On January 1, 2027, the CPT code set deletes 17 maternity codes — including the four global maternity package codes 59400, 59510, 59610 and 59618 — and antepartum care moves to per-encounter E/M billing. Under ACOG and AMA transition guidance, pregnancies whose first prenatal visit falls on or after September 1, 2026 should already be billed with E/M codes.
That September 1 date is today. If your OB/GYN or family medicine practice has not yet changed how it captures antepartum visits, the transition year has officially started without you. Here is what is going away, what replaces it, and what to do in the last four months of 2026.
What is being deleted on January 1, 2027
The CPT Editorial Panel, working with the American College of Obstetricians and Gynecologists (ACOG) and other specialty societies, approved a full restructuring of maternity care services for the CPT 2027 code set. In total, 17 codes are deleted, 12 codes are added and six codes are revised, effective January 1, 2027 (American Medical Association, “CPT 2027 Maternity Care Services code changes,” updated July 8, 2026).
The 17 deleted codes are: 59050, 59400, 59409, 59410, 59425, 59426, 59430, 59510, 59514, 59515, 59525, 59610, 59612, 59614, 59618, 59620 and 59622.
Two clarifications that matter for chargemaster cleanup:
- Only four of the deleted codes are true global maternity package codes: 59400 (vaginal delivery global), 59510 (cesarean global), 59610 (VBAC global) and 59618 (cesarean after attempted VBAC global). The rest are delivery-only, antepartum-only and postpartum-only codes that die alongside them.
- Codes 59412 and 59414 are revised, not deleted, along with 59051, 59300, 59898 and 59899 (AMA, July 8, 2026). Do not strip them from your fee schedule.
What replaces the global package
Beginning January 1, 2027, maternity care is reported separately across four phases — antepartum, labor management, delivery and postpartum — instead of one bundled nine-month service (AMA, July 8, 2026):
- Antepartum care is reported per encounter with the appropriate E/M code based on where the service happens (office, hospital or telehealth), under standard E/M rules.
- Labor management gets new codes for initial and subsequent days, each split into straightforward and complex levels, reported once per calendar date.
- Delivery gets streamlined delivery-only codes for vaginal delivery, VBAC and cesarean (primary versus repeat), plus new stand-alone codes for third-degree and fourth-degree laceration or episiotomy repair and for hysterectomy following cesarean delivery.
- Postpartum care is reported per encounter with E/M codes; routine postpartum care on the delivery date is included in the delivery code, and a new procedure code was added for uterine tamponade.
The 12 new codes are 59080, 59081, 59082, 59083, 59431, 59432, 59433, 59434, 59502, 59503, 59504 and 59623. The AMA released these codes ahead of its standard schedule, with the full descriptors and guidelines available in its downloadable maternity care codes document (AMA, July 8, 2026).
The ACOG timeline: why September 1, 2026 is the trigger
The transition problem is simple: a patient who starts prenatal care this fall will deliver in 2027, after the global codes no longer exist. The AMA’s antepartum transition education brief (April 24, 2026) resolves it this way:
- Antepartum visits furnished in 2026 are reported with 59425 (four to six visits), 59426 (seven or more visits) or E/M codes, depending on how many visits actually occur in 2026. Existing CPT guidance already directs E/M reporting when there are fewer than four antepartum visits.
- Antepartum visits furnished in 2027 are reported with E/M codes, full stop.
- Pregnancies whose first 10-week visit occurs September 1, 2026 or later will generally accumulate three or fewer prenatal visits before December 31 — which means E/M codes, not the antepartum bundles, are the correct way to report their 2026 visits (AMA CPT Education Brief, “Maternity Care Services 2027 – Antepartum Transition Reporting,” April 24, 2026).
ACOG’s coding guidance says the same thing from the front desk’s point of view: beginning September 1, 2026, the first prenatal visit after confirmation of pregnancy should be billed with an E/M code and the appropriate ICD-10-CM diagnosis codes (ACOG, “Payment for Obstetric Services” coding library, 2026).
What Medicare is doing — and what is still unsettled
On the payment side, the RUC surveyed more than 650 obstetricians, family physicians and nurse midwives, and submitted work-value recommendations to CMS on February 3, 2026. The RUC’s analysis anticipates the new values will be budget neutral relative to the old bundled codes — if CMS adopts them. CMS proposed values in July 2026, and final values publish in November 2026 (AMA, July 8, 2026).
One open question: in the CY 2027 Medicare Physician Fee Schedule proposed rule (CMS-1848-P, published in the Federal Register July 16, 2026), CMS is considering 15 new G-codes that would preserve global-style payment for maternity care. That is a consultation, not a decision — comments close September 14, 2026, and ACOG has publicly urged a clean break to the new CPT structure. Watch the final rule in November before assuming Medicare and Medicaid plans will mirror the CPT model.
Your 2026 action items
- Flag every pregnancy by due date. Patients due in 2027 span the boundary. Build a report of active OB patients by estimated delivery date so coders know whose antepartum care follows transition rules.
- Start E/M capture for new pregnancies now. Per ACOG, first prenatal visits from September 1 forward get E/M codes. That means documentation supporting a level of service at every visit — not a tick mark on a flow sheet.
- Hold 59425 and 59426 for the right patients. They remain valid through December 31, 2026 for patients who accumulate four or more antepartum visits this year (AMA transition brief, April 24, 2026).
- Update the chargemaster twice. Remove the 17 deleted codes effective January 1, 2027; load the 12 new codes and the revised descriptors from the AMA’s published guidelines document.
- Watch payer bulletins. Commercial payers and state Medicaid programs will each publish their own transition policies. Do not assume every payer implements identically on day one.
For visit-level coding help during the transition, our team keeps updated cheat sheets in the AMS resource library.
Don’t run this transition alone
AMS Solutions, Inc. has handled OB/GYN billing since 1992, with AAPC-certified (CPC, CPB) coders, a signed BAA, and HIPAA-oriented processes. If your practice wants the 2027 maternity restructure mapped, tested and reconciled before January, talk to us about our medical billing services.
