Effective Jan. 1, 2027, Current Procedural Terminology (CPT®) codes for maternity care services will reflect the realities of contemporary, team-based obstetric care. Significant revisions to this section of the code set will allow obstetric practice to be reported more granularly at the service level, separately identifying four phases of care: antepartum, labor management, delivery and postpartum.
Review the frequently asked questions on this page for answers about the rationale behind revising the maternity care services codes, what is changing, and what to look out for.
- Overview of maternity care services code changes
What is changing in the CPT® code set for maternity care starting Jan. 1, 2027?
The CPT Editorial Panel approved the restructuring of CPT codes for maternity care services to reflect modern, team-based obstetric care, improve transparency, data quality and measurement, and support evidence-based labor and postpartum care. These updates will be effective Jan. 1, 2027. The traditional global maternity codes will be deleted and replaced with phase-specific reporting: antepartum care via evaluation and management (E/M) services, new labor management codes (initial/subsequent; straightforward/complex), new delivery care codes (vaginal and cesarean), and postpartum care via E/M services. This enables more accurate, transparent data across pregnancy.
Why were the global maternity codes deleted?
Global codes no longer reflect contemporary team-based obstetric care, growing complexity and varied care patterns (e.g., telehealth, consultations). Restructuring these codes improves transparency, data quality measurement, and alignment with evidence-based labor and postpartum care.
How many codes were changed?
35 total codes were changed, including 17 deleted codes, 12 new codes and 6 revised codes.
Where can I view the CPT 2027 codes and guidelines for maternity care services?
Download the list of new, revised and deleted CPT 2027 codes and guidelines for maternity care services (PDF). The AMA has published the codes and guidelines early to assist CPT users in preparing for the significant revisions to this section of the CPT code set. Since minor refinements may occur during copyediting, users should consult the AMA’s CPT® 2027 Professional Edition codebook, when available, for final language.
When will payment values be finalized and implemented?
The AMA/Specialty Society RVS Update Committee (RUC) recommendations were submitted to the Center for Medicare & Medicaid Services (CMS) in February 2026 and are available for download (PDF). CMS released the Medicare Physician Payment Schedule (MFS) Proposed Rule on July 14, 2026, followed by a 60-day comment period. CMS has proposed relative values for these services. CMS will release the Final Rule in early November with implementation starting Jan. 1, 2027.
Note: The RUC recommended relative value units (RVUs) and anticipated utilization assumptions submitted to CMS in February 2026 were anticipated to be budget neutral.
- Antepartum care (Prenatal)
How is antepartum care reported under the new structure?
Antepartum care will be reported per encounter with the appropriate E/M service based on location of the patient, such as office, hospital or telehealth. Standard E/M rules apply, using Medical Decision Making (MDM) or time.
Note: For care provided by a nonphysician qualified healthcare professional (QHP) who may not report E/M services, refer to the specific service (examples: genetic counseling or medical nutrition therapy). Antepartum and fetal invasive services procedural codes remain, and some services were relocated there.
Can you review the transition from global obstetric (OB) charges to E/M charging as of 2027: Will some patients have both a global fee closing out the 2026 care and then E/M billing to complete their pregnancy care? For example, how should activity be reported if we see a patient in 2026 for five antepartum visits and also provide antepartum visits in 2027 up until they deliver?
From a CPT reporting perspective, for patients receiving antepartum care services in both 2026 and 2027, CPT codes would be reported in both calendar years.
For antepartum visits occurring in the 2026 calendar year:
- Patients with four or more antepartum visits in the 2026 calendar year would have those visits reported using CPT codes 59425 (for 4-6 visits) or 59426 (for 7 or more visits).
- Patients with three or fewer antepartum visits in the 2026 calendar year should have those visits reported using individual E/M codes, one for each encounter.
- This guidance is currently provided in CPT® 2026 Professional Edition for the reporting of antepartum visits.
For antepartum visits occurring in the 2027 calendar year:
- All of those encounters will be reported using the E/M code most appropriate to the service provided.
For the scenario noted in the question, code 59425 would be reported for the five visits in 2026, and individual E/M codes would be reported for antepartum encounters provided in 2027.
In addition to this CPT reporting guidance, users should check with their third-party payers to confirm any additional payer policies on the transition for antepartum care service reporting.
Do we change to E/M coding for antepartum patients who are pregnant now and due after Jan. 1, 2027, or not until the new year?
Per CPT guidelines, the new guidelines for reporting maternity care do not change until Jan. 1, 2027. Therefore, any antepartum care provided to a patient in 2026 will still fall under the 2026 reporting codes and guidelines.
