare payment. The G-code alternative would preserve the previous MMM global structure if finalized; this is not a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; final transition date not established
Billing starts
Not established in supplied proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B maternity services paid under the PFS; medical scope only, not a dental-product or Maryland-specific MAC directive.
Transition: The supplied proposal does not establish transition handling or a grace period. It cannot verify whether later final rules or MAC instructions exist.
Global billing: CMS is seeking comment on 15 HCPCS G-codes that would preserve current MMM coding, payment conditions and global periods if finalized. This text does not adopt that alternative.
The referenced code tables are not reproduced in the supplied text, so specific G-code identifiers cannot be verified. The source does not substantiate a comparative ranking against other approaches or implementation status as of 2026-08-28.
MA · Transition: CY 2027 proposal; final transition date not established
For CY 2027, CMS proposes maternity CPT work RVUs and seeks comment on creating 15 HCPCS G-codes instead of adopting the new CPT codes for Medicare payment. The G-code alternative would preserve the previous MMM global structure if finalized; this is not a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; final transition date not established
Billing starts
Not established in supplied proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B maternity services paid under the PFS; medical scope only, not a dental-product or Massachusetts-specific MAC directive.
Transition: The supplied proposal does not establish transition handling or a grace period. It cannot verify whether later final rules or MAC instructions exist.
Global billing: CMS is seeking comment on 15 HCPCS G-codes that would preserve current MMM coding, payment conditions and global periods if finalized. This text does not adopt that alternative.
The referenced code tables are not reproduced in the supplied text, so specific G-code identifiers cannot be verified. The source does not substantiate a comparative ranking against other approaches or implementation status as of 2026-08-28.
MI · Transition: CY 2027 proposal; final transition date not established
For CY 2027, CMS proposes maternity CPT work RVUs and seeks comment on creating 15 HCPCS G-codes instead of adopting the new CPT codes for Medicare payment. The G-code alternative would preserve the previous MMM global structure if finalized; this is not a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; final transition date not established
Billing starts
Not established in supplied proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B maternity services paid under the PFS; medical scope only, not a dental-product or Michigan-specific MAC directive.
Transition: The supplied proposal does not establish transition handling or a grace period. It cannot verify whether later final rules or MAC instructions exist.
Global billing: CMS is seeking comment on 15 HCPCS G-codes that would preserve current MMM coding, payment conditions and global periods if finalized. This text does not adopt that alternative.
The referenced code tables are not reproduced in the supplied text, so specific G-code identifiers cannot be verified. The source does not substantiate a comparative ranking against other approaches or implementation status as of 2026-08-28.
MN · Transition: CY 2027 proposal; final transition date not established
For CY 2027, CMS proposes maternity CPT work RVUs and seeks comment on creating 15 HCPCS G-codes instead of adopting the new CPT codes for Medicare payment. The G-code alternative would preserve the previous MMM global structure if finalized; this is not a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; final transition date not established
Billing starts
Not established in supplied proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B maternity services paid under the PFS; a national medical-services proposal, not a Minnesota-specific MAC directive.
Transition: The supplied proposal does not establish transition handling or a grace period. It cannot verify whether later final rules or MAC instructions exist.
Global billing: CMS is seeking comment on 15 HCPCS G-codes that would preserve current MMM coding, payment conditions and global periods if finalized. This text does not adopt that alternative.
The referenced code tables are not reproduced in the supplied text, so specific G-code identifiers cannot be verified. The source does not substantiate a comparative ranking against other approaches or implementation status as of 2026-08-28.
MS · Transition: CY 2027 proposal; final transition date not established
For CY 2027, CMS proposes maternity CPT work RVUs and seeks comment on creating 15 HCPCS G-codes instead of adopting the new CPT codes for Medicare payment. The G-code alternative would preserve the previous MMM global structure if finalized; this is not a final billing instruction.
Published
2026-07-16
Transition starts
CY 2027 proposal; final transition date not established
Billing starts
Not established in supplied proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B maternity services paid under the PFS; medical scope only, not a dental-product or Mississippi-specific MAC directive.
Transition: The supplied proposal does not establish transition handling or a grace period. It cannot verify whether later final rules or MAC instructions exist.
Global billing: CMS is seeking comment on 15 HCPCS G-codes that would preserve current MMM coding, payment conditions and global periods if finalized. This text does not adopt that alternative.
The referenced code tables are not reproduced in the supplied text, so specific G-code identifiers cannot be verified. The source does not substantiate a comparative ranking against other approaches or implementation status as of 2026-08-28.
MO · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes revised maternity CPT work RVUs and seeks comment on creating 15 alternative HCPCS G-codes that would preserve the previous MMM global structure for Medicare PFS payment instead of adopting the new CPT codes. These are proposed alternatives, not finalized billing instructions.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not specified in supplied text
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B/PFS maternity medical services only; not dental-product guidance or Missouri-specific MAC implementation instructions.
Transition: The supplied proposal does not specify a grace period or MAC implementation instructions. It cannot establish whether final rules or additional guidance existed as of 2026-08-28.
Global billing: CMS is considering 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized. This proposal does not authorize billing those alternatives.
The supplied text supports the proposed G-code count but does not name GMAT1-GMAT15 or reproduce the referenced Table A-D3. This entry summarizes a federal proposal for Medicare Part B maternity medical services, not product-specific or MAC implementation guidance.
MT · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes revised maternity CPT work RVUs and seeks comment on creating 15 alternative HCPCS G-codes that would preserve the previous MMM global structure for Medicare PFS payment instead of adopting the new CPT codes. These are proposed alternatives, not finalized billing instructions.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not specified in supplied text
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B/PFS maternity medical services only; not dental-product guidance or Montana-specific MAC implementation instructions.
Transition: The supplied proposal does not specify a grace period or MAC implementation instructions. It cannot establish whether final rules or additional guidance existed as of 2026-08-28.
Global billing: CMS is considering 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized. This proposal does not authorize billing those alternatives.
The supplied text supports the proposed G-code count but does not name GMAT1-GMAT15 or reproduce the referenced Table A-D3. This entry summarizes a federal proposal for Medicare Part B maternity medical services, not product-specific or MAC implementation guidance.
NE · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes revised maternity CPT work RVUs and seeks comment on creating 15 alternative HCPCS G-codes that would preserve the previous MMM global structure for Medicare PFS payment instead of adopting the new CPT codes. These are proposed alternatives, not finalized billing instructions.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not specified in supplied text
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B/PFS maternity medical services only; not dental-product guidance or Nebraska-specific MAC implementation instructions.
Transition: The supplied proposal does not specify a grace period or MAC implementation instructions. It cannot establish whether final rules or additional guidance existed as of 2026-08-28.
Global billing: CMS is considering 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized. This proposal does not authorize billing those alternatives.
The supplied text supports the proposed G-code count but does not name GMAT1-GMAT15 or reproduce the referenced Table A-D3. This entry summarizes a federal proposal for Medicare Part B maternity medical services, not product-specific or MAC implementation guidance.
NV · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes revised maternity CPT work RVUs and seeks comment on creating 15 alternative HCPCS G-codes that would preserve the previous MMM global structure for Medicare PFS payment instead of adopting the new CPT codes. These are proposed alternatives, not finalized billing instructions.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not specified in supplied text
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B/PFS maternity medical services only; not dental-product guidance or Nevada-specific MAC implementation instructions.
Transition: The supplied proposal does not specify a grace period or MAC implementation instructions. It cannot establish whether final rules or additional guidance existed as of 2026-08-28.
Global billing: CMS is considering 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized. This proposal does not authorize billing those alternatives.
The supplied text supports the proposed G-code count but does not name GMAT1-GMAT15 or reproduce the referenced Table A-D3. This entry summarizes a federal proposal for Medicare Part B maternity medical services, not product-specific or MAC implementation guidance.
