Maternity coding is undergoing a significant transformation for CPT ® 2027. Historically, coding for maternity care has relied heavily on global obstetric packages that combine services provided throughout…
Maternity coding is undergoing a significant transformation for CPT ® 2027. Historically, coding for maternity care has relied heavily on global obstetric packages that combine services provided throughout pregnancy, delivery, and the postpartum period. Beginning January 1, 2027, that framework changes substantially. The revised structure places greater emphasis on the individual phases of maternity care: antepartum care, labor management, delivery, and postpartum care. For coders, this means moving away from viewing pregnancy as one global episode and looking more closely at the care provided during each phase.
Antepartum Care Moves to E/M Reporting One of the most notable changes involves antepartum care, or care provided before the onset of labor. Under the 2027 structure, current antepartum-only maternity codes are eliminated, and antepartum visits are reported using the appropriate evaluation and management (E/M) code based on the setting. This may include office or outpatient, telemedicine, home or residence, hospital inpatient or observation, and critical care services.
This change means that code selection will no longer be driven primarily by the number of prenatal visits. Instead, applicable E/M guidelines must be followed, including using the criteria of medical decision making or time, as appropriate. The calendar-year transition will also require attention. For care performed during 2026, the existing CPT structure remains applicable. Beginning with 2027 dates of service, antepartum encounters are reported individually using E/M codes.
Coders should also recognize that separately performed antepartum procedures, fetal invasive services, and applicable diagnostic imaging may be reportable in addition to the antepartum E/M service. Labor Management Becomes a Separate Service Another major change is the introduction of a distinct labor management framework. Labor management includes the clinical decision making necessary to assess and support the fetus or fetuses and the pregnant patient in labor (parturient).
Interim examinations, collection and interpretation of physiologic data, and routine induction or augmentation activities are included in labor management and are not separately reported. Labor management is categorized as either initial or subsequent, and straightforward or complex. In general, the service requires a face-to-face encounter and is reported once per calendar date. Multiple encounters by the same physician or qualified healthcare professional, or the same group practice, during the same calendar date are combined into a single labor management service.
This is a source-linked briefing. Read the original report from Ahima .