What Is the September 2026 Maternity Coding Deadline?
As of September 1, 2026, multiple payers are requiring OB/GYN practices to stop billing prenatal visits under the global maternity code for patients who begin prenatal care on or after that date and instead bill each prenatal visit as an individual E/M encounter. This is not the full January 1, 2027, code set change. It is an interim payer requirement that transitions practices away from the global billing model four months early for new OB patients, while patients already in a global package before September 1 continue under the current codes through delivery. The distinction between patients who started care before and after September 1 creates a split billing workflow that every OB/GYN billing team must manage simultaneously.
What changed: Payers including Blue Cross plans and others issued bulletins requiring claims for prenatal care beginning on or after September 1, 2026, to be billed as individual E/M office visits, not under the global maternity codes (59400, 59510, 59610, 59618).
Who it affects: Every OB/GYN practice that accepts patients from payers enforcing the September 1 cutoff. Patients who began prenatal care before September 1 remain on the global code through delivery.
What comes next: On January 1, 2027, the global maternity codes are deleted from the CPT code set entirely. The 17 legacy codes are replaced with 12 new and 6 revised codes organized into four phases: antepartum, labor management, delivery, and postpartum.
September 1 Payer Requirements
Multiple commercial payers and state Medicaid programs issued bulletins in mid-2026 requiring OB/GYN practices to change how they bill prenatal care for patients whose first prenatal visit falls on or after September 1, 2026. The core requirement is the same across payers: stop billing the global maternity code for these patients and start billing each prenatal visit as a standard E/M office visit (99202 through 99215 for new patients, 99211 through 99215 for established patients) with the appropriate pregnancy-related diagnosis code. For the broader context of the 2027 maternity billing overhaul, see our 2027 OB/GYN billing code changes overview.
| Billing Scenario | Before Sept 1, 2026 | Sept 1 to Dec 31, 2026 | Jan 1, 2027 Onward |
|---|---|---|---|
| Patient starts prenatal care before 9/1/26 | Global code (59400/59510) | Continue global code through delivery if delivery is in 2026 | No global code for a 2027 delivery: 2026 visits by count (E/M, 59425 or 59426), 2027 visits and delivery on the new codes |
| Patient starts prenatal care on or after 9/1/26 | N/A | Bill each visit as E/M (99213/99214); no global code | New 2027 maternity codes for all phases |
| Delivery before 1/1/27 | Global code includes delivery | Global code includes delivery | N/A |
| Delivery on or after 1/1/27 | No global code can be billed for a 2027 delivery | E/M for prenatal; new codes for delivery | New delivery codes apply |
| Postpartum visits | Included in global package | Depends on delivery date and payer | New postpartum codes apply |
The complexity is in the overlap. During the September through December 2026 period, an OB/GYN practice will have patients in two different billing models simultaneously: patients who started care before September 1 on the global code, and patients who started on or after September 1 on per-visit E/M billing. The billing team must track which model applies to each patient based on when their first prenatal visit occurred.
Why Payers Required Early Conversion
The January 1, 2027, deletion of the global maternity codes is a CPT Editorial Panel decision driven by years of ACOG advocacy. The AMA and ACOG recognized that the global billing model, introduced in the 1990s, no longer reflects modern maternity care where patients frequently see multiple providers, transfer between facilities, use telehealth for prenatal visits, and require varying levels of care complexity that the global code cannot distinguish.
Payers moved the operational cutoff to September 1, 2026, for a practical reason: a global maternity code covers approximately nine months of care. A patient who begins a global package in September 2026 would have that package extend past January 1, 2027, when the codes no longer exist. By stopping new global packages four months before the deletion date, payers avoid the administrative problem of having active global codes that expire mid-pregnancy.
In our experience matching OB/GYN providers with billing partners, the September 1 cutoff caught many practices off guard. The January 2027 date had been announced for over a year, but the September 2026 payer bulletins requiring early conversion for new patients arrived in some cases with only 60 to 90 days of notice. Practices that had planned to wait until January to change their workflow suddenly needed to implement the new billing model months ahead of schedule.