NH · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes revised maternity CPT work RVUs and seeks comment on creating 15 alternative HCPCS G-codes that would preserve the previous MMM global structure for Medicare PFS payment instead of adopting the new CPT codes. These are proposed alternatives, not finalized billing instructions.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not specified in supplied text
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B/PFS maternity medical services only; not dental-product guidance or New Hampshire-specific MAC implementation instructions.
Transition: The supplied proposal does not specify a grace period or MAC implementation instructions. It cannot establish whether final rules or additional guidance existed as of 2026-08-28.
Global billing: CMS is considering 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized. This proposal does not authorize billing those alternatives.
The supplied text supports the proposed G-code count but does not name GMAT1-GMAT15 or reproduce the referenced Table A-D3. This entry summarizes a federal proposal for Medicare Part B maternity medical services, not product-specific or MAC implementation guidance.
NJ · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes revised maternity CPT work RVUs and seeks comment on creating 15 alternative HCPCS G-codes that would preserve the previous MMM global structure for Medicare PFS payment instead of adopting the new CPT codes. These are proposed alternatives, not finalized billing instructions.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not specified in supplied text
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B/PFS maternity medical services only; not dental-product guidance or New Jersey-specific MAC implementation instructions.
Transition: The supplied proposal does not specify a grace period or MAC implementation instructions. It cannot establish whether final rules or additional guidance existed as of 2026-08-28.
Global billing: CMS is considering 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized. This proposal does not authorize billing those alternatives.
The supplied text supports the proposed G-code count but does not name GMAT1-GMAT15 or reproduce the referenced Table A-D3. This entry summarizes a federal proposal for Medicare Part B maternity medical services, not product-specific or MAC implementation guidance.
NM · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes revised maternity CPT work RVUs and seeks comment on creating 15 alternative HCPCS G-codes that would preserve the previous MMM global structure for Medicare PFS payment instead of adopting the new CPT codes. These are proposed alternatives, not finalized billing instructions.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not specified in supplied text
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B/PFS maternity medical services only; not dental-product guidance or New Mexico-specific MAC implementation instructions.
Transition: The supplied proposal does not specify a grace period or MAC implementation instructions. It cannot establish whether final rules or additional guidance existed as of 2026-08-28.
Global billing: CMS is considering 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized. This proposal does not authorize billing those alternatives.
The supplied text supports the proposed G-code count but does not name GMAT1-GMAT15 or reproduce the referenced Table A-D3. This entry summarizes a federal proposal for Medicare Part B maternity medical services, not product-specific or MAC implementation guidance.
NY · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes revised maternity CPT work RVUs and seeks comment on creating 15 alternative HCPCS G-codes that would preserve the previous MMM global structure for Medicare PFS payment instead of adopting the new CPT codes. These are proposed alternatives, not finalized billing instructions.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not specified in supplied text
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B/PFS maternity medical services; not Queens-specific MAC implementation instructions.
Transition: The supplied proposal does not specify a grace period or MAC implementation instructions. It cannot establish whether final rules or additional guidance existed as of 2026-08-28.
Global billing: CMS is considering 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized. This proposal does not authorize billing those alternatives.
The supplied text supports the proposed G-code count but does not name GMAT1-GMAT15 or reproduce the referenced Table A-D3. This entry summarizes a federal proposal for Medicare Part B maternity medical services, not Queens-specific or MAC implementation guidance.
NY · Transition: CY 2027 proposal; exact transition date not established
For CY 2027, CMS proposes revised valuations for the restructured maternity CPT codes and seeks comment on creating 15 HCPCS G-codes instead for Medicare payment. The G-code alternative would retain the previous MMM global structure if finalized; the supplied text does not establish a mandatory transition date.
Published
2026-07-16
Transition starts
CY 2027 proposal; exact transition date not established
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services only; not dental coverage or state/MAC-specific implementation guidance.
Transition: The supplied text discusses CY 2027 proposals but gives no exact maternity transition date or grace-period instructions. It cannot establish whether a final rule or MAC guidance existed as of 2026-08-28.
Global billing: If finalized, the contemplated HCPCS G-codes would preserve the MMM global period and all current conditions of payment in lieu of adopting the new CPT codes for Medicare payment.
Proposal only. This source does not establish a final Medicare code set or MAC implementation instructions.
NC · Transition: CY 2027 proposal; exact transition date not established
For CY 2027, CMS proposes revised valuations for the restructured maternity CPT codes and seeks comment on creating 15 HCPCS G-codes instead for Medicare payment. The G-code alternative would retain the previous MMM global structure if finalized; the supplied text does not establish a mandatory transition date.
Published
2026-07-16
Transition starts
CY 2027 proposal; exact transition date not established
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services; not state/MAC-specific implementation guidance.
Transition: The supplied text discusses CY 2027 proposals but gives no exact maternity transition date or grace-period instructions. It cannot establish whether a final rule or MAC guidance existed as of 2026-08-28.
Global billing: If finalized, the contemplated HCPCS G-codes would preserve the MMM global period and all current conditions of payment in lieu of adopting the new CPT codes for Medicare payment.
Proposal only. This source does not establish a final Medicare code set or MAC implementation instructions.
NC · Transition: CY 2027 proposal; exact transition date not established
For CY 2027, CMS proposes revised valuations for the restructured maternity CPT codes and seeks comment on creating 15 HCPCS G-codes instead for Medicare payment. The G-code alternative would retain the previous MMM global structure if finalized; the supplied text does not establish a mandatory transition date.
Published
2026-07-16
Transition starts
CY 2027 proposal; exact transition date not established
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services only; not dental coverage or state/MAC-specific implementation guidance.
Transition: The supplied text discusses CY 2027 proposals but gives no exact maternity transition date or grace-period instructions. It cannot establish whether a final rule or MAC guidance existed as of 2026-08-28.
Global billing: If finalized, the contemplated HCPCS G-codes would preserve the MMM global period and all current conditions of payment in lieu of adopting the new CPT codes for Medicare payment.
Proposal only. This source does not establish a final Medicare code set or MAC implementation instructions, and it does not verify the record's Jurisdiction 11 designation.
ND · Transition: CY 2027 proposal; exact transition date not established
For CY 2027, CMS proposes revised valuations for the restructured maternity CPT codes and seeks comment on creating 15 HCPCS G-codes instead for Medicare payment. The G-code alternative would retain the previous MMM global structure if finalized; the supplied text does not establish a mandatory transition date.
Published
2026-07-16
Transition starts
CY 2027 proposal; exact transition date not established
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services only; not dental coverage or state/MAC-specific implementation guidance.
Transition: The supplied text discusses CY 2027 proposals but gives no exact maternity transition date or grace-period instructions. It cannot establish whether a final rule or MAC guidance existed as of 2026-08-28.
Global billing: If finalized, the contemplated HCPCS G-codes would preserve the MMM global period and all current conditions of payment in lieu of adopting the new CPT codes for Medicare payment.
Proposal only. This source does not establish a final Medicare code set or MAC implementation instructions.
CA · Transition: CY 2027 proposal; exact transition date not established
For CY 2027, CMS proposes revised valuations for the restructured maternity CPT codes and seeks comment on creating 15 HCPCS G-codes instead for Medicare payment. The G-code alternative would retain the previous MMM global structure if finalized; the supplied text does not establish a mandatory transition date.
Published
2026-07-16
Transition starts
CY 2027 proposal; exact transition date not established
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services only; not dental coverage or state/MAC-specific implementation guidance.
Transition: The supplied text discusses CY 2027 proposals but gives no exact maternity transition date or grace-period instructions. It cannot establish whether a final rule or MAC guidance existed as of 2026-08-28.
Global billing: If finalized, the contemplated HCPCS G-codes would preserve the MMM global period and all current conditions of payment in lieu of adopting the new CPT codes for Medicare payment.
Proposal only. This source does not establish a final Medicare code set or MAC implementation instructions.
