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Nebraska MedicaidMedicaid · Billing Codes · Provider Bulletin · NE · OB-GYN, Family MedicineHigh impact

Maternity Service Unbundling

Act
by Jan 1, 2027
Effective date
Jan 1, 2027
Identified
Sep 4, 2026

Summary

Nebraska Medicaid will retire 16 global maternity codes for dates of service on or after January 1, 2027, and move maternity care to E/M codes from 99202 to 99499 with the TH modifier. For antepartum visits where delivery is expected on or after that date, billing waits until after delivery, and Medicaid will allow a limited timely filing exception for certain earlier visits. New labor and delivery codes are also due January 1, 2027, with details expected in December 2026.

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What to do

by Jan 1, 2027 · 7 steps
01Billing team and maternity providers: stop using the 16 retired global codes for dates of service on or after that date, and bill maternity care with the appropriate E/M code from 99202 to 99499 plus the TH modifier in charge entry.
02For any antepartum patient whose expected delivery is on or after January 1, 2027, hold billing until after delivery.
03Keep using global codes for patients who deliver before January 1, 2027.
04Medicare crossover claims with unbundled maternity billing will be rejected through COBA and must be resubmitted on or after January 1, 2027.
05For antepartum visits before January 1, 2027 that are billed on or after that date with the TH modifier, Medicaid counts January 1 as day one of the timely filing limit, but only for deliveries on or after January 1, 2027.
06Rural Health Clinic, FQHC and IHS providers follow the same rules.
07Watch for the new labor and delivery codes expected in December 2026.

Codes mentioned

59400594095941059425594265943059510595145951559525596105961259614596185962059622

Original notice

Maternity Service Unbundling
dhhs.ne.gov · Always check the source before changing claims.
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Related policy hubs

Nebraska Medicaid policiesNE policy changesOB-GYNFamily MedicineCode 59400Code 59409Code 59410Code 59425Code 59426Code 59430Code 59510Code 59514Code 59515Code 59525Code 59610Code 59612Code 59614Code 59618Code 59620Code 59622

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