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Update on maternity coding and reimbursement
Act
by Sep 1, 2026
Effective date
Sep 1, 2026
Identified
Aug 22, 2026
Summary
The AMA released new maternity coding guidelines effective January 1, 2027, replacing the global maternity package with detailed CPT codes. However, Cigna Healthcare is NOT implementing these changes and will maintain current maternity billing guidance. For patients with initial prenatal visits on or after September 1, 2026, providers must continue using existing maternity billing processes and NOT submit the new AMA-recommended prenatal E/M CPT codes to avoid payment delays.
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What to do
by Sep 1, 2026 · 6 steps
01Billing team must ensure that maternity claims for patients with initial prenatal visits on or after this date continue to use existing maternity billing codes and processes.
02Instruct all billing staff and providers to NOT submit the new AMA-recommended prenatal care E/M CPT codes to Cigna Healthcare.
03Update any internal billing guidelines, encounter forms, or software templates to reinforce the continuation of current maternity billing workflows.
04Verify with providers that they understand the requirement to maintain existing contractual billing requirements.
05Non-compliance will result in payment delays and unnecessary claims reprocessing.
06Monitor the Provider Newsroom for additional 2027 guidance from Cigna Healthcare later in the year.
Original notice
Update on maternity coding and reimbursement
providernewsroom.com · Always check the source before changing claims.