OH · Transition: CY 2027 proposal; exact transition date not established
For CY 2027, CMS proposes revised valuations for the restructured maternity CPT codes and seeks comment on creating 15 HCPCS G-codes instead for Medicare payment. The G-code alternative would retain the previous MMM global structure if finalized; the supplied text does not establish a mandatory transition date.
Published
2026-07-16
Transition starts
CY 2027 proposal; exact transition date not established
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services only; not dental coverage or state/MAC-specific implementation guidance.
Transition: The supplied text discusses CY 2027 proposals but gives no exact maternity transition date or grace-period instructions. It cannot establish whether a final rule or MAC guidance existed as of 2026-08-28.
Global billing: If finalized, the contemplated HCPCS G-codes would preserve the MMM global period and all current conditions of payment in lieu of adopting the new CPT codes for Medicare payment.
Proposal only. This source does not establish a final Medicare code set or MAC implementation instructions.
OK · Transition: CY 2027 proposal; exact transition date not established
For CY 2027, CMS proposes revised valuations for the restructured maternity CPT codes and seeks comment on creating 15 HCPCS G-codes instead for Medicare payment. The G-code alternative would retain the previous MMM global structure if finalized; the supplied text does not establish a mandatory transition date.
Published
2026-07-16
Transition starts
CY 2027 proposal; exact transition date not established
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services only; not dental coverage or state/MAC-specific implementation guidance.
Transition: The supplied text discusses CY 2027 proposals but gives no exact maternity transition date or grace-period instructions. It cannot establish whether a final rule or MAC guidance existed as of 2026-08-28.
Global billing: If finalized, the contemplated HCPCS G-codes would preserve the MMM global period and all current conditions of payment in lieu of adopting the new CPT codes for Medicare payment.
Proposal only. This source does not establish a final Medicare code set or MAC implementation instructions.
OR · Transition: CY 2027 proposal; exact transition date not established
For CY 2027, CMS proposes revised valuations for the restructured maternity CPT codes and seeks comment on creating 15 HCPCS G-codes instead for Medicare payment. The G-code alternative would retain the previous MMM global structure if finalized; the supplied text does not establish a mandatory transition date.
Published
2026-07-16
Transition starts
CY 2027 proposal; exact transition date not established
Billing starts
Not established by this source
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services only; not dental coverage or state/MAC-specific implementation guidance.
Transition: The supplied text discusses CY 2027 proposals but gives no exact maternity transition date or grace-period instructions. It cannot establish whether a final rule or MAC guidance existed as of 2026-08-28.
Global billing: If finalized, the contemplated HCPCS G-codes would preserve the MMM global period and all current conditions of payment in lieu of adopting the new CPT codes for Medicare payment.
Proposal only. This source does not establish a final Medicare code set or MAC implementation instructions.
PA · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes maternity CPT valuations and seeks comment on an alternative of 15 HCPCS G-codes preserving the previous MMM global structure for Medicare PFS payment. Neither option is a finalized billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services; not dental billing or Pennsylvania-specific MAC instructions.
Transition: The supplied text does not specify a transition or grace period. It cannot verify whether a final rule, grace period, or MAC guidance existed as of 2026-08-28.
Global billing: CMS seeks comment on 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized; their use is not authorized by this proposal.
The G-code alternative is under consideration and subject to public comment. The supplied text references Table A-D3 but does not reproduce the proposed identifiers, so GMAT1-GMAT15 cannot be verified. It provides no comparative ranking of this proposal against other billing policies.
PR · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes maternity CPT valuations and seeks comment on an alternative of 15 HCPCS G-codes preserving the previous MMM global structure for Medicare PFS payment. Neither option is a finalized billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services; not Puerto Rico-specific MAC instructions.
Transition: The supplied text does not specify a transition or grace period. It cannot verify whether a final rule, grace period, or MAC guidance existed as of 2026-08-28.
Global billing: CMS seeks comment on 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized; their use is not authorized by this proposal.
The G-code alternative is under consideration and subject to public comment. The supplied text references Table A-D3 but does not reproduce the proposed identifiers, so GMAT1-GMAT15 cannot be verified. It provides no comparative ranking of this proposal against other billing policies.
NATIONAL · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes maternity CPT valuations and seeks comment on an alternative of 15 HCPCS G-codes preserving the previous MMM global structure for Medicare PFS payment. Neither option is a finalized billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal maternity-payment proposal for Medicare medical services paid under the PFS; not dental billing or Railroad-specific contractor instructions.
Transition: The supplied text does not specify a transition or grace period. It cannot verify whether a final rule, grace period, or Railroad contractor guidance existed as of 2026-08-28.
Global billing: CMS seeks comment on 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized; their use is not authorized by this proposal.
The G-code alternative is under consideration and subject to public comment. The supplied text references Table A-D3 but does not reproduce the proposed identifiers, so GMAT1-GMAT15 cannot be verified. It provides no comparative ranking of this proposal or evidence of separate Railroad implementation.
RI · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes maternity CPT valuations and seeks comment on an alternative of 15 HCPCS G-codes preserving the previous MMM global structure for Medicare PFS payment. Neither option is a finalized billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services; not dental billing or Rhode Island-specific MAC instructions.
Transition: The supplied text does not specify a transition or grace period. It cannot verify whether a final rule, grace period, or MAC guidance existed as of 2026-08-28.
Global billing: CMS seeks comment on 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized; their use is not authorized by this proposal.
The G-code alternative is under consideration and subject to public comment. The supplied text references Table A-D3 but does not reproduce the proposed identifiers, so GMAT1-GMAT15 cannot be verified. It provides no comparative ranking of this proposal against other billing policies.
SC · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes maternity CPT valuations and seeks comment on an alternative of 15 HCPCS G-codes preserving the previous MMM global structure for Medicare PFS payment. Neither option is a finalized billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services; not dental billing or South Carolina-specific MAC instructions.
Transition: The supplied text does not specify a transition or grace period. It cannot verify whether a final rule, grace period, or MAC guidance existed as of 2026-08-28.
Global billing: CMS seeks comment on 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized; their use is not authorized by this proposal.
The G-code alternative is under consideration and subject to public comment. The supplied text references Table A-D3 but does not reproduce the proposed identifiers, so GMAT1-GMAT15 cannot be verified. It provides no comparative ranking of this proposal against other billing policies.
SD · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes maternity CPT valuations and seeks comment on an alternative of 15 HCPCS G-codes preserving the previous MMM global structure for Medicare PFS payment. Neither option is a finalized billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services; not dental billing or South Dakota-specific MAC instructions.
Transition: The supplied text does not specify a transition or grace period. It cannot verify whether a final rule, grace period, or MAC guidance existed as of 2026-08-28.
Global billing: CMS seeks comment on 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized; their use is not authorized by this proposal.
The G-code alternative is under consideration and subject to public comment. The supplied text references Table A-D3 but does not reproduce the proposed identifiers, so GMAT1-GMAT15 cannot be verified. It provides no comparative ranking of this proposal against other billing policies.
CA · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes maternity CPT valuations and seeks comment on an alternative of 15 HCPCS G-codes preserving the previous MMM global structure for Medicare PFS payment. Neither option is a finalized billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services; not dental billing or Southern California-specific MAC instructions.
Transition: The supplied text does not specify a transition or grace period. It cannot verify whether a final rule, grace period, or MAC guidance existed as of 2026-08-28.
Global billing: CMS seeks comment on 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized; their use is not authorized by this proposal.
The G-code alternative is under consideration and subject to public comment. The supplied text references Table A-D3 but does not reproduce the proposed identifiers, so GMAT1-GMAT15 cannot be verified. It provides no comparative ranking of this proposal against other billing policies.
TN · Transition: CY 2027 proposal; operational transition date not established
For CY 2027, CMS proposes maternity CPT valuations and seeks comment on an alternative of 15 HCPCS G-codes preserving the previous MMM global structure for Medicare PFS payment. Neither option is a finalized billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; operational transition date not established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity-payment proposal for medical Part B services; not dental billing or Tennessee-specific MAC instructions.
