Interim Maternity Care Billing Guidance Effective Immediately
Dear Provider,
The American Medical Association (AMA) and American College of Obstetricians and Gynecologists (ACOG) have announced significant maternity care billing and coding changes effective January 1, 2027. Current global maternity care codes will be replaced by new and revised codes that separately identify antepartum care, labor management, delivery, and postpartum care.
To support the transition, here is our recommendation on interim billing guidance for prenatal care services furnished during calendar year 2026 for pregnancies with expected delivery dates on or after January 1, 2027. Review the guidance below for prenatal and maternity billing prior to and after January 1, 2027.
What providers need to know
Providers should begin preparing now for the transition from global maternity care billing to unbundled maternity care coding. Prenatal services rendered during 2026 for pregnancies that extend into 2027 require special billing considerations outlined below.
Interim billing requirements
Prenatal visits during pregnancy
Billing guidance
4-6 antepartum visits
CPT 59425
7 or more antepartum visits
CPT 59426
Fewer than 4 antepartum visits
Continue to follow current 2026 CPT coding guidance
Transition billing scenarios
Scenario
Billing guidance
Delivery expected before January 1, 2027
Bill maternity care in accordance with current Contract Exhibit B Compensation Agreement, AHCCCS and national guidance, including applicable global maternity care codes.
Prenatal care provided during 2026; delivery expected on or after January 1, 2027
Bill 2026 prenatal care services using CPT 59425 for 4-6 visits or CPT 59426 for 7 or more visits, as applicable.
Any maternity care service furnished on or after January 1, 2027
Bill using 2027 maternity care coding requirements.
Provider action checklist
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Inform appropriate coding, billing, clinical, and revenue cycle staff of the upcoming elimination of global maternity care billing codes effective January 1, 2027.
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Review operational and billing processes affected by unbundled maternity care coding.
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Ensure prenatal services furnished during 2026 are appropriately billed and documented for pregnancies expected to continue into 2027.
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Assess affected claim edits, charge masters, templates, and practice management systems.
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Continue to submit the Maternal Health Risk Assessment to the Blue Cross Blue Shield of Arizona maternal health department; fax to (480) 760-4762. Click here for the Maternal Health Risk Assessment Form.
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Monitor Health Choice and AHCCCS communications for additional coding, claims submission, reimbursement, and implementation guidance.
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