In CPT 2026 Professional Edition, an instruction provided with the antepartum care only codes (59425 and 59426) states: "For 1-3 antepartum care visits, see appropriate E/M codes." This guidance still holds for the remainder of calendar year 2026 activity.
Put another way: For 2026, only report E/M codes for antepartum encounters if there are three or fewer antepartum encounters occurring in calendar year 2026. Using E/M to report all antepartum activity, regardless of the total number of visits in a calendar year, will not begin until on or after Jan. 1, 2027.
Check with your third-party payers to confirm any special policies on the transition for antepartum care service reporting.If reporting an antepartum-only code such as 59425 or 59426, what date of service should be reported?
When reporting antepartum code 59425 or 59426, these codes should be reported when the service has concluded; in this instance, the service would be considered concluded once the number of visits the code represents has been provided to the patient. As such, the date of service to report should reflect the date of the last antepartum encounter included in that code.
Note that third-party payer rules may vary in terms of reporting, with some requesting only the last encounter date, while others, for example, may request a date range reflecting the first and last dates of service when sending documentation. Please check with your third-party payer to determine any third-party reporting guidelines that may apply to date of service reporting.
How can payers identify pregnancy-related encounters in claims?
Use ICD-10-CM pregnancy codes (e.g., Z34- or O chapter codes) and consider HCPCS modifier TH (obstetrical treatment/services, prenatal or postpartum) where applicable to designate maternity-related services.
Will antepartum visit intensity vary across patients?
In 2027, antepartum visits will be reported individually, using E/M codes; and E/M reporting rules will apply. As with other E/M services, the specific code reported for a given encounter will be based on either total time on the date of the encounter, or Medical Decision Making (MDM); and each encounter will be evaluated for code selection based on the service provided in that particular encounter. The 2027 revisions do not assign a fixed level of complexity to a given patient across all of their antepartum encounters.
For E/M leveling purposes, is pregnancy itself considered a chronic condition that should be counted toward the number and complexity of problems addressed, or should providers base MDM solely on pregnancy-related complications and co-existing conditions such as gestational diabetes, hypertension, obesity or advanced maternal age?
Reporting of pregnancy antepartum visits using E/M codes would follow the rules for E/M reporting, both for the base condition, and to reflect related comorbid conditions.
For the base condition: The question of appropriate categorization of a pregnancy as a “problem addressed” in the E/M structure, was answered in the June 2026 issue of CPT® Assistant, in the article "Antepartum Care: Changes for CPT 2027." The question and answer provided is reprinted here:
"Question: Clarification is needed regarding the appropriate evaluation and management (E/M) medical decision making (MDM) level for the complexity of problems addressed for patients who are pregnant. Is pregnancy considered an acute, uncomplicated illness? The definitions in the E/M Services Guidelines section indicate that the expected duration of a chronic condition is at least 1 year; however, with postpartum care, 46 weeks is nearly a year.
Answer: Even though pregnancy is not an illness, it is a condition. For the purposes of E/M reporting, normal pregnancy may be reported with an E/M code as a “problem” addressed. Furthermore, when individual prenatal visits are reported using E/M codes (based on payer requirements), time or MDM may be used to determine the level like any other E/M encounter. A normal pregnancy is not an acute, uncomplicated illness. It is important to note that even an uncomplicated antepartum visit is not comparable to common examples of acute, uncomplicated illnesses (eg, cystitis, allergic rhinitis, simple sprain) listed in Centers for Medicare & Medicaid Services’ (CMS’s) Table of Risk.
Although a pregnancy does not last a year or more, the patient or the fetus’s condition may not be “stable.” Therefore, pregnancy best fits into the moderate category of a “chronic illness with exacerbation, progression, or side effects of treatment.”"
For comorbid conditions: E/M rules should be applied to reflect comorbid conditions that are impacting the care provided in the encounter. Per CPT guidelines, "Comorbidities and underlying diseases, in and of themselves, are not considered in selecting a level of E/M services unless they are addressed, and their presence increases the amount and/or complexity of data to be reviewed and analyzed or the risk of complications and/or morbidity or mortality of patient management." CPT guidelines also indicate that "Multiple problems of a lower severity may, in the aggregate, create higher risk due to interaction."
Important note: E/M reporting is dependent on assessing the levels of three separate elements: Number and Complexity of Problems Addressed at the Encounter, Amount and/or Complexity of Data to Be Reviewed and Analyzed, and Risk of Complications and/or Morbidity or Mortality of Patient Management. The response provided only pertains to the Problems Addressed element; proper E/M code selection requires evaluation on all three elements of service.