Transition: The supplied text does not specify a transition or grace period. It cannot verify whether a final rule, grace period, or MAC guidance existed as of 2026-08-28.
Global billing: CMS seeks comment on 15 alternative HCPCS G-codes that would retain the MMM global period and current conditions of payment if finalized; their use is not authorized by this proposal.
The G-code alternative is under consideration and subject to public comment. The supplied text references Table A-D3 but does not reproduce the proposed identifiers, so GMAT1-GMAT15 cannot be verified. It provides no comparative ranking of this proposal against other billing policies.
TX · Transition: CY 2027 proposal; no operative transition date established
CMS proposes revised valuations for restructured maternity CPT codes for CY 2027 and seeks comment on creating 15 alternative HCPCS G-codes for Medicare PFS payment. Neither approach is a final billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; no operative transition date established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity payment under the PFS; not dental coverage or Texas-specific MAC instructions.
Transition: The supplied text does not establish transition or grace-period rules or MAC implementation instructions. It cannot verify whether a final rule or other guidance existed as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would maintain the MMM global period and all current conditions of payment for the MMM global codes.
Review is limited to the supplied proposal text. The referenced tables are not reproduced, and GMAT1-GMAT15 cannot be verified from this text.
UT · Transition: CY 2027 proposal; no operative transition date established
CMS proposes revised valuations for restructured maternity CPT codes for CY 2027 and seeks comment on creating 15 alternative HCPCS G-codes for Medicare PFS payment. Neither approach is a final billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; no operative transition date established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity payment under the PFS; not dental coverage or Utah-specific MAC instructions.
Transition: The supplied text does not establish transition or grace-period rules or MAC implementation instructions. It cannot verify whether a final rule or other guidance existed as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would maintain the MMM global period and all current conditions of payment for the MMM global codes.
Review is limited to the supplied proposal text. The referenced tables are not reproduced, and GMAT1-GMAT15 cannot be verified from this text.
VT · Transition: CY 2027 proposal; no operative transition date established
CMS proposes revised valuations for restructured maternity CPT codes for CY 2027 and seeks comment on creating 15 alternative HCPCS G-codes for Medicare PFS payment. Neither approach is a final billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; no operative transition date established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity payment under the PFS; not dental coverage or Vermont-specific MAC instructions.
Transition: The supplied text does not establish transition or grace-period rules or MAC implementation instructions. It cannot verify whether a final rule or other guidance existed as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would maintain the MMM global period and all current conditions of payment for the MMM global codes.
Review is limited to the supplied proposal text. The referenced tables are not reproduced, and GMAT1-GMAT15 cannot be verified from this text.
VI · Transition: CY 2027 proposal; no operative transition date established
CMS proposes revised valuations for restructured maternity CPT codes for CY 2027 and seeks comment on creating 15 alternative HCPCS G-codes for Medicare PFS payment. Neither approach is a final billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; no operative transition date established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity payment under the PFS; not Virgin Islands-specific MAC instructions.
Transition: The supplied text does not establish transition or grace-period rules or MAC implementation instructions. It cannot verify whether a final rule or other guidance existed as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would maintain the MMM global period and all current conditions of payment for the MMM global codes.
Review is limited to the supplied proposal text. The referenced tables are not reproduced, and GMAT1-GMAT15 cannot be verified from this text.
VA · Transition: CY 2027 proposal; no operative transition date established
CMS proposes revised valuations for restructured maternity CPT codes for CY 2027 and seeks comment on creating 15 alternative HCPCS G-codes for Medicare PFS payment. Neither approach is a final billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; no operative transition date established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity payment under the PFS; not dental coverage or Virginia-specific MAC instructions.
Transition: The supplied text does not establish transition or grace-period rules or MAC implementation instructions. It cannot verify whether a final rule or other guidance existed as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would maintain the MMM global period and all current conditions of payment for the MMM global codes.
Review is limited to the supplied proposal text. The referenced tables are not reproduced, and GMAT1-GMAT15 cannot be verified from this text.
WA · Transition: CY 2027 proposal; no operative transition date established
CMS proposes revised valuations for restructured maternity CPT codes for CY 2027 and seeks comment on creating 15 alternative HCPCS G-codes for Medicare PFS payment. Neither approach is a final billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; no operative transition date established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity payment under the PFS; not dental coverage or Washington-specific MAC instructions.
Transition: The supplied text does not establish transition or grace-period rules or MAC implementation instructions. It cannot verify whether a final rule or other guidance existed as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would maintain the MMM global period and all current conditions of payment for the MMM global codes.
Review is limited to the supplied proposal text. The referenced tables are not reproduced, and GMAT1-GMAT15 cannot be verified from this text.
WV · Transition: CY 2027 proposal; no operative transition date established
CMS proposes revised valuations for restructured maternity CPT codes for CY 2027 and seeks comment on creating 15 alternative HCPCS G-codes for Medicare PFS payment. Neither approach is a final billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; no operative transition date established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity payment under the PFS; not West Virginia-specific MAC instructions.
Transition: The supplied text does not establish transition or grace-period rules or MAC implementation instructions. It cannot verify whether a final rule or other guidance existed as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would maintain the MMM global period and all current conditions of payment for the MMM global codes.
Review is limited to the supplied proposal text. The referenced tables are not reproduced, and GMAT1-GMAT15 cannot be verified from this text.
WI · Transition: CY 2027 proposal; no operative transition date established
CMS proposes revised valuations for restructured maternity CPT codes for CY 2027 and seeks comment on creating 15 alternative HCPCS G-codes for Medicare PFS payment. Neither approach is a final billing instruction in this source.
Published
2026-07-16
Transition starts
CY 2027 proposal; no operative transition date established
Billing starts
Not established by cited proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare Part B medical maternity payment under the PFS; not dental coverage or Wisconsin-specific MAC instructions.
Transition: The supplied text does not establish transition or grace-period rules or MAC implementation instructions. It cannot verify whether a final rule or other guidance existed as of 2026-08-28.
Global billing: If finalized, the alternative HCPCS G-codes would maintain the MMM global period and all current conditions of payment for the MMM global codes.
Review is limited to the supplied proposal text. The referenced tables are not reproduced, and GMAT1-GMAT15 cannot be verified from this text.
WY · Transition: CY 2027 proposal; no confirmed transition date in supplied text
For CY 2027, CMS proposes valuations for the restructured maternity CPT codes and separately seeks comment on creating 15 alternative HCPCS G-codes reflecting the previous MMM global structure for Medicare payment. The supplied proposal does not establish a final coding choice or an operational transition date.
Published
2026-07-16
Transition starts
CY 2027 proposal; no confirmed transition date in supplied text
Billing starts
Not established in supplied proposal
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Federal Medicare PFS maternity medical services under Medicare Part B; not dental-product policy or Wyoming-specific MAC implementation guidance.
Transition: The supplied text does not establish a final effective date, grace period, or MAC implementation instructions. It cannot verify whether subsequent guidance or a final rule existed as of 2026-08-28.
Global billing: Potentially, if finalized: the alternative HCPCS G-codes would maintain the MMM global period and current conditions of payment. CMS is seeking comment on this alternative; it is not a final billing authorization.
The supplied text supports a federal proposal, not an active policy. It references Table A-D3 for the 15 alternative G-codes, but that table and the identifiers GMAT1-GMAT15 are not reproduced. Apply this interpretation only to Medicare PFS maternity medical services; verify final coding and implementation requirements before submission.
IL · Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Corporate template for medical maternity services; Meridian Illinois Medicaid adoption and effective date are unverified. No dental billing application is established.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
This PDF does not document Meridian Illinois adoption. Conflicting state Medicaid coverage provisions take precedence; applicable coverage documents and plan-level policies must also be checked.
