OB/GYN Medical Billing Services That Protect Every Delivery — and Every Dollar
Global maternity packages, split-billing, modifier-heavy claims, Medicaid postpartum rules, and the biggest OB coding change in 30 years — handled by certified coders who bill women’s health every single day.
- 2027-ready: we’re already remapping charge masters for the new maternity code set before the Jan 1, 2027 deadline
- Global OB packages billed correctly — 59400, 59510, 59610, 59618 and clean split-billing when care is divided
- Modifier mastery (-24, -25, -57, -22, -59/X) that keeps separately billable services from denying
- Underpayment recovery: we compare every ERA line against your contracted global rates
- 12-month postpartum Medicaid billing — revenue most practices never collect
OB/GYN Billing Isn’t General Billing. It’s Its Own Specialty.
Most billing companies treat a maternity claim like any other claim. It isn’t. One pregnancy can span three payers, two providers, ten months of care, and a single bundled fee that only pays correctly if every rule is respected.
One patient, 10-month episode
A single global fee covers months of antepartum visits, delivery, and postpartum care. One miscounted visit or missed transfer note can downgrade the entire package.
Modifier-heavy claims
Office visits with procedures, unrelated E/Ms inside global periods, and delivery decisions at 2 a.m. — every one depends on the right modifier or it denies.
Medicaid-heavy payer mix
Medicaid pays for a large share of U.S. births, and every state plays by different maternity rules, timely-filing windows, and postpartum coverage terms.
Rules changing under you
The 2027 deletion of the global maternity codes will restructure how every OB claim in America is billed. Practices that prepare early win; the rest will drown in denials.
Act before Jan 1, 2027
The Maternity Coding Overhaul Is Coming. We’re Already Ready.
The AMA has approved the most significant restructuring of obstetric coding in decades. If your billing partner hasn’t briefed you on this yet, that’s your sign.
What’s actually changing
- Effective January 1, 2027, the global maternity CPT codes —
59400,59510,59610,59618— and related delivery-only codes (59409/59410,59514/59515) are deleted. - They’re replaced by a new maternity code family (59XX1–59X12) that unbundles care: antepartum visits, labor management, delivery, and postpartum services move toward separate, itemized reporting under E/M-style codes.
- ACOG recommends payers begin transitioning as early as September 1, 2026 — meaning some payers may shift policies before the code change even takes effect.
- Meanwhile, payers have intensified scrutiny of global claims in 2026: antepartum visit-count conflicts and modifier errors are now the top causes of OB downcoding — even though CMS exempted MMM-designated global maternity codes from its 2026 payment efficiency adjustment.
Your RevGen 2027 readiness plan
Gap analysis & charge-master remap. We map every maternity code your practice uses today to its 2027 replacement and rebuild fee schedules before the switchover.
Dual-coding test cycles. We run parallel claims through your top payers to learn exactly how each one handles the transition — before your revenue depends on it.
Go-live with zero guesswork. Clean claims from day one under the new code set, with payer-specific rules already documented.
Contract & underpayment watch. Itemized billing means payers must reprice maternity care — we audit every remit against contracted rates so unbundling doesn’t become underpaying.
Also in effect now (and already handled for you)
✦ 2025 tumor-excision code change: 49203–49205 were deleted (Jan 1, 2025) and replaced by 49186–49190, which are selected by the sum of all tumors/cysts removed — not the largest. 58957 was deleted, and open endometrioma excision now reports 58999. Our coders document total specimen measurements up front so gynecologic oncology and myomectomy claims don’t downgrade.
✦ Telehealth E/M codes (98000+ family): virtual prenatal and postpartum visits are billed under the telemedicine code set introduced in CPT 2025, with payer-specific rules we track continuously.
Global Maternity Packages, Billed to the Letter
The global package only pays when the rules are respected: same provider or group across antepartum care, delivery, and postpartum; the expected visit counts; the right delivery code. Here’s the current code set we master — and the one replacing it in 2027.