The midwifery model requires longer antepartum visit times to allow for client education and shared decision making. What are considerations for E/M coding when the pregnant patient is healthy and low risk (i.e., not "complex") and the provider is face-to-face for a 30-minute visit which includes evaluation of health status and risk status (including vital signs, fetal heart rate, fundal height, any lab results, etc.), and time spent on education and discussions around shared decision making? What code(s) are available and appropriate, and what are the key elements of provider documentation to support them?
When the new Maternity Care Services Guidelines become effective Jan.1, 2027, antepartum visits will be reported utilizing the E/M code appropriate for the care provided. Codes may be selected based on either MDM, or total time on the date of the encounter. The method of code selection is determined by the physician or other QHP based on what is most appropriate for that specific encounter; and the CPT code set does not determine a hierarchy in which one method supersedes another, nor any specific clinical instance in which one method or another must be used.
If MDM is utilized, documentation should support the level decision on each of the three elements considered (problems addressed, data and risk), as well as the overall code level. For total time on the date of the encounter, CPT requires that the total time spent on the date of the encounter (versus a range), must be reported.
Physician or other qualified healthcare professional time includes these activities, when performed:
- Preparing to see the patient (e.g., review of tests)
- Obtaining and/or reviewing separately obtained history
- Performing a medically appropriate examination and/or evaluation
- Counseling and educating the patient/family/caregiver
- Ordering medications, tests, or procedures
- Referring and communicating with other healthcare professionals (when not separately reported)
- Documenting clinical information in the electronic or other health record
- Independently interpreting results (not separately reported) and communicating results to the patient/family/caregiver
- Care coordination (not separately reported)
Do not count time spent on:
- The performance of other services that are reported separately
- Travel
- Teaching that is general and not limited to discussion that is required for the management of a specific patient
While CPT only requires that total time be reported, third-party payers may request additional detail on how the time was spent.
- Labor management
What new labor management codes are available Jan. 1, 2027?
Four new codes will be available:
59080 – Initial day labor management; straightforward, per day
59081 – Initial day labor management; complex, per day
59082 – Subsequent day labor management; straightforward, per day
59083 – Subsequent day labor management; complex, per day
Labor management will include interim physical examinations, collection and interpretation of physiological data and induction/augmentation of labor.
Note: Planned or scheduled cesarean would not have a labor management code associated with the service.
What distinguishes straightforward from complex labor management?
Straightforward management requires that all of these criteria are met: singleton vertex presentation; routine maternal/fetal monitoring; fetal monitoring (e.g., heart rate) not requiring physician or other QHP intervention, normal progression or routine induction/augmentation; stable medical conditions not requiring additional management during labor; and no prior cesarean. Any deviation (e.g., multiples, non-vertex, deteriorating conditions, prior cesarean) elevates labor management to complex.
How do initial day vs. subsequent day labor management codes apply?
Initial day is the first calendar date during the facility admission when labor management starts. Subsequent day management applies to all calendar dates after the initial date of continued labor management. If care transfers to a different specialty/group for medical necessity, the receiving clinician may report initial day labor management.
If the patient is admitted in labor on Dec. 31, is seen for initial labor management and labor management continues on Jan. 1, does this count as a subsequent or initial labor management visit?
Per CPT reporting guidelines on labor management, reporting will be determined by whether physician or other QHP attendance time with the patient is continuous. Per guidelines, "a continuous visit (ie, requiring continuous personal physician or other QHP attendance at bedside or elsewhere on the floor or unit focused on a single parturient) that spans the transition of two calendar dates is a single service and is reported as a single service on one of the two calendar dates." If the conditions have been met for a continuous visit as noted, with the date characteristics in this specific scenario, a single initial day labor management code, 59080 or 59081 as appropriate, would be reported.
Can labor management be reported with other E/M services?
Once labor management begins, hospital E/M services by the same clinician stop for that day. An office/outpatient E/M earlier the same day may be reported if the patient was admitted later that same day for labor management.
59200 cervical dilation is separately billable when it was done more than 48 hours before delivery; is this changing for 2027?
CPT code 59200, Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure), was not changed for 2027; however, for 2027, the determination for separate reporting will be made relative to other services provided in labor management.
The CPT code set defines a "separate procedure" as one that is carried out independently or considered to be unrelated or distinct from other procedures/services provided at that time.
Prior to 2027, cervical dilation would have been considered part of the delivery care codes; and delivery care codes also incorporated labor management services. With the maternity care code changes for 2027, cervical dilation is specifically noted as an included service in the labor management codes; as such, determination of whether cervical dilation should be reported as a separate procedure will be made relative to whether it is carried out unrelated and distinct from other labor management services.