Effective January 1, 2027, global obstetric codes are replaced by itemized visit-level codes and are no longer payable. Providers must bill the appropriate non-bundled antepartum, labor, and delivery codes. The notice says New York Medicaid adopted these coding changes effective June 1, 2026.
Published
Not stated in source
Transition starts
June 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: MetroPlusHealth Medicaid, HARP, and HIV-SNP.
Transition: Not stated in the approved quotes
Global billing: Global obstetric codes will no longer be payable after January 1, 2027.
FL · Transition: Services rendered after March 1, 2026
For Medicaid and Marketplace maternity services covered by this Molina Florida provider posting, bill approved individual service codes per date of service. The guide says listed bundled codes for services rendered after March 1, 2026, will be rejected/denied with code 272; it does not confirm implementation of the AMA's 2027 CPT deletions.
Published
2026-07
Transition starts
Services rendered after March 1, 2026
Billing starts
Services rendered after March 1, 2026
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Molina Medicaid and Marketplace medical maternity services in the supplied Florida provider posting; no Dental or Vision applicability established.
Transition: This guide does not address the 2027 CPT deletions, a 2027 grace period, or handling of maternity episodes spanning the billing change.
Global billing: Listed bundled maternity codes for services rendered after March 1, 2026, are rejected/denied with remittance code 272, “Coverage/program guidelines were not met.” Providers must use individual service codes.
Operational 2026 individual-service billing guidance, revised July 2026, aligned with anticipated ACOG guidelines. This is not an explicit AMA 2027 CPT deletion implementation policy. Florida context is supplied by the document URL rather than an express state designation in the extracted text; verify the member's Medicaid or Marketplace medical product.
OH · Transition: Services follow the date each service is rendered, not the claim billing date
RP-202701, created and initially effective 01/01/2027, reimburses maternity care by the separately reported component, including antepartum care, labor management, delivery, and postpartum care. Antepartum care must be reported with the appropriate E/M code and modifier TH. 0500F is billed on the initial visit with that E/M code, modifier TH, and a pregnancy-related ICD-10 diagnosis, and is not separately reimbursable. Maternity care codes are not eligible for dates of service on or after January 1, 2027. Labor management may be reported once per calendar date and is not separately reimbursable for a scheduled or planned cesarean when labor does not occur. Multiple-gestation vaginal delivery is one appropriate vaginal delivery code per fetus; only one cesarean delivery code is eligible. Immediate maternal postpartum care on the delivery date is included in delivery care. RP-202701 names Mutual Health Services for Commercial (Self-Funded) only. Marketplace, fully insured commercial, and Medicare Advantage in this policy belong to the other named entities, not this plan.
Published
2027-01-01
Transition starts
Services follow the date each service is rendered, not the claim billing date
Billing starts
January 1, 2027
Evidence checked
2026-10-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Commercial (Self-Funded); Mutual Health Services only
Transition: applicable to the date each service is rendered, not the billing date for the service.
Global billing: Maternity care codes are not eligible for reimbursement for dates of service on or after January 1, 2027.
Medical Mutual Services, LLC is listed except Mutual Health Services.
NE · Transition: Not stated in the approved quotes
The stored quotes say billing is delayed until January 2027 and until after the delivery occurs, and they name 99202-99499 and the TH modifier. They do not state which cohort those codes apply to.
Published
Not stated in source
Transition starts
Not stated in the approved quotes
Billing starts
Not stated as a full calendar rule in the stored quotes
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Nebraska Medicaid managed-care advisory. Named MCO adoption is not in the stored quotes.
Transition: Not stated in the approved quotes
Global billing: Not stated in the stored quotes.
The approved candidateStatus was 'confirmed_2027 subject to timing/scope review'. The stored quotes are fragments, so this record stays pending_guidance.
Effective June 1, 2026, Independent Health applies its antepartum billing transition across Commercial, Medicare, State Programs and Self-Funded products. For affected routine antepartum visits, report the appropriate E/M code (e.g., 99202-99215) with Modifier TH and a pregnancy-related O or Z ICD-10 diagnosis code; submit 0500F on the initial antepartum visit claim. E/M visits outside routine antepartum care are billed without TH. See transition notes for inconsistent cohort wording.
Published
2026-06
Transition starts
June 1, 2026
Billing starts
June 1, 2026
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Independent Health medical antepartum services across Commercial, Medicare, State Programs and Self-Funded products.
Transition: The State Products paragraph applies initiation on or after June 1, 2026 and/or expected delivery on or after January 1, 2027. The 59425/59426 denial paragraph uses initiation on or after June 1 alone, while the highlights describe initiation on or after June 1 with expected delivery on or after January 1. Confirm the intended cohort with Independent Health, particularly for earlier-established members expected to deliver in 2027. The article does not expressly authorize earlier-established members to retain current 2026 billing. It says a portal reimbursement-manual section with billing examples will be available as of June 1, 2026.
Global billing: For members initiating antepartum care on or after June 1, 2026, the article states that 59425 and 59426 are not reimbursable and submitted claim lines will deny. It does not establish comprehensive rules for other global maternity codes or expressly permit continued global billing for earlier-established members.
The source identifies Independent Health Association, Inc. and expressly names the covered product categories; it does not establish a separate Western-specific policy. This is operational 2026 transition guidance in preparation for the 2027 overhaul, not a complete 2027 replacement-code policy. Referenced portal materials were not provided for review.
OH · Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Corporate template for medical maternity services; adoption and effective date for Next Generation MyCare Ohio - Buckeye are unverified. No dental billing application is established.
Transition: The cited policy contains no 2027 transition or grace-period instructions and does not address a MyCare program transition.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
This PDF does not document adoption by the named program. For Medicaid members, conflicting state Medicaid coverage provisions take precedence. For Medicare members, review all applicable NCDs and LCDs before applying the policy.
Beginning Sept. 1, 2026, NC Medicaid Direct and NC Medicaid Managed Care providers are encouraged to use E/M 99202-99215 with TH for prenatal or postpartum care. The bulletin identifies first prenatal visits after confirmation and antepartum visits where delivery and/or the postpartum visit is anticipated after Jan. 1, 2027. On Jan. 1, 2027, all current maternity service codes, including global billing, will be deleted from the fee schedule and new AMA maternity billing codes become effective. Clinical Coverage 1E-5 is being revised.
Published
2026-07-10
Transition starts
September 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Maternity medical billing under NC Medicaid Direct and NC Medicaid Managed Care.
Transition: The pre-2027 E/M transition is encouraged, not mandatory; health plans may not require individual E/M codes instead of current bundled codes for dates of service before Jan. 1, 2027. For pregnancies culminating with a postpartum visit before that date, existing codes including global, 59425 and 59426 may be billed. Record appropriate ICD-10-CM coding including gestational weeks, and support medical decision making or time under CPT guidelines.
Global billing: Existing global codes may be billed for pregnancies culminating with a postpartum visit before Jan. 1, 2027. All current maternity service codes, including global billing, will be deleted from the fee schedule on Jan. 1, 2027. The bulletin does not supply a complete cross-year claim procedure.
The bulletin itself confirms the Jan. 1, 2027 code replacement while Clinical Coverage 1E-5 is being revised. It points to AMA's website for the new, revised and deleted code list rather than reproducing that list. It is statewide program guidance and does not establish whether any individually named plan has issued separate instructions.
AL; AZ; FL; GA; IL; IA; KS; MI; MS; MO; NE; NJ; NY; NC; OH; OK; PA; TN; TX; VA · Transition: Not stated on cited page
The cited Oscar maternity page describes member medical coverage and network requirements. It provides no global OB coding instructions or 2027 billing transition guidance and cannot establish whether Oscar has issued such guidance elsewhere.
Published
Not stated in source
Transition starts
Not stated on cited page
Billing starts
Not stated on cited page
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Oscar member-facing medical maternity and newborn coverage information; no Dental or comprehensive state/product billing applicability established.
Transition: The cited page does not discuss the 2027 maternity CPT deletions, a billing transition, or a grace period.
