Obstetrical Providers Encouraged to Use E&M Codes with Modifier TH
Effective November 1, 2026, Medi-Cal encourages obstetrical providers to bill prenatal and postpartum care using E&M codes (99204, 99205, 99213, 99214, 99215) with modifier TH instead of global obstetric codes. This change aligns with upcoming AMA coding framework changes (effective January 1, 2027) that separately identify antepartum, labor, delivery, and postpartum services. Prenatal claims must include gestational age codes (Z3A.00-Z3A.49); postpartum claims must include relevant postpartum diagnosis codes (O86-O92, Z39.0-Z39.2, or F53.0-F53.1).