After decades of global maternity billing, January 1, 2027 will bring the largest change in OB coding in many years. For an OB/GYN practice, the important question now is practical: what should you be doing between now and December 31, and what changes on January 1?
Importantly, this change is being driven by physicians and the national organizations representing obstetricians and gynecologists. The revised codes came out of nearly two years of work by the CPT Editorial Panel, the American College of Obstetricians and Gynecologists (ACOG), and other specialty societies.1 They are designed to make maternity coding reflect the work physicians actually perform, not simply to create another layer of billing complexity.
The goal is a system that is more physician-friendly and that more accurately recognizes the individual services provided throughout pregnancy, labor, delivery, and postpartum care. But even a physician-driven improvement requires preparation.
Identify your crossover pregnancies, keep an external list of their 2026 prenatal visits, follow each payer’s instructions, and reconcile at year-end. December 31 is the end of an entire method of billing maternity care.
Between Now and December 31
1. Identify your crossover pregnancies.
Identify patients receiving prenatal care during 2026 whose pregnancies will continue into 2027. Pay particular attention to patients beginning prenatal care during the final months of 2026.
These patients will receive care during the transition between two coding systems.
2. Keep an external list of these patients and their 2026 prenatal visits.
While your EHR may have the capability to track these patients and their claims, we recommend maintaining a separate working list during this transition.
For each crossover patient, record the patient and the dates of prenatal visits provided during 2026.
This gives the practice, and The Valletta Group, a straightforward way to reconcile the patient’s 2026 prenatal care and ensure that each service is ultimately submitted under the appropriate coding rules.
3. Do not assume that 2026 prenatal-visit billing should be held until 2027.
We are not recommending that practices hold all claims for 2026 prenatal visits in crossover pregnancies until January 1.
Payer readiness may vary. Some payers may be prepared to accept and process the applicable prenatal-visit coding during 2026, while others may provide different transition instructions. The AMA’s own transition guidance says that antepartum services for these patients can be coded at the end of 2026 or in early 2027, that billing does not have to be held until the patient delivers, and that practices should confirm any special transition policies with their payers.2
The practical approach is to maintain the external record of 2026 prenatal visits and follow the requirements of the individual payer. The Valletta Group can use that information to determine how and when those prenatal services should be submitted under the appropriate coding rules.
4. Continue applying the 2026 rules to 2026 dates of service.
For qualifying routine antepartum care provided during 2026:2
| Qualifying 2026 antepartum visits | How to report them |
|---|---|
| 1–3 visits | Bill the appropriate E/M code for each encounter. |
| 4–6 visits | Report CPT 59425. |
| 7 or more visits | Report CPT 59426. |
The key distinction is the date the service was provided, while recognizing that the timing and processing of claims may depend upon payer-specific transition requirements.
5. Reconcile your crossover list at year-end.
At year-end, compare the external tracking list with the practice’s records. Account for every qualifying 2026 prenatal encounter and make certain nothing has been overlooked.
Beginning January 1, 2027
Beginning January 1, antepartum encounters move into the new coding structure. CPT 59425 and 59426 no longer apply to 2027 dates of service, and maternity care moves into the new 2027 framework. Deleted codes are invalid for dates of service on or after January 1, 2027, and claims systems are expected to reject them.3
For practices, the immediate job is straightforward: identify the crossover pregnancies, maintain an external record of their 2026 prenatal visits, follow payer-specific billing instructions, reconcile those services at year-end, and be prepared for the new system on January 1.
December 31 is not simply year-end closing for an OB practice. It marks the end of an entire method of billing maternity care.
This article is part of our series on the 2027 maternity coding changes. For the background, read Global OB Billing Changes 2027: What OB/GYN Practices Need to Know. For what changes in the office on day one, continue to January 1, 2027 Is Here: What Does Your OB/GYN Practice Do Now?
Not sure which of your patients will cross into 2027, or how each payer wants those 2026 visits submitted? The Valletta Group can help you build the crossover list and close out 2026 cleanly.
Sources
- American Medical Association. CPT® 2027 Maternity Care Services code changes. Updated September 17, 2026.
- American Medical Association. FAQs: CPT® 2027 coding for maternity care spanning transition date. Updated September 17, 2026.
- American Medical Association. FAQs: Preparing for the CPT® 2027 Maternity Care Services code changes. Updated September 17, 2026.
This article is general information about CPT coding changes and is not legal, coding, or payer-specific advice. Confirm transition requirements with each payer.
