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HighmarkAll Plans · Billing Codes · Provider Bulletin · PA, NY, DE, WV · OB-GYNHigh impact

Maternity Billing Changes for 2027

Act
by Dec 31, 2026
Effective date
Jan 1, 2027
Identified
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.

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What to do

by Dec 31, 2026 · 8 steps
01Billing team and providers must complete the following preparation for the January 1, 2027 maternity billing transition.
02Audit current maternity billing workflows and identify all claims currently using global maternity codes.
03Update billing system configuration to recognize and process new service-level codes for the four phases of maternity care (antepartum, labor management, delivery, postpartum).
04Modify encounter forms and EMR templates to capture service-level coding requirements for each maternity phase.
05Train 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.
06Coordinate with Highmark's Provider Resource Center and monitor Provider News for specific code updates and operational guidance.
07Failure to transition by the effective date will result in claim denials and revenue delays.
08Do not continue billing under the current global maternity code structure after December 31, 2026.

Original notice

Maternity Billing Changes for 2027
providers.highmark.com · Always check the source before changing claims.
View original ↗

Related changes

See all Highmark changes →
Guidance on New Coding and Billing Model for Maternity CareHighEffective Oct 1, 2026 · CodingBrowse every Highmark change in the policy list

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Highmark policiesPA policy changesNY policy changesDE policy changesWV policy changesOB-GYN

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