The American Medical Association (AMA) CPT Editorial Panel has approved a comprehensive redesign of the CPT code set for maternity care services. Effective January 1, 2027, the longstanding global maternity care model will be replaced with a more detailed reporting framework that captures services across distinct stages of care.

The updated structure is intended to better reflect modern obstetric practice, including team-based care, provider and facility transfers, individualized prenatal care, telehealth services, and evolving approaches to labor and postpartum management. The changes are also expected to enhance coding accuracy, increase transparency, and support more meaningful maternal health data analysis. Overall, 35 maternity-related CPT codes will be affected by this restructuring.

WHY THE CHANGE?

For many years, maternity services have commonly been reported using global maternity codes that bundle antepartum care, labor management, delivery, and postpartum services into a single code. While this approach simplified billing and reporting, it does not always reflect how maternity care is frequently delivered today, which often involves multiple practices, specialties, and physicians throughout pregnancy and the postpartum period.  

Several factors contributed to the redesign:

• Team-based care models have become increasingly common, with multiple clinicians participating in different phases of a patient's care.
• Patients may transition between providers and facilities during pregnancy, particularly when higher levels of maternal or neonatal care are needed.
• Prenatal care is increasingly tailored to individual patient needs rather than following a standard visit schedule.
• Labor management has evolved in complexity, monitoring requirements, and clinical decision-making.
• Postpartum care now includes a broader range of services and follow-up models than when the current codes were developed.

Under the new framework, providers will report the specific services they perform rather than relying on a bundled maternity code.

AT-A-GLANCE: HOW MATERNITY CARE REPORTING CHANGES IN 2027 

ANTEPARTUM CARE

One of the most significant changes is the elimination of the current antepartum-only codes:

• 59425 (4-6 antepartum visits)
• 59426 (7 or more antepartum visits)

Beginning January 1, 2027, all prenatal visits will be reported individually using the appropriate Evaluation and Management (E/M) code based on the services provided and the care setting, such as office, hospital, or telehealth. Standard E/M reporting guidelines will apply.

Providers may select the appropriate E/M level based on:

• Medical Decision Making (MDM), or
• Total time spent on the date of the encounter.

Documentation must support the selected E/M level, including applicable clinical decision-making, patient complexity, and services performed during the encounter.

TRANSITION PERIOD CONSIDERATIONS

Providers should be aware that pregnancies spanning calendar years may require special billing considerations. For patients expected to deliver on or after January 1, 2027, antepartum services provided before January 1, 2027, may still be reported using the current antepartum coding structure, while services provided on or after January 1, 2027, will be reported under the new CPT 2027 guidelines using the appropriate E/M code.

Providers should review payer-specific billing instructions, transition policies, and implementation guidance for pregnancies that begin under the current coding framework and conclude after the transition to the new reporting structure. Because billing requirements may vary by payer, providers should continue monitoring payer communications and policy updates throughout the implementation period.

There are no billing changes for members who deliver before January 1, 2027. Those services should continue to be billed using the current global maternity care codes. If a patient is expected to deliver in 2027 but unexpectedly delivers during 2026 and an antepartum has already been billed, providers will need to submit a corrected claim using the appropriate global delivery code for services provided before December 31, 2026.

MODIFIER TH REPORTING

The American College of Obstetricians and Gynecologists (ACOG) has recommended using modifier TH with maternity-related E/M services to identify visits associated with obstetrical care and distinguish them from other E/M services that may be reported by obstetric providers.

Utah Medicaid has confirmed that modifier TH (Obstetrical treatment/services, prenatal or postpartum) is required on maternity-related E/M services reported under the new maternity care coding structure. Health Choice Utah also requests that providers append modifier TH to applicable maternity-related E/M services.

LABOR MANAGEMENT

CPT 2027 introduces four new daily labor management codes:

• 59080: Initial day labor management, straightforward
• 59081: Initial day labor management, complex
• 59082: Subsequent day labor management, straightforward
• 59083: Subsequent day labor management, complex

Labor management includes services such as patient assessment, monitoring maternal and fetal status, interpreting physiologic data, and managing labor induction or augmentation.

Scheduled cesarean deliveries without labor management are not eligible for labor management coding.

Examples of situations that may qualify as complex labor management include:

• Multiple gestation pregnancies
• Abnormal fetal monitoring requiring intervention
• Prolonged labor
• Preeclampsia or intraamniotic infection
• Significant maternal medical conditions requiring additional management
• Previous cesarean delivery

DELIVERY

VAGINAL DELIVERY

• 59431: Vaginal delivery, with or without episiotomy
• 59432: Vaginal delivery, with or without episiotomy, following a previous cesarean delivery

CESAREAN DELIVERY

• 59502: Primary cesarean delivery
• 59503: Repeat cesarean delivery

MULTIPLE GESTATION REPORTING

• One cesarean delivery code is reported for all fetuses delivered by cesarean.
• One vaginal delivery code is reported for each fetus delivered vaginally.

LACERATION REPAIR

• 59433: Repair of episiotomy or laceration; third-degree laceration 
• 59434: Fourth-degree laceration

POSTPARTUM CARE

Effective January 1, 2027, CPT code 59430 will be deleted. Postpartum services will be reported using the appropriate E/M code based on the service provided and care setting.

CESAREAN HYSTERECTOMY

• 59504: Subtotal or total hysterectomy following cesarean delivery

UTERINE TAMPONADE

• 59623: Uterine tamponade (e.g., balloon, catheter, vacuum, or packing material)

SUMMARY OF 2027 MATERNITY CARE CODE CHANGES 

WHAT SHOULD PROVIDERS DO?

• Become familiar with the new maternity care coding framework.
• Review current documentation practices to ensure each phase of care is adequately supported.
• Participate in upcoming coding education and training opportunities.
• Collaborate with coding, compliance, and information technology teams to prepare for system and workflow updates.
• Review payer-specific transition billing guidance for pregnancies that span the January 1, 2027 implementation date, including scenarios involving earlier-than-expected deliveries. 
• Prepare billing workflows and system configurations to support reporting modifier TH on applicable maternity-related E/M services as required by Utah Medicaid. 
• Ensure modifier TH is appended to applicable maternity-related E/M services.
• Monitor payer communications and policy updates as implementation requirements continue to evolve.