What 2027 maternity billing changes mean for employer health plans 

A major change to maternity care billing will take effect on January 1, 2027. The American Medical Association has announced that the long-standing global obstetric codes, which have bundled much of pregnancy, delivery and postpartum care into a single claim since the 1990s, will be retired. Global obstetric fees will be eliminated and replaced with a new code set that moves maternity billing toward fee-for-service, with services billed separately across the pregnancy journey.

That shift may sound technical, but its implications are not. It could affect claims administration, member experience and overall maternity spend.

Why the change matters

The global maternity codes were designed for a more standardized model of care, but today’s maternity care is more complex. That care can include telehealth, remote monitoring, improved diagnostics for preterm labor and preeclampsia and more intensive postpartum monitoring. The current bundled structure often does not capture that complexity well.

The American College of Obstetricians and Gynecologists supports the shift, noting that unbundling may improve data collection, support more patient-centered care and better align reimbursement with patient complexity.

What may change in practice

Unbundled billing may give health plans a clearer view of the care members receive and a better understanding of which interventions are most effective. It may also improve measurement and outcome tracking, making it easier to identify and replicate impactful interventions. Separately billable postpartum services could expand access to critical care after delivery, which is especially important given the continuing risk of hypertension, hemorrhage and mental health complications. At the same time, administrative complexity is likely to increase, and claim denials may become more common during the transition.

The effects may not be uniform. Midwives and birth centers, particularly those serving mostly low-risk pregnancies, may face meaningful revenue disruption if reimbursement patterns shift, while more granular billing could create opportunities for maternity centers of excellence and more targeted maternal health and postpartum care strategies.

What employers should expect

Final coding guidance is still pending, and many stakeholders are waiting to model the financial impact. Employers should expect a transition period marked by coding updates, processing errors and member confusion, especially for pregnancies that span 2026 and 2027. Billing may also shift toward one-day increments for labor and delivery, which could affect claims processing and payment. Depending on plan design, unbundling could affect cost sharing, utilization patterns and total plan spend. The American Medical Association says the change is intended to be budget-neutral overall, but some women’s and family health vendors believe it could lead to materially higher costs.

What employers can do now

While it’s too early to model exact financial impacts, employers can use this time to consider their clinical management strategy as it relates to pregnancy and postpartum care. The U.S. continues to face poor maternal and infant health outcomes, including high preterm birth rates and rising maternal mortality, with significant geographic, socioeconomic and demographic variation. Employers should look for opportunities to engage members earlier in pregnancy as well as during the postpartum period, close gaps in care, identify high-risk pregnancies and direct employees to high-quality maternity providers. Behavioral health, lactation support and return-to-work resources can help reduce complications and support recovery. Employers should also ensure maternity programs are built to measure clinical outcomes, not just utilization.

The 2027 maternity billing change is more than a coding update. It is a reminder that maternity care is becoming more complex and more visible to payers and employers alike. Organizations that strengthen care navigation, risk identification and postpartum support will be better positioned to respond to the transition, manage spend and support better outcomes.