Global billing: The cited page does not address global OB billing or establish whether it should continue or change.
This is an Oscar-hosted member coverage page, not a provider reimbursement policy or reimbursement-policy index. The supplied source cannot verify the contents of Oscar's policy index or the absence of guidance elsewhere. Exact member-product applicability is not established.
· Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Corporate template for medical maternity services; the exact Peach State product, state, program, adoption and effective date require verification. No dental billing application is established.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
This PDF does not identify an adopting Peach State product. Application is subject to coverage documents, applicable plan-level policies and state and federal requirements.
Premera’s cross-year tip sheet establishes staged antepartum cohorts beginning 2026-05-15 and itemized maternity coding beginning 2027-01-01.
Published
2026-07-27
Transition starts
May 15, 2026
Billing starts
January 1, 2027
Evidence checked
2026-09-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Premera Blue Cross Blue Shield of Alaska provider coding resources. The visible notice does not expressly assign the rule to a particular line of business.
Transition: First antepartum visit 2026-05-15 through 2026-07-14 with delivery due Dec. 2026/Jan. 2027 uses 59426 plus delivery-only coding. The next cohort uses 59425 plus 2027 delivery-only coding. On/after 2026-09-01 for deliveries due after Apr. 2027, use E/M; 59425 may still apply when 4+ visits occur before 2027-01-01.
Global billing: The tip sheet retains defined 2026 antepartum visit-count codes during transition; service-level coding starts 2027-01-01.
Do not extend this record to separately listed unscoped HMO or individual-plan aliases without product confirmation.
Premera’s cross-year tip sheet establishes staged antepartum cohorts beginning 2026-05-15 and itemized maternity coding beginning 2027-01-01.
Published
2026-07-27
Transition starts
May 15, 2026
Billing starts
January 1, 2027
Evidence checked
2026-09-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Premera Blue Cross of Washington provider notice and tip sheet. The visible notice does not expressly assign the rule to a particular line of business.
Transition: First antepartum visit 2026-05-15 through 2026-07-14 with delivery due Dec. 2026/Jan. 2027 uses 59426 plus delivery-only coding. The next cohort uses 59425 plus 2027 delivery-only coding. On/after 2026-09-01 for deliveries due after Apr. 2027, use E/M; 59425 may still apply when 4+ visits occur before 2027-01-01.
Global billing: The tip sheet retains defined 2026 antepartum visit-count codes during transition; service-level coding starts 2027-01-01.
Do not extend this record to separately listed unscoped HMO or individual-plan aliases without product confirmation.
Priority Health says patients beginning prenatal care on or after 2026-06-01 are no longer billed with global maternity care codes; bill E/M, required TH, and the correct pregnancy diagnosis. The new code set begins 2027-01-01.
Published
2026-05-05
Transition starts
June 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-09-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Priority Health Maternity Services Policy 071. Review the member benefit and the policy’s self-funded-plan limitation before applying.
Transition: Patients who begin prenatal care on or after 2026-06-01 use E/M + TH + pregnancy diagnosis. Patients beginning prenatal care before 2026-06-01 and delivering before 2027-01-01 may continue the global package under the stated policy.
Global billing: Not for the defined prenatal-care-start cohort on/after 2026-06-01. The policy retains a limited pre-cutoff/pre-2027 delivery pathway.
Policy 071 also contains claim-level maternity requirements. This refresh does not infer that its rules apply to a self-funded member whose benefit excludes maternity services.
The linked maternity PDF directs per-encounter antepartum E/M coding with TH and a pregnancy-related diagnosis. It recommends starting E/M antepartum billing now for anticipated deliveries on or after January 1, 2027; global codes remain permitted for earlier anticipated deliveries. Applicability to individual insurance products requires confirmation.
Published
2026-07
Transition starts
Now — no calendar date stated
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Security Health Plan publisher provenance verified through its newsletter; the PDF does not name a product line.
Transition: Preserve should for early adoption. No visit-count rule or dated early start. Confirm whether TH applies during early adoption.
Global billing: The PDF permits global codes for anticipated deliveries before January 1, 2027.
Proposed interpretation only. Confirm product scope and reconcile the existing awareness-only golden before publication.
Sentara’s Sept. 3 update identifies global maternity billing changes effective 2027-01-01 and says that, effective immediately, providers should bill 59425 and 59426 for pregnant Sentara members delivering after that date.
Published
2026-09-03
Transition starts
September 3, 2026
Billing starts
January 1, 2027
Evidence checked
2026-09-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Sentara Health Plans provider update. The notice does not state which product lines or selection threshold applies to 59425 versus 59426.
Transition: The notice says to bill 59425 and 59426 for members pregnant but delivering after 2027-01-01; it does not provide a visit-count rule, E/M instruction, modifier, diagnosis, or grace-period detail.
Global billing: Global maternity billing is described as changing effective 2027-01-01. The only current interim coding instruction is to use 59425/59426 for the identified delivery cohort.
This record is confirmed only for the stated interim instruction. Do not manufacture 59425/59426 selection logic; await Sentara’s promised additional resources.
· Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Corporate medical maternity template; the exact SilverSummit product, state, program, adoption and effective date require verification.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
This PDF does not identify an adopting SilverSummit product. Application is subject to coverage documents, applicable plan-level policies and state and federal requirements.
Applicability to Student Resources medical products is unverified. Within its stated Commercial and Individual Exchange scope, the cited policy directs global OB reporting for complete same-group care, component itemization in specified circumstances, and separate reporting of excluded services when permitted. It states no 2027 transition date.
Published
Not stated in source
Transition starts
Not stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: UHC Commercial and Individual Exchange professional maternity claims on CMS-1500 or its equivalent/successor; Student Resources medical-product applicability is unverified. No Dental billing guidance.
Transition: No 2027 transition date, grace period or cross-year pregnancy rule is stated in this document. No conclusion is established about other public guidance.
Global billing: The source directs 59400, 59510, 59610 and 59618 for complete same-group maternity care, with the group identified by federal tax identification number. Applying this instruction to Student Resources requires product verification.
Do not infer Student Resources applicability from UnitedHealth Group affiliation. Verify the member's medical benefit plan and governing reimbursement policy. The cited source does not discuss the 2027 deletion or mandate a replacement policy before 2027.
KS · Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Corporate template for medical maternity services; adoption and effective date for the exact Sunflower Kansas product are unverified. No dental billing application is established.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
This PDF does not identify an adopting Sunflower product or establish its program. Application is subject to coverage documents, applicable plan-level policies and state and federal requirements.
The cited TRICARE manual section describes an all-inclusive global maternity professional fee. Codes 59400 or 59510 may be allowed only when the billing professional or a supervised alternate provides all segments of maternity care. Separate segment billing and additional allowances for extraordinary services may be reimbursed subject to the section's limitations and review requirements. This section contains no 2027 CPT transition instructions.
Published
Not stated in source
Transition starts
Not stated in cited section
Billing starts
No 2027 billing date stated
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: TRICARE medical professional obstetrical reimbursement for network and non-network providers, subject to DHA-approved alternatives specifically included in network provider agreements; not dental, vision, or East-specific 2027 implementation guidance.
Transition: No 2027 transition date or grace period is stated in the supplied section. This does not establish whether guidance exists elsewhere.
Global billing: Under the cited section, global codes 59400 or 59510 may be allowed only when the billing professional or a supervised alternate provides antepartum care, delivery, and postpartum care. Separate procedures are subject to rebundling when the same professional provides all-inclusive care. Partial-care reimbursement and additional allowances remain subject to the section's conditions and exceptions; the section does not specify handling of the 2027 CPT deletions.
This is a program-level TRICARE reimbursement manual section, not a 2027 notice. The supplied version does not establish the latest policy, name TRICARE East or Humana Military, or provide East-region claim-submission procedures.
FL · Transition: 2026 antepartum services for 2027 deliveries
Florida Blue’s August notice expressly names Truli and directs a cross-year antepartum transition for 2027 deliveries, then individual prenatal, labor, delivery, and postpartum billing from 2027-01-01.
