How Does Telehealth Billing Work for OB/GYN Visits in 2026?
As of September 2026, telehealth billing for OB/GYN visits operates under two different systems depending on whether the visit falls inside the global obstetric package or outside it. Routine prenatal visits delivered by video are currently bundled into the global OB payment and do not generate a separate billable encounter. That changes on January 1, 2027, when the global codes are deleted and every antepartum visit, including telehealth, becomes a separately billable E/M encounter with its own place of service code and modifier requirements.
What is billable now: Non-routine OB visits, gynecology E/M encounters, postpartum mental health follow-ups, and consultations outside the global package can be billed as telehealth today using standard E/M codes with the appropriate place of service code.
What changes in 2027: Every prenatal visit becomes individually billable under E/M codes, which means telehealth antepartum encounters will generate separate claims for the first time. Practices already delivering virtual prenatal care will see new revenue from visits that were previously absorbed by the bundle.
The compliance layer: Medicare telehealth flexibilities are extended through December 31, 2027 under H.R. 7148. Commercial and Medicaid payer rules vary by state and by plan, so coverage verification before the visit is not optional.
What Changed for OB/GYN Telehealth Billing
Three developments converged in 2026 to reshape how OB/GYN practices bill telehealth visits. First, Congress extended Medicare telehealth flexibilities through December 31, 2027 by passing the Consolidated Appropriations Act, 2026 (H.R. 7148), signed on February 3, 2026. That extension preserved the ability to bill Medicare for audio-video telehealth visits without geographic restrictions and without requiring patients to be in a clinical setting, after a brief lapse in late January 2026 that CMS covered retroactively.
Second, the AMA CPT Editorial Panel approved the deletion of 17 global obstetric codes effective January 1, 2027. Under the current system, a routine prenatal visit delivered by telehealth does not produce a separately billable claim because it is already inside the global OB package. Starting in 2027, that visit becomes an individually billable E/M encounter, and telehealth delivery becomes a billing decision rather than just a care delivery decision.
Third, ACOG set September 1, 2026 as the recommended date for practices to begin billing antepartum visits using E/M codes with modifier TH. Practices that have already made the switch are now billing prenatal visits on a per-encounter basis, and the telehealth versus in-person distinction matters on every claim because place of service codes and payer coverage rules apply at the encounter level. For a full breakdown of the code transition itself, see the 2027 OB/GYN billing code changes overview on this site.
Which OB/GYN Telehealth Visits Are Billable Today?
Not every OB/GYN telehealth visit is billable as a separate encounter right now. The distinction depends on whether the visit falls inside or outside the global obstetric package. Here is what is separately billable via telehealth today:
- Gynecology E/M visits, such as follow-ups for abnormal bleeding, contraceptive management, or menopause symptom management, billed with the standard E/M code and the appropriate telehealth place of service code.
- Problem visits during pregnancy for conditions beyond routine prenatal care, such as management of gestational diabetes, preeclampsia monitoring, or a new complaint unrelated to the pregnancy.
- Postpartum visits, including postpartum depression screening and lactation support, billed as E/M encounters when documented as separately identifiable from routine postpartum care.
- Mental and behavioral health services delivered by telehealth, which CMS made permanent in the 2026 PFS final rule without geographic restrictions.
- Consultations and second opinions that fall outside the referring provider’s global package.
What is not separately billable today: a routine prenatal visit for a patient whose care is being billed under one of the current global OB codes (59400, 59510, 59610, 59618). That visit is already paid for inside the bundle. Delivering it by video does not change the billing, it just changes the care delivery method. Across the billing companies we vet for OB/GYN practices, this distinction is the single most common source of telehealth billing confusion in obstetrics.
How Do You Bill an OB/GYN Telehealth Visit?
When a telehealth encounter is separately billable, the billing mechanics follow the same framework as any telehealth claim, with OB/GYN-specific considerations layered on top. Here is the step-by-step process:
- Confirm the visit qualifies as a separately billable encounter. If the patient is under a global OB package and the visit is a routine prenatal check, it is not separately billable until the 2027 unbundled codes take effect.
