OBHG Statement on Maternity Care Provisions in the 2027 Medicare Physician Fee Schedule Proposed Rule

OBHG Statement on Maternity Care Provisions in the 2027 Medicare Physician Fee Schedule Proposed Rule

Statement attributable to Mark N. Simon, MD, MMM, CPE, Chief Medical Officer, Ob Hospitalist Group

Ob Hospitalist Group (OBHG) is encouraged that CMS’s 2027 Medicare Physician Fee Schedule proposed rule recognizes the restructured maternity care codes and proposes enhanced valuation for labor and delivery services. Replacing a three-decades-old global package with service-level reporting is an essential step toward a payment system that reflects how obstetric care is actually delivered by coordinated teams across prenatal, hospital, and postpartum settings.

The proposed changes would better recognize and pay for the critical bedside care OB hospitalists provide during labor and delivery. OB hospitalists provide continuous in-house coverage, evaluate patients in triage, manage inductions and complex labor, interpret fetal heart tracings, respond to emergencies, and often care for a patient for hours before, even if another clinician performs the delivery. Under the current bundle, that specialized, resource-intensive labor management can be difficult to identify and may go unrecognized as a distinct service. The new maternity care coding framework gives labor management its own clinical and economic recognition, while creating a clearer record of who delivered care, when it was delivered, and at what level of complexity.

OBHG is therefore deeply concerned that CMS is considering 15 temporary HCPCS G-codes. These Medicare billing codes would keep the current bundled payment system for maternity care in place, weakening the benefits of the new codes precisely where hospitals need consistency. OB hospitalist programs operate at the intersection of hospitals, community practices, Medicaid, Medicare, and commercial payers. 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. This burden would fall especially hard on smaller, rural, and safety-net organizations – systems with already limited administrative resources.

The choice also has implications beyond payment structures. Service-level data helps hospitals support quality measurement, and reveal what care elements need strengthening. Recreating the global bundle through G-codes would continue to obscure the team-based work that supports safe maternity care and innovation.

CMS has an opportunity to align Medicare with a modern and clinically accurate maternity coding system. OBHG urges CMS to not move forward with a separate set of Medicare-only codes that would preserve the outdated bundled system, even if temporary. A consistent approach will better support OB hospitalists, community clinicians, hospitals and, most importantly, the patients who rely on coordinated obstetric care around the clock.