The September 2026 maternity coding cutoff means your practice is running two billing models simultaneously: global codes for existing OB patients and per-visit E/M billing for every new OB patient. If your billing team is not tracking which model applies to which patient, claims are going to deny. An OB/GYN billing partner who has already operationalized the transition handles the split workflow. OB/GYN Bill Co matches your practice with vetted billing companies, free.
How to Operationalize the September 1 Cutoff
These six steps cover the operational changes your practice needs to make for the September through December 2026 transition period.
1. Identify which payers enforce the September 1 cutoff. Not every payer has moved the deadline to September 1. Check each payer’s bulletin or provider update for their specific transition date. Some payers may allow global codes for new patients through December 2026.
2. Flag every new OB patient starting on or after September 1. In your EHR and billing system, mark patients who begin prenatal care on or after September 1 as ‘per-visit billing.’ This prevents the billing team from accidentally submitting a global code for these patients.
3. Bill prenatal visits as E/M encounters. For new OB patients after September 1, each prenatal visit is billed as an office visit (99213, 99214, or higher based on MDM) with the appropriate pregnancy diagnosis code. The E/M documentation rules, including MDM complexity, apply to every visit.
4. Continue global billing for patients who started before September 1. Patients already in a global package continue under the global code through delivery when that delivery falls in 2026. For patients who will deliver on or after January 1, 2027, no global code can be billed, because those codes no longer exist on that date of service: count each patient’s 2026 antepartum visits and bill 1 to 3 as E/M, 4 to 6 as 59425, or 7 or more as 59426, then bill 2027 visits as E/M. Do not switch a patient who will deliver in 2026 to per-visit billing without payer confirmation.
5. Train the front desk and billing team on the split workflow. The most dangerous period is September through December 2026 when both billing models run simultaneously. The front desk needs to know which billing model applies to each patient. The billing team needs to submit the correct code type for each encounter. For how OB ultrasound billing works alongside the new E/M model, see our CPT 76805 billing guide.
6. Prepare for the January 2027 full conversion. The September cutoff is the transition. January 2027 is when the 17 legacy codes are deleted and replaced with the new 12 new and 6 revised codes covering antepartum, labor management, delivery, and postpartum. Practices that master the per-visit E/M model in September will be better prepared for the full code set change in January.
The CMS G-Code Proposal and What It Means
One question we hear constantly from OB/GYN practice managers is whether CMS will preserve the global billing option through HCPCS G-codes. In the proposed 2027 Medicare Physician Fee Schedule rule published July 16, 2026, CMS asked for comment on creating 15 G-codes that Medicare would use in place of the new unbundled CPT codes starting January 1, 2027. The comment period for this proposal closed September 14, 2026. ACOG and the Ob Hospitalist Group (OBHG) have publicly opposed the G-code approach, arguing it would create two parallel billing systems and increase administrative burden. For additional context on the OB/GYN coding reference tools, see our OB/GYN Red Book guide.
As of October 2026, CMS has not issued the final rule. If CMS finalizes the G-codes, Medicare maternity claims would use the G-codes in place of the new CPT codes rather than alongside them, so practices would not choose between the two for Medicare. If CMS does not finalize the G-codes, Medicare maternity billing follows the new CPT code set exclusively. Commercial payers have generally moved toward the unbundled model regardless of what CMS does with G-codes.
For practices, the safest path is to prepare for the unbundled model. If G-codes are finalized, they would apply to Medicare claims in place of the new CPT codes, while commercial payers move to the new CPT codes regardless. A practice that only knows the global model and is counting on G-codes to avoid the transition is taking a risk that could leave it unprepared if the G-codes are not finalized or if the practice’s commercial payers do not adopt them.
How Does the Per-Visit Model Affect Revenue?
Across the billing companies we vet for OB/GYN practices, the revenue impact of the per-visit model depends entirely on how well the practice documents and codes each prenatal encounter. Under the global model, every prenatal visit is included in a single bundled payment regardless of complexity. Under the per-visit model, each prenatal visit is reimbursed based on its E/M level, which means the practice captures more revenue on high-complexity visits and less on routine check-ins.
