Starting January 1, 2027, the way maternity care is coded and reimbursed in the United States is set to change for the first time in more than three decades. On the surface, this looks like a billing update. Underneath, it is a test of whether the healthcare system will finally measure maternity care the way it is actually delivered, or preserve a model built for a different era.
From one bundle to many services
For decades, most maternity care has been billed through global codes: a single payment covering prenatal visits, delivery, and postpartum care, regardless of how many clinicians were involved or how complex the pregnancy was. That model made sense when one OB/GYN typically managed a patient’s care from the first prenatal visit through the postpartum checkup.
That is no longer how maternity care usually works. A patient today might see a community obstetrician for prenatal visits, an OB hospitalist for labor and delivery in the middle of the night, and a certified nurse-midwife for the postpartum visit. The global code cannot show any of that. It records one bundled event and leaves the details of who did what, and how complex the care was, invisible.
The American Medical Association, working with the American College of Obstetricians and Gynecologists and other specialty societies, developed new CPT codes to fix this. Beginning in 2027, prenatal care, labor management, delivery, and postpartum care can be reported as distinct services. The change was designed to be budget neutral: an AMA survey of more than 650 clinicians found the total value of the new codes is not expected to exceed the value of the codes they replace.
A modernization effort that isn’t fully settled
Federal regulators are still finalizing exactly how Medicare will treat the new coding structure, and there is a real possibility Medicare could end up applying its own rules alongside the new CPT codes used by commercial insurers and Medicaid. If that happens, practices and hospitals would need to track more than one system, train staff accordingly, and determine which rules apply to which patient. The burden would fall hardest on smaller practices, rural hospitals, and safety-net providers with the least administrative capacity to absorb it.
Whatever the final federal policy looks like, the direction of travel is clear: maternity care is moving toward service-based reporting that reflects how care is actually delivered today.
Why the visibility question matters
This is not only an administrative debate. The United States continues to have one of the worst maternal mortality rates among high-income countries, and outcomes are significantly worse for Black women than for white women. Part of the difficulty in closing that gap is that the data available to researchers and health systems has been limited by the same bundled codes now under discussion. When months of care are compressed into one billing event, it becomes harder to see where care succeeds and where it breaks down.
More granular coding will not fix maternal health outcomes on its own. But it gives health systems, payers, and researchers a clearer record of who provided care, when, and how complex it was, which is a foundational step toward understanding what is working and what is not.
What this means for hospitals and health systems
Separately from the coding debate, the shift toward service-based billing is likely to accelerate a trend already underway: community physicians focusing more of their time on office-based prenatal and postpartum care, and relying more on hospital-based clinicians for labor and delivery coverage. That shift has been building for years due to workforce shortages, burnout, and changing career expectations. The coding changes did not create that dynamic, but they may speed it along.
For hospitals, the practical question is not really about codes. It is whether labor and delivery coverage, emergency response, and care for unassigned patients remain reliable regardless of how physician practice patterns evolve. Organizations that begin evaluating their coverage models, physician alignment strategies, and workforce plans now will be better positioned than those that wait for the final rule to force the issue.
Where OB hospitalist care fits in
Dedicated OB hospitalist programs, hospital-based OB/GYN clinicians who provide around-the-clock labor and delivery coverage, are one way hospitals are already managing this shift. Rather than relying solely on community physicians to cover call in addition to their office practices, hospitals with an OB hospitalist program have a consistent, in-house clinician available for every labor and delivery patient and every obstetric emergency, regardless of whether a community physician is available at that moment.
This model does not depend on how maternity care is coded or reimbursed. It is built to keep coverage reliable and consistent even as physician practice patterns, workforce availability, and payment structures continue to change. For hospitals weighing how to adapt to the 2027 transition, it is worth understanding how an OB hospitalist program could support that stability.
The bottom line
The 2027 transition is a genuine opportunity to modernize how maternity care is measured and paid for, but the greater significance may lie beyond the coding itself. Healthcare leaders should be preparing now for a maternity care landscape where team-based delivery, not a single bundled visit, is the standard the system is built to reflect.
To see where your organization stands, take OBHG’s Maternity Care Readiness Check, a short self-assessment to help identify where the conversations about coverage, physician alignment, and long-term sustainability stand today.