New 2027 Maternity Billing Codes Will Force Medicaid Plans to Overhaul Payment Systems

Manatt examines the AMA's upcoming 2027 restructuring of maternity CPT codes, which unbundles the decades-old global maternity billing approach into discrete, service-level codes for prenatal, labor, delivery, and postpartum care. While billed as budget-neutral nationally, the shift could create winners and losers among states, MCOs, and providers depending on population risk profiles, requiring Medicaid agencies and health plans to update claims systems, rate-setting methodologies, and quality analytics well ahead of the 2027 effective date.

Maternal · Managed Care · Finance

This is outside commentary from Manatt Health, not part of Medicaid Monitor's independently scored news coverage.