- Select the correct E/M code based on medical decision making or total time, the same way you would code an in-person visit. For new OB patients, use 99202 through 99205. For established patients, use 99211 through 99215.
- Assign the correct place of service code. For Medicare, use POS 10 if the patient is at home, or POS 02 if the patient is at a non-home location. Medicare does not use modifier 95 for telehealth identification. Commercial payers vary. Some require modifier 95 in addition to or instead of a POS code.
- Append modifier TH if the visit is an antepartum encounter being billed under E/M codes as part of the September 2026 transition, per ACOG guidance.
- Verify payer-specific telehealth coverage before the visit. Not every commercial plan reimburses telehealth at the same rate as in-person visits, and some Medicaid programs have state-level restrictions on which telehealth services are covered.
- Document the visit as you would an in-person encounter. The medical record must support the E/M level billed, including the clinical indication, the method of communication (audio-video, not audio-only for most payers), and the clinical findings.
2026 vs 2027: OB Telehealth Billing Side by Side
The table below shows how telehealth billing for obstetric visits changes between the current global package system and the 2027 unbundled structure.
| Element | 2026 (Global Package) | 2027 (Unbundled E/M) |
|---|---|---|
| Routine prenatal visit by telehealth | Bundled, not separately billable | Separately billable E/M encounter |
| CPT code for a virtual prenatal visit | No separate code (inside 59400/59510) | 99202 to 99215 with modifier TH |
| Place of service code | N/A for bundled visits | POS 10 (home) or POS 02 (non-home) |
| Revenue per telehealth prenatal visit | $0 additional (already in the bundle) | Individually reimbursed per encounter |
| Payer verification required? | Only for problem visits outside the bundle | For every telehealth encounter |
| Documentation standard | Included in global OB documentation | Full E/M documentation per visit |
The revenue implication is significant. A practice that currently delivers four or five routine prenatal visits by telehealth per pregnancy collects nothing additional for those encounters under the global package. Starting in 2027, each of those visits becomes a separately reimbursable claim. For a high-volume OB practice, that shift can add tens of thousands of dollars in annual collections from visits the practice is already delivering.
If your practice is delivering prenatal care by telehealth but not capturing the revenue, the billing mechanics are about to change in your favor. A billing partner with OB/GYN experience can set up your telehealth workflows, place of service codes, and payer verification process before January 2027 so you collect from day one. Get matched with a vetted OB/GYN billing company, free.
Common Telehealth Billing Mistakes in OB/GYN
Providers often come to us after months of telehealth denials with no clear pattern. When we help them look at the claims, the same handful of mistakes appear repeatedly.
Billing a routine prenatal visit as a separate telehealth encounter while the patient is still under a global OB code. This is the most frequent error. The global package already pays for the visit. Submitting a separate telehealth claim for it results in a denial, and repeated submissions can trigger a payer audit.
Using the wrong place of service code. Medicare uses POS 10 for patient-at-home telehealth and POS 02 for patient at a non-home clinical site. Some commercial payers still require POS 11 with modifier 95. Submitting the wrong POS code changes the allowed amount or triggers a denial.
Billing audio-only visits to payers that require audio-video. Medicare reimburses audio-only telehealth only for mental and behavioral health services (and only for established patients). Most commercial OB/GYN telehealth visits require a real-time audio-video platform. Billing a phone call as a telehealth visit to a payer that requires video is a denial.
Skipping payer verification. Telehealth coverage varies by plan, by state, and by service type. A payer that covers telehealth gynecology visits may not cover telehealth prenatal visits under the same terms. Verifying coverage before the visit prevents the denial after it.
Failing to document the telehealth modality. The medical record must state that the visit was conducted via real-time audio-video (or audio-only where permitted), identify the platform used, and confirm that the patient consented to the virtual visit. Missing any of these elements gives the payer grounds to deny.
