Before January 1, 2027, practices need to fix three things: maternity billing, where 17 CPT codes including the global packages are deleted in favor of phase-based reporting; home sleep testing, where 95800, 95801 and 95806 are deleted and replaced by six new complexity-based codes; and Medicare fee schedule assumptions, which stay provisional until CMS publishes the final rule, expected late in the year.
Ninety-three days remain. Here is the verified list of what changes, who it hits, and the checklist to work through in the fourth quarter.
Change 1: The maternity restructure (OB/GYN, family medicine, midwifery)
The CPT 2027 code set deletes 17 maternity codes, adds 12 and revises six, effective January 1, 2027, replacing the global maternity package with separate reporting across four phases: antepartum, labor management, delivery and postpartum (American Medical Association, “CPT 2027 Maternity Care Services code changes,” updated July 8, 2026).
The deleted codes: 59050, 59400, 59409, 59410, 59425, 59426, 59430, 59510, 59514, 59515, 59525, 59610, 59612, 59614, 59618, 59620 and 59622. The revised codes — 59051, 59300, 59412, 59414, 59898 and 59899 — stay on your fee schedule with updated descriptors.
What replaces the bundles: antepartum and postpartum care are reported per encounter with standard E/M codes; labor management gets new initial-day and subsequent-day codes at straightforward and complex levels; and delivery gets streamlined delivery-only codes plus new stand-alone codes for third- and fourth-degree laceration or episiotomy repair, hysterectomy following cesarean delivery and uterine tamponade (AMA, July 8, 2026).
The transition is already underway. Under AMA and ACOG guidance, pregnancies whose first prenatal visit fell on or after September 1, 2026 should be billed with E/M codes for antepartum care, since they will generally accumulate fewer than four visits before year-end; 59425 and 59426 remain available for 2026 visit counts of four or more (AMA CPT Education Brief, “Maternity Care Services 2027 – Antepartum Transition Reporting,” April 24, 2026; ACOG, “Payment for Obstetric Services,” 2026). If that is news to your OB service line, start with our September posts on the restructure and on per-encounter antepartum E/M.
Change 2: Home sleep apnea testing codes (sleep medicine, pulmonology, primary care that orders HSATs)
The home sleep apnea test codes 95800, 95801 and 95806 are deleted effective January 1, 2027 and replaced by six new unattended sleep study codes — the six new codes CMS will number in the final rule (American Academy of Sleep Medicine, “CMS releases 2027 physician fee schedule proposed rule: Key takeaways for sleep medicine,” July 24, 2026).
The new structure splits the service two ways:
- Technical versus professional. Three codes cover setup, data acquisition and technical analysis; three cover physician interpretation and report.
- By complexity. Low (three or four channels), moderate (five to ten channels) and high (eleven or more channels), defined by the parameter categories the device generates (AASM, July 24, 2026).
That means your HSAT claims will need to reflect which component you furnished and what class of device you used — a mapping exercise between your device inventory and the new descriptors that should happen before January, not during it. CMS’s proposed rule largely accepted the RUC’s recommended values for the new codes, with one professional-component code proposed below the RUC recommendation (CY 2027 PFS proposed rule, Federal Register 2026-14327). The AASM is publishing coder cheat sheets, FAQs and payer template letters over the coming months — assign someone to collect them.
Change 3: The Medicare numbers behind all of it
Two milestones frame fourth-quarter planning:
- September 14, 2026 — the comment period closed on the CY 2027 Medicare Physician Fee Schedule proposed rule (CMS-1848-P, Federal Register, July 16, 2026). Among the open items: CMS is considering 15 new G-codes that would preserve global-style maternity payment for Medicare — a consultation, not a decision, and one ACOG has pushed back on in favor of a clean break to the new CPT structure.
- The final rule — when CMS publishes the final rule, expected late in the year, it sets final values for the new maternity and sleep codes (AMA, July 8, 2026). The proposed rule would also reduce the conversion factor — a proposed $33.17 for qualifying alternative payment model participants and a proposed $32.84 for everyone else, proposed decreases of 1.19% and 1.68% respectively — and would extend several telehealth flexibilities through 2027 (CMS, CY 2027 Physician Fee Schedule proposed rule fact sheet, July 14, 2026; Federal Register 2026-14327).
Do not lock 2027 fee schedules, budgets or payer-contract models until the final rule lands.
The Q4 practice checklist
- Chargemaster and EHR. Term the 17 maternity codes and the three sleep codes with a December 31, 2026 end date; stage the new codes to activate January 1. Purge retired codes from favorites lists and order sets — deleted codes surviving in templates is the most common January denial source.
- Charge capture templates. Rebuild OB flow sheets for per-encounter E/M documentation and map each HSAT device to its complexity tier.
- Boundary patients. List every pregnancy spanning December 31 by due date and decide now how each 2026 antepartum bundle will be held and released (AMA transition brief, April 24, 2026).
- Payer bulletins. Assign someone to collect each major payer’s 2027 implementation policy for maternity and sleep — commercial plans and state Medicaid programs will not all mirror Medicare.
- Fee schedule review. When CMS publishes the final rule, expected late in the year, load final RVUs and reprice your top codes before January, including the conversion factor change.
- Staff training. Coders and front-desk staff need the new maternity phase logic and E/M level-selection rules before the first 2027 date of service.
- Denial watch. Build a January dashboard filtered to the new codes so mapping errors surface in days, not at the 90-day aging review.
Our updated cheat sheets for the 2027 transitions are collected in the AMS resource library.
Start January with clean claims
Code-set turnover years are when in-house billing teams drown quietly: the denials from a bad January mapping surface in March. AMS Solutions, Inc. is physician-founded, has managed transitions like this since 1992 and serves practices in all 50 states, with AAPC-certified coders and a signed BAA for covered services across OB/GYN, sleep medicine and other specialties. If you want the 2027 changes implemented, tested and monitored for you, talk to us about our medical billing services.
