American Medical Association is Ending Traditional Bundled Maternity Billing in 2027

Natashia Wright, Director, Benefits Compliance

The American Medical Association (“AMA”) recently announced that effective January 1, 2027, the common procedural terminology codes (“CPT”) will change from a bundled global maternity billing/code approach to multiple itemized codes reflecting each individual service. For group health plans, the shift in how services are coded for billing could affect claims administration, cost sharing, member experience, maternity vendor strategy, and overall plan spend, especially for pregnancies that span both 2026 and 2027.

Beginning in 2027, maternity care will be reported separately across four phases: antepartum care, labor management, delivery, and postpartum care. The intention of the change is to reflect how maternity care is delivered in current times, including team-based care, telehealth, remote monitoring, transfers between facilities and more intensive postpartum needs. It may also improve data collection and make it easier to align reimbursement with patient complexity.

While unbundling billing is intended to give plans a clearer view of what specific, maternity care members receive when services are delivered and which interventions are tied to better outcomes; the change can also cause friction. Plans and administrators should expect coding updates, new claim edits, provider questions, possible processing errors, and member confusion. Cost-sharing may also become more visible if services that were previously bundled are billed separately. There could also be an increase in costs.

The impact will vary by provider type, setting, and patient population. Midwives and birth centers that primarily serve low-risk pregnancies may experience disruption if reimbursement patterns change. Acute or critical settings may benefit from more specific reporting for transfers, prolonged labor management, complex deliveries, and postpartum monitoring. For employers, the broader opportunity is to use the added claims visibility to evaluate whether maternity programs are identifying risk early, closing gaps in care and connecting members to high-quality providers and meaningful recovery support.

Final implementation details and payer-specific approaches are still developing, so employers should be cautious about assuming that the changes will be cost-neutral at the plan level. Actual experience may vary based on network contracts, utilization, provider billing behavior, claim adjudication rules and plan design.

Pregnancies that begin in 2026 and continue into 2027 may be particularly challenging. Administrators, providers, and vendors will need to determine how to handle services that cross the effective date while minimizing claim issues and member confusion.

Employer action items

• Confirm insurer and third-party administrator (TPA) readiness for changes to code maps, claim edits, payment policies, accumulator logic, and member-facing materials.
• Discuss and review cost-sharing impacts across prenatal care, labor and delivery, postpartum care, deductibles, coinsurance, copays, and out-of-pocket maximums with insurers, TPAs, and brokers.
• Plan for transition claims involving pregnancies that begin in 2026 and continue into 2027.
• Evaluate maternity vendors to confirm navigation, telehealth, behavioral health, lactation, and return-to-work support are coordinated and measurable.
• Partner with insurers and TPAs to monitor provider access and networks.
• Prepare member communications that explain why maternity claims may look different in 2027 and where members can go for help.

Additional information and resources

• American Medical Association: “CPT 2027 Maternity Care Services Code Changes.” Updated July 8, 2026.
• American Medical Association: “FAQs: CPT 2027 Maternity Care Services Code Changes.”
• Centers for Disease Control and Prevention: “Data from the Pregnancy Mortality Surveillance System.”
• Centers for Disease Control and Prevention: “Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 U.S. States, 2017–2019.” May 28, 2024.