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CignaCommercial · Billing Codes · Coding · OB-GYNHigh impact

Cigna Healthcare evaluates maternity coding options ahead of final CMS rule

Act
by Jan 1, 2027
Effective date
Jan 1, 2027
Identified
Oct 16, 2026

Summary

This is historical material (published August 24, 2026; updated October 15, 2026; discovered October 16, 2026) outlining Cigna Healthcare's conditional approach to maternity coding changes pending a final CMS rule. Cigna will adopt either 15 new HCPCS G-codes (if CMS approves them) or the AMA maternity coding framework on January 1, 2027. Current 2026 billing guidance remains unchanged; providers should continue existing maternity billing practices through December 31, 2026.

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What to do

by Jan 1, 2027 · 6 steps
01Billing team must monitor Cigna Healthcare's Provider Newsroom and await final CMS rule publication and Cigna's confirmed implementation guidance to determine which maternity coding framework will apply (either 15 new HCPCS G-codes or AMA framework).
02Specific codes and workflow changes will be communicated by Cigna after CMS issues its final rule.
03Until then, continue billing maternity services using current contractual requirements and existing Cigna Healthcare reimbursement policies through December 31, 2026.
04For patients with initial prenatal visits on or after September 1, 2026, do not submit AMA-recommended prenatal care E/M CPT codes; continue using existing maternity billing processes.
05After CMS publishes its final rule (expected later in 2026), update billing software, encounter forms, and reimbursement policies to reflect the finalized code set.
06Contact AMAMaternityCodes@CignaHealthcare.com with questions.

Original notice

Cigna Healthcare evaluates maternity coding options ahead of final CMS rule
providernewsroom.com · Always check the source before changing claims.
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