Third-party payer rules may vary in determining if there is a specific length of time prior to the initiation of labor management services for cervical dilation to be considered a separate procedure; consult your third-party payer for any specific guidelines that may apply in this regard.
Are any modifiers mandated when using labor management , delivery and third-degree laceration codes on same day?
CPT reporting guidelines do not have a mandate for a specific modifier to be applied when labor management, delivery and a third-degree laceration repair are performed on the same day by the same physicians or QHP. However, given that labor management was proposed as an XXX global (similar to E/M codes), while delivery and third-degree laceration repair are 000-day globals (per CMS designations), it is anticipated that some type of modifier designation (e.g., Modifier 51 for multiple procedures) will be requested by third-party payers to reflect the combined activity.
As a maternal-fetal medicine (MFM) practice, we are often called in as a separate group to see patients while inpatient for gestational diabetes mellitus (GDM), hypertension (HTN), etc. or for ultrasound. For GDM/HTN, would those still be considered E/M included in the labor management? Would the ultrasound services also fall under labor management?
Per the CPT 2027 Maternity Care Services guidelines reporting for labor management, "When the physician or other QHP is consulted during labor management but does not assume care for the parturient or fetus(es), the consultant may report their services with E/M codes, such as synchronous audio-video E/M (98000, 98001, 98002, 98003, 98004, 98005, 98006, 98007), initial hospital inpatient or observation care (99221, 99222, 99223), inpatient or observation consultation (99252, 99253, 99254), or interprofessional telephone/internet/electronic health record (99446, 99447, 99448, 99449, 99451).”
Ultrasounds have always been and continue to be separately payable services.
Regarding the reporting of ultrasound services performed by the physician or QHP performing the E/M consultation, note that E/M reporting rules would apply; in particular:
- Any specifically identifiable procedure or service (i.e., identified with a specific CPT code) performed on the date of E/M services) may be reported separately
- The ordering and actual performance and/or interpretation of diagnostic tests/studies during a patient encounter are not included in determining the levels of E/M services when the professional interpretation of those tests/studies is reported separately by the physician or other qualified health care professional reporting the E/M service
- The physician or other qualified healthcare professional may need to indicate that on the day a procedure or service identified by a CPT code was performed, the patient’s condition required a significant separately identifiable E/M service
Can you capture labor management and the delivery code on the same date of service?
If a physician or other QHP performs both services for a patient on the same day, yes, both services may be reported on the same day per CPT guidelines. CPT does not mandate that a specific modifier be reported, but third-party payers may have additional reporting requests surrounding modifier use.
For a designated obstetric ER staffed by OB physicians, if the patient comes in for labor and is monitored but does not deliver, are the E/M codes for the ER used instead of the Labor Management codes?
Yes—in the scenario where the patient is managed entirely in the emergency room setting, the appropriate code from the emergency department services area (99281–99285 for non-critical care management) should be reported. Labor management codes are only reported when the patient being managed ultimately leads to delivering the fetus(es) during that management. If the patient presents "in labor" but it is determined after a time that the patient is experiencing false labor or Braxton-Hicks contractions and is discharged prior to delivering, the appropriate E/M services codes are reported.
- Delivery care
How is vaginal delivery reported in 2027?
Two new codes:
59431 – Vaginal delivery, with or without episiotomy
59432 – Vaginal delivery, with or without episiotomy; after previous cesarean delivery
These include delivery of the placenta and repair of first- or second-degree lacerations done by the delivering physician or other QHP or their group, plus routine same-day postpartum care.
How is cesarean delivery reported in 2027?
Two new codes:
59502 – Cesarean delivery; primary
59503 – Cesarean delivery; repeat
Each includes incision, delivery, placenta and closure. Typically reported once per delivery event regardless of number of fetuses. Labor management may be separately reported when applicable (e.g., failed labor before primary cesarean, TOLAC before repeat cesarean).
How are perineal laceration or episiotomy repairs handled?
First-or second-degree lacerations or episiotomy repairs are not separately reported by the delivery physician or other QHP as that work is included in the vaginal delivery code being reported.
If performed by an unrelated clinician, code 59300 may be reported for first-or second-degree repair.
59300 – Repair of first or second-degree episiotomy or laceration, by other than attending physician or other qualified health care professional performing vaginal delivery care (separate procedure)
Third-and fourth-degree lacerations or episiotomy repairs are separately reportable procedure codes regardless of who is reporting the delivery.
