MedicaidBilling CodesHigh impact
REVISED - Obstetrics (OB) Services Billing Changes (Global/Itemized) and Postpartum Visits
Arkansas Medicaid·AR · OB-GYN·Claims & Billing
Effective date
Jul 1, 2025
We identified it
Jun 26, 2025
Summary
Effective July 1, 2025, Arkansas Department of Human Services will no longer cover global OB codes unless beneficiaries have third-party liability insurance and/or Medicare. All OB services must be billed using itemized procedure codes (59409, 59425, 59426, 59514, 59612, 59620 for delivery/prenatal care) and postpartum visits must be billed as E&M codes with modifier TH. Eight previously bundled global OB codes are being terminated for non-TPL/non-Medicare beneficiaries.
Action Required
By June 30, 2025: Billing team must update billing system to discontinue global OB codes (59400, 59410, 59510, 59515, 59610, 59614, 59618, 59622) for all Medicaid beneficiaries without TPL insurance and/or Medicare. Implement logic to bill itemized delivery codes (59409, 59514, 59612, 59620) with appropriate modifiers (80, 81, or 82) and prenatal care codes (59425, 59426) based on visit count. Configure system to bill postpartum visits using E&M codes (99203-99205, 99212-99215) with modifier TH instead of global codes; ensure TH modifier bypasses the 16-visit per SFY limit for FQHCs and RHCs. Update encounter forms and provider documentation templates to specify itemized code selection. Train all billing staff, providers (physicians, CNMWs, NPs, RHCs, FQHCs, ASCs), and front-desk staff on new billing requirements. Verify TPL/Medicare status at time of service to determine if bundled codes can be used. Failure to implement these changes will result in claim denials for non-TPL/non-Medicare Medicaid beneficiaries.