Published
2026-08
Transition starts
2026 antepartum services for 2027 deliveries
Billing starts
January 1, 2027
Evidence checked
2026-09-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Exact Truli for Health commercial record; the Florida Blue notice expressly names Truli for Health.
Transition: For a 2027 delivery, bill 1–3 2026 antepartum visits with E/M, 4–6 with 59425, and 7+ with 59426. From 2027-01-01, bill antepartum and postpartum E/M under CPT guidance; Florida Blue says TH is not required for routine prenatal E/M but is encouraged.
Global billing: For the stated 2027-delivery cohort, use the notice’s 2026 visit-count approach; global obstetric bundles end under the announced 2027 framework.
Affected contracts will be amended and a fuller 2027 policy is forthcoming.
National commercial guidance — verify the member's plan applicability.
The cited UMR page provides general claim-submission instructions using payer ID 39026. It does not address maternity reimbursement or the 2027 global OB CPT changes; no maternity billing start date can be established from this page.
Published
Not stated in source
Transition starts
Not stated on cited page
Billing starts
Not stated on cited page
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: UMR general claim-submission information; employer-plan and line-of-business applicability not specified
Transition: The cited page does not discuss a 2027 maternity transition or grace period.
Global billing: The cited page provides no maternity-specific reimbursement or global OB billing instructions.
These findings are limited to the cited page and do not establish whether UMR publishes maternity guidance elsewhere. The page does not establish employer-plan reimbursement rules or adoption of UnitedHealthcare commercial maternity policy.
National commercial guidance — verify the member's plan applicability.
If CMS finalizes the proposed 2027 maternity G-codes, UnitedHealthcare says commercial providers should report those G-codes. If CMS does not, dates of service on or after January 1, 2027 leave global obstetric reporting: 2026 services stay on CPT 2026, including 59425, 59426, or an E/M code, and 2027 antepartum and postpartum services use an E/M code, modifier TH, and an obstetric diagnosis. UnitedHealthcare says it may revise this if the final CMS rule differs. This does not replace the current global-package policy for dates before 2027.
Published
2026-10-01
Transition starts
January 1, 2027
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: UnitedHealthcare Commercial reimbursement bulletin. Not Dental, Vision, Community Plan, Medicare Advantage, or AARP supplemental.
Transition: Services on or before December 31, 2026 stay on CPT 2026, including 59425, 59426, or an E/M code. The 2027 path is phase-based reporting only if CMS does not finalize the proposed G-codes.
Global billing: The current global-package policy still applies for dates before 2027. The October 2026 bulletin does not replace it for those dates.
Do not mark this confirmed. Do not copy this bulletin onto AARP supplemental, Community Plan, Medicare Advantage, Dental, or Vision.
If CMS finalizes the proposed 2027 maternity HCPCS G-codes, UnitedHealthcare Community Plan says providers should report maternity services with those G-codes. If not, dates of service on or after January 1, 2027 move from global obstetric reporting to phase-based reporting. Services on or before December 31, 2026 are reported under CPT 2026, including 59425, 59426, or E/M, and services on or after January 1, 2027 use the appropriate E/M code. Antepartum-only global codes no longer apply in 2027. UnitedHealthcare may revise this after the final CMS rule.
Published
2026-10-01
Transition starts
January 1, 2027
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: UnitedHealthcare Community Plan Medicaid professional claims. The bulletin states all states. It does not apply to Medicare Advantage or AARP products, and it is separate from the unitedhealthcare record.
Transition: For pregnancies spanning 2026 and 2027, services on or before December 31, 2026 stay on CPT 2026, including 59425, 59426, or E/M. Services on or after January 1, 2027 use the appropriate E/M code if CMS does not finalize the G-codes.
Global billing: If the CMS proposal is not finalized, global obstetric reporting transitions to phase-based reporting effective January 1, 2027, and antepartum-only global obstetric CPT codes no longer apply to 2027 services.
Do not mark this confirmed. Do not copy it onto the unitedhealthcare commercial record, Medicare Advantage, or AARP supplemental. State-specific Community Plan catalog records are separate and do not inherit this row automatically.
Applicability to UnitedHealthcare FACETS Detroit is unverified. For benefit plans governed by the cited policy, complete same-group maternity care is reported globally; component itemization and separate reporting of excluded services follow the policy's specified rules. No 2027 transition date is stated in this document.
Published
Not stated in source
Transition starts
Not stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: UHC Commercial and Individual Exchange professional maternity claims on CMS-1500 or its equivalent/successor. FACETS Detroit benefit-plan applicability is unresolved; no Dental billing guidance.
Transition: The cited policy states no 2027 transition date, grace period or cross-year pregnancy rule. It does not establish the absence of other public guidance.
Global billing: Within the source's stated scope, 59400, 59510, 59610 and 59618 are directed for complete maternity care by the same group reporting the same federal tax identification number. Applicability to this record is unverified.
Identify the underlying benefit plan and governing reimbursement policy rather than relying on the FACETS Detroit label. The source allows implementation variations across claims systems but identifies no FACETS Detroit-specific rule. It does not discuss the 2027 deletion or mandate a replacement policy before 2027.
Not specified · Transition: Not stated in cited policy
Applicability to UnitedHealthcare Freedom Insurance Company is unverified. For plans governed by the cited Commercial and Individual Exchange policy, report complete same-group maternity care globally and follow its component-itemization and separately reportable-service rules. This document states no 2027 transition date.
Published
Not stated in source
Transition starts
Not stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: UHC Commercial and Individual Exchange professional maternity claims on CMS-1500 or its equivalent/successor; Freedom Insurance Company product applicability is unverified.
Transition: No 2027 transition date, grace period or cross-year pregnancy rule is stated in this policy. Other public guidance has not been assessed.
Global billing: The source directs 59400, 59510, 59610 and 59618 for complete maternity care provided by the same group reporting the same federal tax identification number. This is not verified Freedom Insurance Company billing guidance.
Confirm the company's specific benefit product and governing reimbursement policy before applying these instructions. The source does not discuss the 2027 code deletion or require a replacement policy before 2027 dates of service.
National · Medicare Advantage · Transition: Not published
No UnitedHealthcare Medicare Advantage obstetrical reimbursement policy or 2027 implementation date was found in the public MA reimbursement index.
Published
Not stated in source
Transition starts
Not published
Billing starts
Not published
Evidence checked
2026-09-04
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: none for obstetrical reimbursement; MA index checked
Transition: No 2027 transition or grace period was located.
Global billing: Unknown; verify the member-specific plan before submission.
Do not apply UHC's Commercial/Individual Exchange obstetrical policy to MA. Original Medicare's proposed GMAT structure also does not automatically establish UHC MA billing.
Not specified · Transition: Not stated in cited policy
The products represented by UnitedHealthcare Nevada Market are not established. For plans governed by the cited Commercial and Individual Exchange policy, complete same-group maternity care is reported globally, with component itemization and separately reportable services governed by the specified exceptions. This policy states no 2027 transition date.
Published
Not stated in source
Transition starts
Not stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: UHC Commercial and Individual Exchange professional maternity claims on CMS-1500 or its equivalent/successor; applicability to the products represented by Nevada Market requires verification.
Transition: No 2027 transition date, grace period or cross-year pregnancy rule is stated in the cited policy. No conclusion is established about other public guidance.
Global billing: For plans within the cited policy's scope, report 59400, 59510, 59610 or 59618 for complete maternity care by the same group reporting the same federal tax identification number. Do not apply this instruction to every Nevada Market product without verification.
Identify the member's benefit-plan program and governing policy. The source establishes neither a Nevada-specific exception nor applicability to every product in that market. It does not discuss the 2027 deletion or mandate a replacement policy before 2027.
Applicability to UnitedHealthCare Shared Services is unverified. Within the cited policy's Commercial and Individual Exchange scope, complete same-group maternity care is reported globally; specified component-itemization rules and separately reportable-service exceptions apply. This document states no 2027 transition date.
