AMA Unbundles Maternity Care CPT Codes Effective January 2027
The American Medical Association has restructured maternity care CPT coding to replace the traditional bundled global obstetric payment model, effective January 1, 2027. The changes will affect how obstetric providers, hospitals, payors, billing vendors, and managed care organizations document, bill, adjudicate, and contract for maternity care services. Stakeholders should begin assessing payor contracts, billing systems, and clinical documentation workflows in preparation for implementation. The restructuring moves away from the longstanding global OB package approach that has governed maternity care reimbursement.
Managed care organizations must renegotiate maternity capitation rates, update claims processing systems, and revise provider contracts before the January 2027 effective date — maternal health is a major cost driver and quality measure for Medicaid MCOs.
Maternal · Managed Care
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