AMA Launches New Maternity Care Codes
The American Medical Association has launched a new coding system designed to overhaul pregnancy and OBGYN CPT codes. The move is aimed at improving billing accuracy and could ultimately enhance access to maternal care by better reflecting the services provided.
The new coding structure, effective January 1, 2027, dismantles a decades-old system of "global" billing. Previously, a single bundled code was used for most prenatal visits, delivery, and postpartum care, a model that no longer reflects the complexity of modern obstetric services. This shift to a more granular, itemized system aims to provide insurers with earlier and more detailed data. Global codes were often not billed until delivery, leaving payers unaware of a patient's pregnancy, which hindered care coordination and efforts to ensure adequate prenatal services. The American College of Obstetricians and Gynecologists (ACOG) had urged the AMA for this change, arguing that bundled codes made services like mental health screenings, nutrition counseling, and care coordination invisible and non-reimbursable. The new framework allows for separate billing of these vital services. This move comes as the demand for midwives is surging, with the Bureau of Labor Statistics projecting a 35% growth for nurse-midwives between 2024 and 2034. In 2021, midwives attended 12% of all births in the United States, a number that has been on the rise. The coding overhaul aligns with broader pushes to improve maternal outcomes through policy and technology. The AMA is advocating for expanded telehealth reimbursement and legislation like the Connected MOM Act to strengthen remote monitoring coverage. Digital health platforms and AI-driven analytics are increasingly integrated into prenatal care for real-time monitoring and early detection of complications. In Virginia, where 47% of counties are considered maternity care deserts, organizations like the Virginia Midwives Alliance and Virginia Families for Access to Midwifery advocate for policies that expand access to care. This includes efforts to improve access to community-based doula and midwifery services, which are seen as crucial for addressing health disparities.
