The questionIs global OB billing going away in 2027?
Short answerGlobal OB billing goes away for dates of service starting January 1, 2027, when the AMA replaces the global obstetric package with separate billing for prenatal visits, labor, delivery and postpartum care. Every visit must then be charged, documented and paid on its own. The bigger risks are visits that never become claims, notes that undersell the visit and insurance contracts still built around one global rate.
Think about one patient's pregnancy. Today, months of prenatal visits, the delivery and the postpartum checkup mostly go out together as one package. If a visit never gets charged, or the note is thin, nobody notices. It's buried inside the bundle.
Starting January 1, 2027, the bundle is gone. Every visit becomes its own claim. Miss one, and you simply don't get paid for it.
Ask yourselfIf every prenatal visit from last month had to be billed on its own, how many would have made it to a claim?
Why this matters to you
This isn't a code update. It's a change to how your practice gets paid for every pregnancy you care for. A pregnancy that went out as one bill becomes a dozen or more. Each one has to be charged, documented, submitted and paid on its own.
You might be thinking your billing team will handle it. They'll handle the codes, and that part is in good hands. The risk is everything around the codes. Does every visit create a charge? Do your payer contracts still assume one global rate? Will you see a problem in January, or find it in March when the cash doesn't show up?
What it means for you as a physician
You went into medicine to take care of patients, not to think about billing. Under the bundle, you mostly didn't have to. A quick note on a routine prenatal visit cost nothing, because the visit was already paid for in the package. Starting January 1, every note decides what that visit pays. That's billing showing up in every exam room, whether you want it there or not.
None of this means you should have to become a coder. It means the templates and workflows around you need to change now, so the right documentation is the easy documentation by the time the switch happens. You keep your attention on your patients. The business side gets handled.
What's changing, in plain English
Today, one "global" code effectively bills nine months of care as a single service. For dates of service from January 1, 2027, the American Medical Association (AMA) replaces that with four phases, each billed on its own. In all, 17 codes are deleted, 12 are added and 6 are revised.
| Phase | Before 2027 | From January 1, 2027 |
|---|---|---|
| Prenatal care | Usually bundled into one package with delivery and postpartum care | Every visit billed separately, based on where it happens (office, hospital or telemedicine) |
| Labor | Not billed on its own | New labor codes, billed once per calendar day, by day and complexity |
| Delivery | Global, delivery-only and delivery-plus-postpartum codes | New codes for delivery care only, including VBAC, cesarean and complex repairs |
| Postpartum care | Usually bundled into a global or delivery-plus-postpartum code | Every visit billed separately; routine care on the day of delivery stays in the delivery code |
The AMA also publishes separate guidance for pregnancies that span January 1, 2027, so ask each payer how it will handle them.
Where the money can slip
A bundle hides small misses. When every visit is its own claim, every miss shows up as lost revenue.
- Visits that never become a claim. Under a bundle, routine prenatal visits aren't billed one by one. Now each needs its own charge. A visit that never reaches a claim is money you earned and never collected. More claims also mean more chances for eligibility and documentation denials.
- Notes that undersell the visit. A separately billed visit is paid at the level the note supports. Templates built for a bundle may not capture what makes a high-risk visit more complex, so your providers can do more work than you bill.
- Handoffs and shared care. When a patient transfers, or when an MFM specialist and an obstetrician share her care, each practice bills its own visits. Someone has to own flagging the transfer and deciding who bills what, or you get duplicate claims and missing ones.
- Contracts written around one rate. Payers have to load the new codes and decide what they'll pay for each. The AMA reports the recommended values were budget neutral overall. That's overall, not yours. What you're paid still depends on each payer's fee schedule and your contract terms, including any contract built around a global rate.
- Cash that arrives differently. Visit-by-visit billing changes when money comes in and how many claims your team works each month. Your staffing and cash forecasts may need to change with it.
How Practice Now helps you get ready
Your coders will handle the codes. Practice Now handles the business around them, so you can keep your focus on patients and January 1 doesn't show up as a revenue dip in March.
- We find the contracts that need to change. We review your payer contracts for terms written around a global rate, and negotiate the ones that matter most.
- We check that every visit gets paid. We look at how visits turn into charges, and whether your notes and templates support what you bill.
- We measure before and after. We set your baseline now (charges per pregnancy, denial rate, days to collect) so you can see right away if anything slips after the switch.
Your 90-day checklist
Whether you work with us or not, these are the six things to have done before January 1.
- Charge capture. Make sure every prenatal and postpartum visit, labor day and delivery creates a charge. Reconcile charges against the schedule every week.
- Documentation templates. Update prenatal and postpartum templates so the note supports the level you bill, including what makes a visit more complex.
- Payer fee schedules. Ask each payer what it will pay for the new codes and how it handles pregnancies that span January 1, 2027. Load those rates into your billing system.
- Contract review. Find every contract term written around a global rate, and decide which are worth renegotiating.
- Transfers and shared care. Name one person who flags transfers and decides who bills which visit when care is shared.
- Measurement. Track charges per pregnancy, denial rate and days to collect for maternity claims, and compare them with your numbers before the change.
Ask yourselfWhich of your payer contracts still describes maternity care as one global rate?
Questions practices ask
When does this take effect?
For dates of service starting January 1, 2027. The AMA publishes separate guidance for pregnancies that span that date, so ask each payer how it will handle them.
What replaces the global package?
Billing by phase. Prenatal and postpartum visits are billed as individual office or hospital visits, and labor and delivery each get their own new codes.
Will we get paid less?
It depends on your payers and contracts. The AMA reports the recommended values were budget neutral overall, but your revenue depends on your fee schedules, your contract terms and how completely you capture and document each visit.
Does this change clinical care?
No. It changes how maternity care is coded and billed. This brief covers the business side only.
Billing rules vary by payer and state. Confirm specifics with your coding team or payer contracts.
Sources AMA, FAQs on CPT 2027 Maternity Care Services code changes; AMA, Preparing for the CPT 2027 maternity care changes; AAPC, Ob-Gyn Coding Alert on the 2027 maternity coding reset.
See where your practice stands.
Start with a free first look at your numbers in a discovery call.
Terms used here are defined in the Practice Performance Glossary.