Preparing for 2027 Telehealth Revenue
The January 2027 code restructure turns telehealth prenatal visits from a cost center into a revenue line. Practices that prepare now will collect from the first encounter. Those that wait will spend the first quarter of 2027 troubleshooting denials. In our experience matching OB/GYN providers with billing partners, the practices that transition smoothly are the ones that build their telehealth billing workflows before the codes change, not after.
Here is what to do now:
- Audit your current telehealth prenatal volume. Count how many routine antepartum visits your practice delivers by video per month. That number is the revenue you are leaving inside the global bundle today and will be able to bill separately in 2027.
- Confirm your telehealth platform meets HIPAA compliance requirements. CMS has signaled enforcement of HIPAA-compliant platform requirements for Medicare telehealth, and commercial payers are following. If your practice is using a consumer video tool without a BAA, fix that before 2027.
- Contact each contracted payer and confirm their telehealth coverage for antepartum E/M visits under the new unbundled structure. Get the answer in writing. Do not assume that a payer covering telehealth gynecology visits will automatically cover telehealth prenatal visits under the new codes.
- Update your EHR charge capture to include place of service codes (POS 10 and POS 02) and modifier TH on telehealth antepartum encounters. Build this into the prenatal visit template so the coding is automatic, not manual.
- Train front desk and scheduling staff to flag telehealth visits for payer verification at the time of scheduling, not after the visit has already happened.
Frequently Asked Questions
Can you bill a routine prenatal visit as telehealth in 2026?
Under the current global OB package, a routine prenatal visit delivered by telehealth is not separately billable because it is already included in the bundled payment. Starting January 1, 2027, when the global codes are deleted, every prenatal visit becomes a separately billable E/M encounter, including those delivered by telehealth.
What place of service code do you use for OB/GYN telehealth?
For Medicare, use POS 10 when the patient is at home and POS 02 when the patient is at a non-home clinical location. Medicare does not use modifier 95 for telehealth identification. Some commercial payers require modifier 95 with POS 11. Verify with each contracted payer before submitting claims.
Are Medicare telehealth waivers still in effect in 2026?
Yes. The Consolidated Appropriations Act, 2026 (H.R. 7148), signed February 3, 2026, extended most Medicare telehealth flexibilities through December 31, 2027. The brief lapse in late January 2026 was covered retroactively, so there is no gap in coverage for practices that billed during that period.
Does ACOG support telehealth for prenatal visits?
ACOG supports using the full range of E/M codes (99202 through 99499) for antepartum visits, which includes visits delivered by telehealth where the payer allows it. ACOG has stated that the transition to E/M codes will allow more comprehensive billing of telemedicine and home monitoring services.
Will telehealth prenatal visits be reimbursed the same as in-person visits?
Reimbursement parity varies by payer. Some commercial plans and state Medicaid programs reimburse telehealth visits at the same rate as in-person encounters. Others apply a reduced rate or limit which visit types qualify. There is no universal parity rule. Verify with each payer before building a telehealth care model around an assumed rate.
What modifier do you use for OB/GYN telehealth visits?
For Medicare fee-for-service claims, the place of service code identifies the visit as telehealth, and no additional modifier is needed. For antepartum visits billed under E/M codes during the September 2026 transition, append modifier TH per ACOG guidance. Some commercial payers require modifier 95. Check each payer’s billing instructions.
Next Steps
For the full breakdown of the OB global code deletion and the 2027 unbundled billing structure, see the 2027 OB/GYN billing code changes overview.
If your practice bills antepartum care across providers and needs to understand how visit-count thresholds work under the current system, see our guide to CPT code 59426.
Ready to get your telehealth billing right before the 2027 transition? Get matched with a billing company that knows OB/GYN telehealth inside and out.
Telehealth prenatal visits are about to become separately billable for the first time. If your practice is already delivering virtual care, the revenue opportunity starts January 2027, but the billing setup starts now. OB/GYN Bill Co matches your practice with vetted billing companies that specialize in obstetrics and gynecology. Over 2,000 providers matched nationwide, rates starting at 2.95%, and the service is 100% free to providers.