Published
Not stated in source
Transition starts
Not stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: UHC Commercial and Individual Exchange professional maternity claims on CMS-1500 or its equivalent/successor. Shared Services benefit-plan applicability is unverified; no Dental billing guidance.
Transition: The cited policy states no 2027 transition date, grace period or cross-year pregnancy rule. It does not establish the absence of other public guidance.
Global billing: The source directs 59400, 59510, 59610 and 59618 for complete maternity care by the same group reporting the same federal tax identification number. These instructions are not verified for Shared Services plans.
Confirm the underlying benefit plan and governing reimbursement rules before applying this corporate policy. The history's shared-template wording does not identify Shared Services adoption. The source does not discuss the 2027 deletion or mandate a replacement policy before 2027.
Applicability to UnitedHealthcare West/PacifiCare products in Arizona, Colorado and Nevada is unverified. For plans governed by the cited policy, report complete same-group maternity care globally and follow its component-itemization and separately reportable-service rules. This document states no 2027 transition date.
Published
Not stated in source
Transition starts
Not stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: UHC Commercial and Individual Exchange professional maternity claims on CMS-1500 or its equivalent/successor. West/PacifiCare medical-product applicability requires verification; no Dental or Vision billing guidance.
Transition: No 2027 transition date, grace period or cross-year pregnancy rule is stated in the cited policy. Other public guidance has not been assessed.
Global billing: Within the source's stated scope, 59400, 59510, 59610 and 59618 are directed for complete maternity care by the same group reporting the same federal tax identification number. Applicability to individual West/PacifiCare products is unverified.
Confirm the member's benefit-plan program and governing reimbursement policy rather than relying on regional branding or UnitedHealth Group affiliation. The source does not discuss the 2027 deletion or require a replacement policy before 2027 dates of service.
NATIONAL · Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Corporate template for medical maternity services; adoption and effective date must be verified for each Wellcare state, program and product. No dental or vision billing application is established.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
This PDF does not document Wellcare product adoption. For Medicaid members, conflicting state Medicaid coverage provisions take precedence. For Medicare members, review all applicable NCDs and LCDs before applying the policy.
NATIONAL · Transition: No 2027 transition date stated in cited policy
CC.PP.016 describes global maternity bundling and prepayment claims review for adopting health plans. It contains no 2027 code-deletion implementation instructions and does not establish encounter-specific submission requirements for this record.
Published
Not stated in source
Transition starts
No 2027 transition date stated in cited policy
Billing starts
No 2027 billing date stated in cited policy
Evidence checked
2026-08-28
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Corporate template for medical maternity payment; WellCare Medicare-product adoption, effective date and encounter-reporting applicability are unverified. No dental or vision billing application is established.
Transition: The cited policy contains no 2027 transition or grace-period instructions.
Global billing: Verify the member's exact Centene subsidiary and state; do not treat the corporate PDF as self-executing for every plan.
Verify the exact WellCare product and its encounter submission requirements separately. This PDF does not document adoption by the encounters record. For Medicare members, review all applicable NCDs and LCDs before applying the policy.
MD · Medicaid · Transition: No separate 2026 transition date stated
Effective January 1, 2027, Wellpoint Maryland Medicaid replaces the global obstetric package with service-level reimbursement. Antepartum care is reported per encounter with the applicable E/M code and modifier TH, and the first prenatal E/M after confirmation must carry a Z3A weeks-of-gestation code. Labor management uses 59080-59083, one per calendar date per setting at the highest level. Delivery uses 59431, 59432, 59502, or 59503 with a Z3A code. Postpartum care is per-encounter E/M with modifier TH, and Z3A is not required on postpartum E/M claims.
Published
2026-09-09
Transition starts
No separate 2026 transition date stated
Billing starts
January 1, 2027
Evidence checked
2026-10-06
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: Wellpoint Maryland, Inc. Medicaid. The New Jersey version of G-14001 is a different document and is not this record's rule.
Transition: The Maryland policy does not state a 2026 transition date. It replaces the global package with service-level reimbursement effective January 1, 2027.
Global billing: The September 9, 2026 review replaces the global obstetric care package with service-level reimbursement effective January 1, 2027.
The New Jersey version of G-14001 has the same policy number and dates but says modifier TH is not required. This record stays Maryland Medicaid, where TH is required on antepartum and postpartum E/M. Other Wellpoint states were not checked.
WPS requests prenatal/antepartum E/M + TH for dates of service on or after 2026-09-01 and says component maternity reporting takes effect 2027-01-01.
Published
Not stated in source
Transition starts
September 1, 2026
Billing starts
January 1, 2027
Evidence checked
2026-09-08
Billing notes and scope
Codes affected
Not published
Modifiers
Not published
Global allowed through
Not published
Applies by
Not published
Product
Not published
Source excerpt
Not published
Scope: WPS provider page for WPS insurance products. Its legal notice says Wisconsin Physicians Service Insurance Corporation and its products are not connected with the federal Medicare program.
Transition: For dates of service on or after 2026-09-01, WPS requests appropriate prenatal/antepartum E/M with TH. The notice provides no EDD, visit-count, delivery, postpartum, or grace-period rule.
Global billing: The notice states global maternity codes will be replaced by per-encounter reporting from 2027-01-01; it does not detail 2026 global-package handling.
Mapped only to the exact WPS Health Plan record. Do not apply this source to Medicare routing/MAC records or the Medicare portion of a mixed record without product-specific confirmation.
Frequently asked questions
What you need to know
Is global billing for maternity ending everywhere at once?
No. CPT revisions take effect January 1, 2027, but that is not each payer's billing date. Search tracked payers to see who published a transition date, whose guidance is still proposed, and whose policies are unchanged.
What is changing about maternity billing in 2027?
Today, maternity care is largely reported using a global code. Beginning January 1, 2027, CPT revisions will allow care to be reported more granularly at the service level. Whether and when a payer moves off global billing depends on that payer's own policy.
How do I see what’s changing by payer in my market?
Search the 2027 Substrate Maternity Resource Center by payer, then open the primary policy. Confirm the transition and billing dates, and recheck the source before submitting claims. This is policy intelligence, not coding or legal advice.
Can I download policies for multiple payers?
Yes. Select payer cards and download one PDF guide for that payer mix. It opens with background on the 2027 change, links to every cited payer policy, and each policy gets its own page with the verbatim payer guidance and source links. The source documents remain on each payer's website.
Which bundled maternity CPT codes are retired on January 1, 2027?
The following bundled CPT codes will be retired and should not be reported for dates of service on or after January 1, 2027: 59050, 59400, 59409, 59410, 59425, 59426, 59430, 59510, 59514, 59515, 59525, 59610, 59612, 59614, 59618, 59620, and 59622.
Which maternity CPT codes are revised effective January 1, 2027?
The following CPT codes have revised descriptions or reporting requirements effective January 1, 2027: 59412, 59051, 59414, 59300, 59898, and 59899.
Which new maternity CPT codes take effect on January 1, 2027?
The following new CPT codes take effect January 1, 2027: 59080, 59081, 59082, 59083, 59431, 59432, 59433, 59434, 59502, 59503, 59504, and 59623. They cover labor management, vaginal and cesarean delivery, laceration repair, hysterectomy after cesarean delivery, and uterine tamponade. Routine prenatal and separately reportable postpartum visits use the appropriate evaluation and management (E/M) codes.
How many codes were changed in total?
35 total codes were changed, including 17 deleted codes, 12 new codes and 6 revised codes.
Why are these updates being made?
The updates align with CMS guidance and support more accurate, consistent reporting of prenatal and postpartum care. Phase-specific coding helps identify services at the appropriate stage of care and supports quality measurement. More details can be found from the AMA here: https://www.ama-assn.org/practice-management/cpt/cpt-2027-maternity-care-services-code-changes
Disclaimer
The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.
Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.
Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.
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