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Maternity Billing Changes for 2027
Highmark·PA, NY, DE, WV · OB-GYN·Provider Bulletin
Effective date
Jan 1, 2027
We identified it
Jul 2, 2026
Summary
Effective January 1, 2027, Highmark will implement industry-wide maternity billing changes replacing the current global maternity code with service-level coding across four phases of care (antepartum, labor management, delivery, postpartum). Antepartum and postpartum care will now use standard E/M codes instead of global codes, while new codes will be introduced for labor management, delivery, and specific obstetric procedures. Billing teams must prepare systems and workflows for this transition before the effective date.
Action Required
By December 31, 2026: Billing team and providers must complete the following preparation for the January 1, 2027 maternity billing transition: (1) Audit current maternity billing workflows and identify all claims currently using global maternity codes; (2) Update billing system configuration to recognize and process new service-level codes for the four phases of maternity care (antepartum, labor management, delivery, postpartum); (3) Modify encounter forms and EMR templates to capture service-level coding requirements for each maternity phase; (4) Train clinical and billing staff on the new coding model, specifically that antepartum and postpartum visits now use E/M codes rather than global codes, and that labor management and delivery services are reported separately; (5) Coordinate with Highmark's Provider Resource Center and monitor Provider News for specific code updates and operational guidance. Failure to transition by the effective date will result in claim denials and revenue delays. Do not continue billing under the current global maternity code structure after December 31, 2026.