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BT2026180: IHCP announces updates to maternity codes due to nationally recognized changes
Effective date
Jan 1, 2027
Identified
Oct 28, 2026
Summary
Starting Jan. 1, 2027, Indiana Medicaid (IHCP) will follow the AMA's revised CPT maternity codes, and the current maternity codes will no longer be valid for dates of service on or after that date. The IHCP will no longer accept global or bundled maternity billing on any claim, including when billed as secondary, so prenatal care, labor management, delivery and postpartum care must each be billed with the appropriate codes. Prenatal and postpartum visits will be billed as E/M codes with modifier TH and the trimester or postpartum modifier, and the new labor management and delivery codes replace the discontinued ones.
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What to do
Action · 12 steps
01Already effective Oct.
021, 2026: The IHCP began accepting prenatal services billed with the appropriate E/M code and modifiers for dates of service on or after Oct.
031, 2026.
04Code 59430 will be discontinued Dec.
0531, 2026: Billing team, update billing systems and workflows to remove discontinued maternity CPT codes, and bill postpartum visits with the appropriate E/M codes with modifiers TH and U4.
06Starting Jan.
071, 2027: Billing team, stop billing the end-dated maternity codes in Tables 1, 2 and 4 of the bulletin, including 59425, 59426, 59409, 59514, 59400 and 59510, because they will no longer be valid for dates of service on or after that date.
08Billing team, bill labor management with codes 59080 through 59083, vaginal and cesarean deliveries with the new delivery codes in Table 5, and prenatal care with E/M codes billed with modifier TH and trimester modifier U1, U2 or U3.
09Billing team, bill each E/M visit with modifier TH and the applicable U modifier, since E/M codes billed with TH but without an applicable U modifier will be denied.
10Billing team, implement the TH and other modifiers and adjust documentation templates to support the new coding structure.
11Clinical and billing teams, train on the new labor management and delivery codes.
12Billing team, the IHCP will not accept global maternity billing on any claim, including secondary claims, and the IHCP will discontinue the $10 add-on for high-risk prenatal visits, so bill E/M codes that reflect the complexity of each visit instead.
Codes mentioned
59409594255942659430595145952559612596205940059410595105951559610596145961859622590805908159082590835943159432594335943459502595035950459623G9997
Original notice
BT2026180: IHCP announces updates to maternity codes due to nationally recognized changes
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT202343: IHCP establishes rates for coordinating benefits for global maternity codesMediumEffective Dec 31, 2021 · Provider BulletinBT202418: IHCP corrects errors on the Professional Fee ScheduleMediumEffective Jan 1, 2024 · Claims & BillingBT202312: IHCP updates Notification of Pregnancy billing guidelinesMediumEffective Jan 1, 2023 · Claims & BillingBT202511: IHCP updates Notification of Pregnancy billing guidelines for FQHCs and RHCsMediumEffective Jan 30, 2025 · Claims & BillingBrowse every Indiana Medicaid (IHCP) change in the policy list
Related policy hubs
Indiana Medicaid (IHCP) policiesIN policy changesOB-GYNCode 59409Code 59425Code 59426Code 59430Code 59514Code 59525Code 59612Code 59620Code 59400Code 59410Code 59510Code 59515Code 59610Code 59614Code 59618Code 59622Code 59080Code 59081Code 59082Code 59083Code 59431Code 59432Code 59433Code 59434Code 59502Code 59503Code 59504Code 59623Code G9997