59433 – Repair of episiotomy or laceration; third-degree laceration
59434 – Repair of episiotomy or laceration; fourth-degree laceration
How are multiple gestations coded?
Labor management: report one complex labor management code per calendar date regardless of number of fetuses. Labor is complex by default for multiples.
Delivery: Report one cesarean code regardless of number of fetuses delivered by cesarean; report one vaginal delivery code per fetus delivered vaginally. For mixed-mode deliveries (e.g., one vaginal, two cesarean), report one vaginal delivery code and one cesarean code.
How are cesarean hysterectomies reported?
Subtotal or total hysterectomy performed at the same encounter as a cesarean is separately reportable with a new code, 59504, and may be billed by the same or a different physician than the one reporting the cesarean.
- Postpartum care
How is postpartum care reported?
Routine same-day postpartum care is included in the delivery code. After the day of delivery, inpatient postpartum care is reported with subsequent hospital care E/M codes per day until discharge, then a discharge day management code. Outpatient postpartum visits are reported with the appropriate E/M codes, following usual E/M rules.
Are there new postpartum procedure codes?
Yes. 59623 is a new code for uterine tamponade (e.g., balloon, catheter, vacuum, or packing material) to manage postpartum hemorrhage, distinct from pharmacologic management. Existing codes remain for postpartum curettage (e.g., retained products) and hysterorrhaphy (repair after uterine rupture).
How do coverage timelines interact with postpartum coding?
Coding uses standard E/M services across inpatient and outpatient settings. Coverage durations (e.g., Medicaid’s 60 days postpartum in some states) are policy-specific and separate from coding rules.
What scenario would lead a provider to include postpartum with the delivery?
In terms of reporting postpartum care relative to delivery services, these guidelines will be applicable:
- Postpartum care provided on the same calendar date as a vaginal or cesarean delivery (otherwise known as 'Immediate' postpartum care), is not reported separately.
- Inpatient maternal postpartum care on a calendar date other than the delivery date, may be reported with an E/M service, such as subsequent hospital inpatient or observation care service (99231, 99232, 99233), hospital inpatient or observation discharge service (99238, 99239), or critical care service (99291, 99292).
- Outpatient postpartum care on a calendar date subsequent to delivery care, should be reported with the appropriate E/M service (e.g., office or other outpatient service [99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215], telemedicine service [98000 – 98015], virtual check-in [98016], home or residence service [99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350]).
When patients come back to our office after delivery for postpartum follow up (blood pressure checks and postpartum physical), would we code those the same way as the antepartum visits with the E/M codes?
Correct; Postpartum follow-up visits are reported separately using the appropriate E/M services based on what was provided and who provided the service (e.g., a nurse-only visit report 99211).
- Claims, editing and payer readiness
What should health plans do to prepare for 2027?
Begin now. Review contracts and fee schedules that reference deleted global codes; update claims systems and edits; coordinate with vendors; plan for transition scenarios; and align with state-specific requirements (e.g., Medicaid tracking rules). Expect more granular, real-time claims data across prenatal, labor, delivery and postpartum.
How will claims editing handle common and uncommon code combinations?
As with any other CPT code guidelines and instructions, it is expected that a claims editing process will review the revised guidelines to determine if there are pairs of codes that are appropriate to be reported together (e.g., a labor management code and a vaginal delivery on the same date of service); as well as those that should not be reported together and would likely be denied (e.g., reporting both a straightforward and complex labor management code by the same physician for the same date of service); as well as combinations that may be more unusual, but could be valid in specific circumstances (e.g., a labor management code present on the claim for patient who is attempting a vaginal birth after a previous cesarean, and labors to this goal, but ultimately has a repeat cesarean delivery).
How does the change support care management and public health?
Phase-specific reporting provides earlier visibility into specific care provided, facilitates early detection of pregnancy risks via frequent E/M claims and ICD-10 diagnoses (e.g., medical complexity, social determinants), and highlights key information to identify beneficial interventions, including timely outreach and care management, as well as improved tracking of maternal and infant outcomes.
Will deleted global codes be accepted in 2027 claims?
No. Deleted CPT codes are invalid for dates of service on or after Jan. 1, 2027. Claims systems and clearing houses should reject them. Services must be reported using the new phase-specific codes and E/M services.
What can organizations do to help support appropriate use of the new codes going forward?
There will be an ongoing need to monitor utilization patterns across phases, diagnosis-driven risk indicators and claims edits aligned to coding rules. As a new normal emerges, analytics can identify outliers and irregularities more effectively than under the old global structure. Many of these activities can be achieved and enhanced through education and training on the new code guidelines, as well as proactive auditing activities and compliance programs.
