How do I bill a pregnancy that starts in 2026 and delivers in 2027?

Count the prenatal visits provided in 2026 and report them under 2026 rules: E/M for 1 to 3 visits, 59425 for 4 to 6, and 59426 for 7 or more. Bill 2027 visits as E/M, and use the new labor management and delivery codes for the delivery.

Will patients owe a copay for every prenatal visit?

It depends on the plan. Per-encounter E/M claims can trigger cost-share that a global package didn't, so confirm how each plan applies preventive prenatal benefits and update your patient estimates.

What is the TH modifier, and do I need it?

TH is a HCPCS modifier for obstetrical services, prenatal or postpartum. The AAFP recommends payers adopt it to flag E/M visits that are pregnancy care. Use it where a payer requires it.

How do I report a cesarean after an attempted VBAC?

From 2027, report 59503 for the repeat cesarean. Don't report 59432, since a vaginal delivery wasn't achieved. Labor management for each labor day is reported separately with 59080 to 59083.

Maternity billing resource center

Global billing for maternity ends January 1, 2027

CPT 2027 deletes the global obstetric codes. Prenatal and postpartum visits move to per-encounter E/M reporting, and labor and delivery get codes of their own. Here is what changes, how to bill each phase, and how to handle pregnancies that span the transition.

Current as of September 2026

Maternity codes deleted, including every global package

New codes for labor management and delivery

Existing codes with revised descriptors

Phases now reported separately: antepartum, labor, delivery, postpartum

What's changing

One episode code becomes four phases, each billed on its own

Through December 31, 2026

Global package

One code covers antepartum visits, delivery, and postpartum care, billed once after delivery by the group that provided the whole episode.

59400 · 59510 · 59610 · 59618

AntepartumLaborDeliveryPostpartum

From January 1, 2027

Component reporting

Each phase is reported when it happens, by whoever provides it. Delivery codes no longer depend on who performed the other components.

E/Mper visit

59080–83per day

59431–59503per delivery

E/Mper visit

AntepartumLaborDeliveryPostpartum

“Pregnancy care is now routinely delivered by multiple, sometimes unaffiliated care teams across antepartum, labor management, delivery and postpartum phases.”
American Medical Association, on the reason for the CPT 2027 restructure

Code changes

Every deleted, new, and revised code

All changes take effect January 1, 2027. Confirm final descriptor wording in the 2027 CPT code book before you update charge masters.

Deleted

17 codes

59050Fetal monitoring by consultant, with interpretation
59400Global OB care, vaginal delivery
59409Vaginal delivery only
59410Vaginal delivery with postpartum care
59425Antepartum care only, 4 to 6 visits
59426Antepartum care only, 7 or more visits
59430Postpartum care only
59510Global OB care, cesarean delivery
59514Cesarean delivery only
59515Cesarean delivery with postpartum care
59525Hysterectomy after cesarean, add-on
59610Global OB care, VBAC
59612VBAC delivery only
59614VBAC delivery with postpartum care
59618Global OB care, cesarean after attempted VBAC
59620Cesarean only, after attempted VBAC
59622Cesarean after attempted VBAC, with postpartum

New

12 codes

Labor management, per calendar date

59080Initial day, straightforward
59081Initial day, complex
59082Subsequent day, straightforward
59083Subsequent day, complex

Delivery and related procedures

59431Vaginal delivery, with or without episiotomy
59432Vaginal delivery after previous cesarean
59433Repair of third-degree laceration
59434Repair of fourth-degree laceration
59502Cesarean delivery, primary
59503Cesarean delivery, repeat
59504Hysterectomy after cesarean delivery
59623Uterine tamponade, such as balloon or packing

Revised

6 codes

59051Fetal monitoring during labor, interpretation only
59300Episiotomy or vaginal repair, other than attending
59412External cephalic version
59414Delivery of placenta, separate procedure
59898Unlisted laparoscopy procedure, maternity
59899Unlisted procedure, maternity care and delivery

What stays the same

Standard E/M codes are unchanged. They now carry prenatal and postpartum visits, so each visit needs documentation that supports the level billed.

