Inside Health Policy: ACOG, OBHG Oppose CMS’ Plan for Implementing New Maternity Pay Codes Proposed in 2027 PFS

Inside Health Policy: ACOG, OBHG Oppose CMS' Plan for Implementing New Maternity Pay Codes Proposed in 2027 PFS

From Inside Health Policy/An Inside Washington news service

Wednesday, July 20, 2026

ACOG, OBHG Oppose CMS' Plan For Implementing New Maternity Pay Codes Proposed In 2027 PFS

By Dorothy Mills-Gregg / July 20, 2026 at 6:15 PM

Maternal health providers are thrilled that CMS wants to add new labor and delivery codes adopted by industry -- and to increase their value -- but the lobby disagrees with the agency’s plan to mitigate potential disruptions by also creating new “G-codes” that would maintain the current coding and payment structure.

"Health plans have been given ample time to facilitate this transition, and our members are currently working toward it," American College of Obstetricians & Gynecologists President Camille Clare said in a statement Wednesday (July 15). "We urge CMS to adopt the new obstetric codes and make a clean break by not implementing the proposed G-codes. Otherwise, we will remain stuck in the current system, instead of moving forward toward true value-based maternity care.”

At issue is a provision in the 1,600-page proposed 2027 physician fee schedule that CMS unveiled Tuesday (July 14). The sweeping rule proposes a cut in physician reimbursements for next year, improvements to the Medicare Shared Savings Program and to sunset Merit-Based Incentive Payment System reporting in 2029.

The proposed rule would also increase the proposed value for the new labor and delivery codes recently adopted by the American Medical Association.

The current bundle makes it difficult to break out and recognize as a distinct service specialized, resource-intensive labor management like continuous in-house coverage and emergency response, Ob Hospitalist Group Chief Medical Officer Mark Simon promoted the new pay code framework in a statement Friday (July 17). The new coding framework will recognize labor management on its own and create a clearer record of who delivered care, when it was delivered, and at what level of complexity.

But CMS is worried providers will be disrupted by these new obstetric codes, and the administration wants to resolve this by adding 15 new Healthcare Common Procedure Coding System G-codes related to pregnancy, delivery and postpartum care.

"Although the RUC asserts that these proposed coding changes discussed above reflect clinical consensus, we have concerns that our adoption of the new codes would be disruptive based on how the longstanding existing code structure is currently accounted for in clinical practice patterns," the proposed rule said.

"We are seeking comment on whether CMS should create HCPCS G-codes that would maintain the current coding and payment for maternity services to ameliorate this concern, while we continue to consider the potential impact that changes in the maternity care code family have on clinical outcomes for maternal care," it adds.

ACOG opposed this approach, saying it would create two separate billing structures -- one for insurers that unbundle maternity care and another for those that don't -- for providers to navigate.

"[I]mplementing these G-codes, even for a year, would cause even greater disruption and confusion by increasing administrative burden for obstetric clinicians and practices and forcing them to learn and operate under two separate billing structures," Clare said.

The G-codes would also decrease the price transparency compared to the other approach, Clare said.

OBHG also opposed CMS' proposed transition with the G-codes, saying the administration would be recreating a global bundle that obscures the team-based work that supports safe maternity care and innovation.

"OB hospitalist programs operate at the intersection of hospitals, community practices, Medicaid, Medicare, and commercial payers," Simon said. "Requiring parallel coding and billing pathways would increase administrative burden, make care attribution less consistent, and create unnecessary confusion for clinicians and health systems preparing for January 1, 2027." -- Dorothy Mills-Gregg (dmillsgregg@iwpnews.com)

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