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CMO Corner: Important Changes to Global Maternity Care Coding and Billing
Act
by Dec 15, 2026
Effective date
Jan 1, 2027
Identified
Sep 30, 2026
Summary
Effective January 1, 2027, maternity care coding transitions from global bundled codes to encounter-based billing with 17 deleted codes, 12 new codes, and 6 revised codes. Maternity services will now be billed separately by phase (antepartum, labor management, delivery, postpartum) instead of as one combined claim. For services spanning 2026-2027, specific transition codes and modifiers apply based on antepartum visit count.
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What to do
by Dec 15, 2026 · 7 steps
01Billing team must update billing software to transition from global maternity codes to new encounter-based codes effective January 1, 2027.
02Implement transition billing logic in system for claims spanning 2026-2027 based on antepartum visit count (use CPT 59426 for 7+ visits, CPT 59425 for 4-6 visits, E/M codes for 3 or fewer).
03Add modifier -TH functionality to system for antepartum and postpartum E/M codes with supporting ICD-10 diagnosis codes (Z34.XX or O00-O9A).
04Train providers to document services separately by phase rather than as global bundles and to include medical decision making supporting E/M level coding.
05Update encounter forms and EMR templates to reflect new four-phase coding structure.
06Coordinate with compliance team to ensure claims submitted for 2026 deliveries use current global codes through 12/31/2026, while 2027 deliveries use new codes.
07Update patient statements and EOB templates to reflect separate billing, as members will receive multiple Summary of Health Plan Payment statements instead of one bundled statement.
If missed: Failure to implement transition rules will result in claim denials for services spanning 2026-2027.
Codes mentioned
59050590805908159082590835940059409594105941259414594255942659430594315943259433594345950259503595045951059514595155952559610596125961459618596205962259623Z34.XX
Original notice
CMO Corner: Important Changes to Global Maternity Care Coding and Billing
bluecrossvt.org · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of Vermont changes →Contraceptive Counseling ReminderHighNo effective date · Provider NewsPreventive Care Reminder Sent to MembersHighEffective Dec 1, 2026 · Provider NewsChanges to Global Maternity Care and Delivery CodingHighEffective Sep 1, 2026 · CodingGlobal Obstetrics/New Maternity Services CodesHighEffective Sep 1, 2026 · CodingBrowse every Blue Cross Blue Shield of Vermont change in the policy list
Related policy hubs
Blue Cross Blue Shield of Vermont policiesVT policy changesOB-GYNCode 59050Code 59080Code 59081Code 59082Code 59083Code 59400Code 59409Code 59410Code 59412Code 59414Code 59425Code 59426Code 59430Code 59431Code 59432Code 59433Code 59434Code 59502Code 59503Code 59504Code 59510Code 59514Code 59515Code 59525Code 59610Code 59612Code 59614Code 59618Code 59620Code 59622Code 59623Code Z34.XX