New Obstetric Billing and Transition Guidance – 2026 / 2027
The American Medical Association (AMA) and the American College of Obstetricians & Gynecologists (ACOG) have introduced a major restructuring of pregnancy care coding that replaces the long-standing bundled “global obstetric” payment with a phase-based, unbundled billing system.
Key Changes
End of the global obstetric payment: The single code that bundled prenatal, labor, delivery, and postpartum care into one service is being eliminated.
Four Distinct Phases of Care
- Prenatal care – the routine visits throughout pregnancy (normally 12-13 visits). Each visit will be billed separately starting as early as September 1, 2026.
- Labor management – the period between when the patient admits to the hospital for labor or scheduled surgery and just prior to delivery (one or more days).
- Delivery care – the period when the baby is actively delivered.
- Postpartum care – inpatient and outpatient visits, including mental health, hemorrhage, and cardiac monitoring.
Separate reporting: Each phase is billed individually, reflecting the actual services performed and the care team involved
Rationale for Change
- Modern obstetric care is delivered by multiple, sometimes unaffiliated teams across different phases.
- Increasing use of home monitoring, telehealth, and specialized postpartum follow-up makes the old bundled model outdated.
- Simplifies billing for situations where patients experience change in jobs, insurance or providers.
- ACOG’s 2025 guidance on tailored prenatal care supports appropriate numbers of visits based on individualized needs/plans, which are not supported under the global system.
How will this affect me?
- Depending on when you deliver, you may be billed differently for your pregnancy and some costs may be incurred earlier in the pregnancy as prenatal visits are billed as incurred. The chart on the reverse side of this page gives a general guide to how obstetric billing will occur; you may be billed differently based on exact dates.
- Insurance companies will be expected to comply with these changes, but your particular plan may differ in its coverage. We encourage you to reach out to your insurance company if you have questions about how your pregnancy services may be covered under the new guidance.
Resources
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Timeline – from first Obstetric Visit
| Mar 2026 | Jun 2026 | Sep 2026 | Jan 1, 2027 | Mar 2027 | Jun 2027 | Sep 2027 | |
|---|---|---|---|---|---|---|---|
| Full Global | Prenatal Care, Labor Management, Delivery and Postpartum Care (one charge) | ||||||
| "Split" Global | Prenatal Care (one charge, multiple visits) | Prenatal Care (per visit charges) Labor Management (per day charges) Delivery (one charge) | Postpartum Care (per visit charges) | ||||
| New Method | Prenatal Care (per visit charges) | Labor Management (per day charges) Delivery (one charge) | Postpartum Care (per visit charges) | ||||
FAQs
Does this new billing change how much I will be charged for my pregnancy?
We expect that the total amount that we bill for our services related to pregnancy (prenatal visits, labs, ultrasounds, delivery) will not be much different than the current method (“global”). It’s more about the timing of when we charge for services. Previously, most of the prenatal, delivery and postpartum care was billed after delivery in one lump sum. Under the new method, care will be billed as care is received. So, for instance, each prenatal visit will be billed separately as it is incurred. Depending on your individual insurance plan and cost sharing (deductible, coinsurance), and the timing of when your pregnancy occurs, you may incur costs in two different deductible years.
Will I now be charged a copay for each prenatal visit?
Insurance companies that adhere to the Affordable Care Act (ACA) statute (which is about 93% of plans) are required to not charge copays or apply cost-sharing for visits that are considered ‘preventive’ or ‘screening’. Prenatal care is considered preventive and not subject to copays or other cost-sharing. If other non-pregnancy related health issues are discussed in a prenatal visit, you may be subject to a copay for any charges related to that discussion. If you are not sure of whether your insurance company adheres to ACA statutes regarding preventive and prenatal care, we encourage you to call them.
