Changes to OB billing starting in 2027

Beginning January 1, 2027, healthcare providers across the country will transition away from the traditional “global maternity billing” model that has been used for many years.

Instead of billing pregnancy care as one bundled package after delivery, maternity care services may now be billed separately throughout your pregnancy, delivery, and postpartum care.

This change is being made at the national level and is not specific to our office.

Under the previous system, most maternity care was billed as one combined package that included:

• Routine prenatal visits
• Labor and delivery services
• Postpartum care

Typically, insurance claims were submitted after delivery for the full maternity package.

Starting January 1, 2027, your maternity care may be billed in smaller portions throughout your pregnancy rather than as one final bundled claim.

Depending on your insurance plan and the services you receive, you may see:

• Charges for prenatal visits during pregnancy
• Separate billing for delivery services
• Separate billing for postpartum visits
• Additional charges for non-routine services, ultrasounds, testing, procedures, or complications

No. Your medical care, providers, and treatment plans will remain focused on keeping you and your baby healthy.

These changes primarily affect how maternity services are reported and processed with insurance companies.

Possibly. Because services may now be billed separately throughout pregnancy, patients may receive insurance statements or patient balances earlier and more frequently than under the previous system.

The amount you owe will still depend on:

• Your insurance plan
• Deductible
• Copayments
• Coinsurance
• Remaining out-of-pocket responsibility

Not necessarily. The new guidelines change how services are billed, but they do not automatically increase the cost of care.

However, your personal financial responsibility will continue to depend on your specific insurance benefits and coverage.

We always recommend contacting your insurance company directly with questions about your maternity benefits.

Most insurance plans will continue to cover maternity care according to your plan benefits.

Coverage, deductibles, copays, and coinsurance amounts are determined by your insurance company.

If you have questions about your coverage, we encourage you to contact the member services number listed on your insurance card.

National medical coding organizations periodically update healthcare billing guidelines to better reflect the care patients receive.

The 2027 maternity coding updates are intended to provide more detailed reporting of maternity services throughout pregnancy, delivery, and postpartum care.

Patients whose pregnancy care began before January 1, 2027 may have some services billed under the current global maternity system and other services billed under the new 2027 guidelines, depending on the timing of care and delivery.

Our billing team will work to process claims according to insurance and coding requirements.

Yes. Certain services have always been billed separately from routine maternity care and will continue to be processed separately.

Examples may include:

• Ultrasounds
• Laboratory testing
• Non-stress tests
• Procedures
• High-risk pregnancy management
• Hospital services
• Visits not related to pregnancy

We encourage patients to:

• Review their maternity insurance benefits
• Understand their deductible and out-of-pocket costs
• Keep insurance information updated with our office
• Contact their insurance company with benefit questions
• Reach out to our billing department with concerns early in pregnancy

If you have questions regarding your maternity billing or insurance processing, please contact our office at 603-641-0002. We appreciate your patience and understanding as healthcare providers and insurance companies transition to these new national maternity billing guidelines.