A routine prenatal visit that involves a brief check with minimal MDM may support only 99213 (approximately $97 under 2026 Medicare). A prenatal visit that involves managing gestational diabetes, reviewing lab results, adjusting medications, and coordinating with maternal-fetal medicine supports 99214 (approximately $143) or 99215 (approximately $193). Under the global model, both visits pay the same because they are bundled. Under the per-visit model, the higher-complexity visit pays more, but only if the documentation supports the E/M level.
The risk is undercoding. A practice that bills every prenatal visit at 99213 because ‘it is just a prenatal check’ will collect less than the global package was worth. A practice that documents MDM correctly on every visit and bills at the supported level will likely collect more. The difference is entirely in the documentation and coding workflow, which is why the transition is a billing problem as much as it is a coding problem.
Frequently Asked Questions
Do I have to stop billing global codes on September 1, 2026?
For new OB patients whose first prenatal visit is on or after September 1, 2026, yes, if your payers require it. Multiple payers issued bulletins requiring per-visit billing for these patients. Patients already in a global package before September 1 continue under the global code through delivery unless the payer directs otherwise.
When are the global maternity codes deleted?
The global maternity CPT codes (59400, 59510, 59610, 59618, and related codes) are deleted from the CPT code set effective January 1, 2027. They are replaced with 12 new and 6 revised codes organized into antepartum, labor management, delivery, and postpartum phases.
How do I bill a prenatal visit after September 1, 2026?
Bill each prenatal visit as a standard E/M office visit, using 99202 through 99205 for a new patient and 99211 through 99215 for an established patient, selected based on medical decision making complexity or total time. ACOG recommends payers accept the full 99202 through 99499 range. Use the appropriate pregnancy-related ICD-10 diagnosis code. E/M documentation rules apply to every visit.
Will CMS keep the global billing option with G-codes?
CMS asked for comment on 15 HCPCS G-codes in the 2027 Medicare Physician Fee Schedule proposed rule that would preserve the global maternity payment for Medicare in place of the new CPT codes. ACOG opposes this approach. As of October 2026, CMS has not issued the final rule. The outcome will determine whether Medicare offers a global billing option starting January 1, 2027.
Does the unbundled model pay more or less than global billing?
It depends on documentation. The new model is projected to be budget-neutral at the system level, but individual practices will see higher or lower revenue depending on how accurately they document and code each prenatal visit. Practices that underdocument will collect less. Practices that document MDM correctly on complex visits will likely collect more.
What happens if a patient starts on global codes and delivers after January 1, 2027?
No global code can be billed for a delivery on or after January 1, 2027, because the global codes are deleted from the code set on that date and code validity follows the date of service. Count the patient’s 2026 antepartum visits and bill 1 to 3 as E/M, 4 to 6 as 59425, or 7 or more as 59426; bill 2027 antepartum and postpartum visits as E/M, and bill the delivery with the new 2027 labor management and delivery codes. Check each payer’s transition guidance for cross-year pregnancies.
Next Steps
For the full scope of the January 2027 code changes, see our 2027 OB/GYN billing code changes overview.
Check each payer’s September 2026 bulletin to confirm whether the September 1 cutoff applies to your patients on that plan.
Flag every new OB patient starting September 1 or later as per-visit billing in your EHR to prevent global code claims from going out incorrectly.
Ready to navigate the split billing workflow without losing revenue? Get matched with an OB/GYN billing partner who has already operationalized the transition.
The September 2026 payer deadline turned a January 2027 problem into an October 2026 problem. Your practice is running two billing models right now, and every new OB patient needs per-visit E/M coding that documents MDM correctly to capture the revenue the global code used to bundle. OB/GYN Bill Co matches your practice with vetted billing companies that specialize in OB/GYN maternity coding. Free quotes, all 50 states, rates starting at 2.95%.
