MedicaidBilling CodesHigh impact
09-01-2026 AMA updates global obstetric CPT code structure effective 01-01-27
Molina Healthcare·CA · OB-GYN·Coding
Effective date
Jan 1, 2027
We identified it
Sep 10, 2026
Summary
Effective January 1, 2027, the AMA is replacing the current global obstetric CPT code structure with a disaggregated model that separately identifies antepartum care, labor management, delivery care, and postpartum services. California's Medi-Cal program intends to align with these changes pending CMS approval. Billing teams must prepare documentation and workflow changes to accommodate the new maternity care coding structure.
Action Required
By December 31, 2026: Billing team and providers must review and update obstetric billing workflows, documentation practices, and operational processes to align with the new disaggregated CPT code structure. Actions include: (1) Review current global obstetric coding assignments in billing software and prepare for code mapping to new antepartum, labor management, delivery, and postpartum categories; (2) Update provider documentation templates and encounter forms to separately capture services across all pregnancy stages; (3) Train billing staff on new code structure and ensure EMR/billing system is configured for January 1, 2027 implementation; (4) Contact assigned Molina Provider Relations Representative for county-specific implementation guidance as it becomes available from DHCS and CMS. Failure to transition to compliant coding by the effective date will result in claim denials for obstetric services billed under the outdated global structure.