If you’re a clinician providing obstetric care, you have likely heard that maternity billing codes are changing on January 1, 2027. What you may not have had time to think through yet is what that shift could mean for how you structure your practice, your call schedule, and your relationships with hospital-based colleagues.
Why the old codes stopped fitting how you practice
The global maternity codes now in use were built more than 30 years ago, when it was common for one OB/GYN to manage a patient’s care from the first prenatal visit through the postpartum checkup. That is often not how care happens today. A patient’s labor might be managed overnight by an OB hospitalist, her delivery performed by her community obstetrician, and her postpartum visit handled by a certified nurse-midwife. The current global code cannot show any of that. It records one bundled payment and leaves no record of who did what or how complex the care was.
The new CPT codes, developed by the AMA in collaboration with the American College of Obstetricians and Gynecologists (ACOG) and other specialty societies, let you report prenatal care, labor management, delivery, and postpartum care as distinct services. That is a more accurate reflection of team-based obstetric care, and it is designed to be budget neutral. An AMA survey of more than 650 clinicians found that the value of the new codes is not expected to exceed the value of the bundled codes they replace.
Where it gets complicated
Medicare’s treatment of the new codes is still being worked out, and there is a real chance Medicare could end up applying different rules than commercial insurers and Medicaid. If that happens, you could end up managing two coding systems at once: the new CPT structure for most patients, and a separate approach for Medicare patients. That means separate documentation habits and separate rules for the same clinical work, depending on the patient’s payer. It is worth staying engaged on this through ACOG and other specialty societies as the details are finalized.
What this could mean for your practice model
The coding change itself is not the biggest question. The more significant one is how it interacts with pressures you are likely already feeling: workforce shortages, administrative burden, burnout, malpractice exposure, and a desire for more predictable hours. As maternity care becomes less dependent on a single bundled payment tied to delivery, some physicians may choose to spend more time on office-based prenatal and postpartum care and less time on labor and delivery call.
To be clear, this is not about physicians leaving obstetrics. It is about physicians having more flexibility to practice in ways that fit their careers and their lives, while still delivering excellent care. That only works well for patients if hospitals and community physicians build stronger partnerships around who covers labor and delivery, who responds to obstetric emergencies, and who manages unassigned patients.
The case for collaboration, not disruption
Dedicated OB hospitalist programs exist precisely to make this kind of flexibility sustainable. When hospital-based clinicians provide consistent 24/7 labor and delivery coverage, community physicians are not forced to choose between a full outpatient practice and round-the-clock call responsibilities. You can focus more of your time on the relationships and care you built your practice around, while trusting that your patients have reliable coverage when you are not the one in the hospital.
This model is not new, and it is not a replacement for community obstetricians. It is a way of sharing the workload of maternity care across a team, so that no single physician is asked to be everything to every patient at every hour.
What to do now
Regardless of exactly how Medicare’s rules shake out, the underlying shift toward team-based, service-specific maternity care is already underway. A few things worth doing now:
- Talk with your hospital about how call coverage and unassigned patient responsibilities are currently structured, and whether that structure still works for you.
- Review how your practice documents and codes maternity care today, so you are ready for CPT changes regardless of what CMS finalizes for Medicare.
- Consider what a more sustainable division of labor and delivery coverage would look like for your practice, and start that conversation with hospital leadership before it becomes urgent.
The 2027 transition is an opportunity to rethink how maternity care is delivered in ways that support your practice and your patients. Physicians who start planning for it now, rather than reacting once the details are finalized, will be in a stronger position either way.
For more on how the transition may affect your practice, visit OBHG’s industry insights hub, where we’ll be adding resources for community physicians as the 2027 changes take shape.