Billing by phase

How to report each phase from 2027

Phase 1

Antepartum

E/M code per encounter

Office visits bill 99202 to 99215, telehealth 98000 to 98015, and home visits 99341 to 99350.
Each visit is billed on its own date of service, not held until delivery.
Add TH or pregnancy diagnosis codes, such as Z34 and Z3A weeks of gestation, where the payer requires them.

Phase 2

Labor management

59080 to 59083, per calendar date

Choose initial or subsequent day, then straightforward or complex.
Report once per calendar date.
The initial day is reported once per facility admission unless a unique provider manages labor.

Phase 3

Delivery

59431, 59432, 59502, or 59503

Delivery codes cover delivery care only and don't depend on who provided the other phases.
Routine postpartum care on the delivery date is included.
Third- and fourth-degree repairs bill separately with 59433 and 59434.

Phase 4

Postpartum

E/M code per encounter

Hospital days after the delivery date bill 99231 to 99233.
Office follow-up visits bill 99202 to 99215.
Some payers also ask for Category II code 0503F to track postpartum visits for quality measures.

Transition rules

Pregnancies that span January 1, 2027

Services follow the CPT rules in effect on their date of service. Count the prenatal visits provided in 2026 and report them under 2026 rules. Everything from January 1 on uses the new structure.

Example: estimated due date in March 2027, vaginal delivery

2026 visits

59425

4 to 6 visits under 2026 rules. With 1 to 3, bill E/M. With 7 or more, bill 59426.

2027 visits

E/M × 3

Each visit billed on its own date with the E/M level documented.

Labor and delivery

59080 + 59431

Labor management for the day, plus the new vaginal delivery code.

Some payers have announced transition dates before January 1, 2027, and others haven't published guidance yet. Confirm each payer's date, and when it wants the 2026 antepartum claim submitted.

Encounter lookup

Which code does this encounter get?

Pick the date of service and the phase of care to see how it's reported.

Date of service

Phase of care

Report

E/M per visit

Each antepartum encounter

Office 99202 to 99215, telehealth 98000 to 98015, home 99341 to 99350. Add TH or pregnancy diagnosis codes where the payer requires them.

Payers with an earlier transition date may already expect encounter billing. Check the payer's date first.

Payer checklist

8 things to confirm with every payer

Commercial, Medicare Advantage, and Medicaid plans under the same parent company can publish different rules. Work through this list for each contract.

1
Transition date
Does the payer follow January 1, 2027, or an earlier date?
2
Episodes already in progress
Can pregnancies that started under global billing finish that way, and by which date?
3
Modifiers
Is TH or another modifier required on prenatal and postpartum E/M claims?
4
Diagnosis coding
Which Z34, O-chapter, and Z3A weeks-of-gestation codes does it expect on each encounter?
5
Patient cost-share
Per-visit E/M claims can trigger copays a global package didn't. How does the plan apply preventive prenatal benefits?
6
Fee schedule
Has the payer loaded rates for 59080 to 59083 and the new delivery codes?
7
Quality reporting
Does it want Category II codes such as 0500F and 0503F for prenatal and postpartum measures?
8
Authorizations
Which ultrasounds, genetic tests, and admissions need prior authorization?

FAQs

Common questions about the change

Yes. Services in 2026 follow 2026 CPT, so the global codes stay valid for episodes that end in 2026, unless a payer has set an earlier transition date.

Get your OB billing ready before January 1

Talk to our billing team about your open pregnancies, each payer's transition rules, and moving to encounter-level OB billing.

Talk to our team

Sources: American Medical Association, CPT 2027 Maternity Care Services code changes and FAQs. American Academy of Family Physicians, maternity care and obstetrical services CPT codes. This page summarizes coding changes for billing teams and is not payer policy. Always confirm with the payer.