CPT global maternity codes deleted Jan 1, 2027 — current through 2026
| Code | Global package | What it bundles |
|---|---|---|
59400 | Routine OB care, vaginal delivery | Antepartum care, vaginal delivery & postpartum care |
59510 | Routine OB care, cesarean delivery | Antepartum care, C-section & postpartum care |
59610 | Routine OB care after prior C-section — vaginal delivery (VBAC) | Antepartum care, VBAC delivery & postpartum care |
59618 | Routine OB care after prior C-section — cesarean after attempted VBAC | Antepartum care, C-section following failed VBAC & postpartum care |
Component & split-billing codes — when one provider didn’t do it all
| Code | Use it when |
|---|---|
59425 | Antepartum care only, 4–6 visits (e.g., patient transferred in mid-pregnancy) |
59426 | Antepartum care only, 7+ visits |
59409 / 59410 | Vaginal delivery only / delivery + postpartum (covering physician delivered your patient) |
59514 / 59515 | Cesarean delivery only / delivery + postpartum |
59430 | Postpartum care only (you provided the 6-week follow-up, another practice delivered) |
99202–99215 | Fewer than 4 antepartum visits — itemized E/M visits instead of package codes |
Common OB/GYN procedure codes we bill daily
| Code | Procedure | Code | Procedure |
|---|---|---|---|
58150 | Total abdominal hysterectomy | 76805 | Obstetric ultrasound |
585xx/582xx | Laparoscopic / vaginal hysterectomy | 76811 | Detailed fetal anatomic survey |
57522 | Conization of cervix with loop (LEEP) | 58300 | IUD insertion |
58558 | Diagnostic hysteroscopy w/ D&C | 58671 | Laparoscopic tubal ligation |
59812 | D&C after missed abortion | 49186–49190 | Intra-abdominal tumor/cyst excision 2025 codes |
58120 | D&C, non-obstetric | 19125/19126 | Breast biopsy / marker removal (benign breast services) |
ICD-10-CM diagnosis codes we see on every OB panel correctly labeled
| Code | Diagnosis | Code | Diagnosis |
|---|---|---|---|
Z34.80 | Encounter for supervision of other normal pregnancy, unspecified trimester | O80 | Encounter for full-term uncomplicated (vaginal) delivery |
Z34.00/01/02 | Supervision of first normal pregnancy, by trimester | O82 | Encounter for cesarean delivery without indication |
O09.5-–O09.9- | Supervision of high-risk pregnancy (age, prior loss, etc.) | O24.410– | Pre-existing diabetes in pregnancy, by trimester |
Z33.1 | Pregnant state, incidental (not the reason for the visit) | O99.- | Pregnancy complicated by other maternal conditions |
Diagnosis codes tell payers why; CPT codes tell them what. We keep both clean — because a cesarean diagnosis code (O82) will never pay an office visit, and a prenatal-supervision code (Z34.80) has nothing to do with a D&C.
When Care Is Divided, We Split — Not Guess
Payers downcode global claims the moment documentation suggests shared care. We itemize correctly the first time, every time.
| Scenario | Correct billing approach |
|---|---|
| Patient transfers OB care at 28 weeks | Original practice bills 59425/59426 (by visit count); delivering practice bills delivery (+ postpartum if provided) |
| Patient’s insurance changes mid-pregnancy | Split claim by coverage periods; itemized visits under each payer with eligibility verified before each phase |
| Covering physician performs the delivery | Delivery-only codes (59409/59410, 59514/59515) under same-group rules; global only when same physician/group provides all care |
| Patient presents in labor with no prenatal records | Delivery-only coding plus itemized E/M for any visits actually provided and documented |
| Fewer than 4 antepartum visits provided | Itemized E/M codes (99202–99215) instead of antepartum package codes |
| Postpartum care by a different provider (e.g., patient relocates) | Delivering practice bills delivery + antepartum; new provider bills 59430 postpartum-only |
Modifier Mastery: The Difference Between Paid and Denied
OB/GYN is one of the most modifier-dependent specialties in medicine. Generic billers guess; ours don’t.
| Modifier | What it’s for | OB/GYN example |
|---|---|---|
-25 | Significant, separately identifiable E/M same day as a procedure | Office visit + IUD insertion or LEEP on the same date |
-24 | Unrelated E/M during a postoperative/global period | Unrelated problem visit during another procedure’s global period |
-57 | Decision for surgery at an E/M visit | Office visit where the decision for hysterectomy is made |
-22 | Substantially increased procedural complexity | Highly complicated cesarean delivery — with documentation to support it |
-59 / X{E,S,P,U} | Distinct procedural service | Separately identifiable procedures during the same operative session |
-51 | Multiple procedures in one session | Hysterectomy with additional procedures at the same operative session |
-76 / -77 | Repeat / repeat by another physician | Repeat procedure during the postoperative period |
Denial Management & Underpayment Recovery
In 2026, payers are auditing maternity globals harder than ever — visit-count conflicts, modifier errors, and co-management scrutiny are the top downcoding triggers. And because a global fee is one big number, an underpaid global is easy to miss and expensive to ignore.
🔍 Every remit line, compared to contract
We auto-compare each ERA against your contracted global and component rates — so a 59400 paid at 82% of contract gets flagged, appealed, and recovered, not silently written off.
📊 Root-cause denial reporting
Monthly denial-pattern analysis by payer, code, provider, and reason — then we fix the upstream cause, not just the individual claim.
⏱️ Timely-filing protection
Payer-specific filing deadlines tracked per claim, with state Medicaid maternity rules handled per state.
The KPIs we report weekly
| OB/GYN billing KPI | Typical target |
|---|---|
| First-pass clean claim rate | ≥ 95% |
| Initial denial rate | < 5–10% |
| Days in A/R | < 35 |
| A/R > 90 days | < 15–20% |
| Global packages underpaid vs. contract | Caught & appealed, every time |
| Cost to collect | Reduced vs. in-house |
| Net collection rate | ≥ 96% of contracted |
Free audit shows your baseline
We’ll benchmark your practice against these targets — using your own claims data — before you commit to anything.
Payer Intelligence: Including the Money Others Leave Behind
The 12-month postpartum opportunity most practices miss
49 states plus Washington, D.C. have now extended Medicaid postpartum coverage from 60 days to a full 12 months after pregnancy ends (Arkansas is the last state without the extension as of 2026). That means postpartum visits beyond week six, depression screening and treatment, chronic-condition management, contraception, and lactation support may all be billable to Medicaid for a full year — care your clinicians may already be providing for free. We rework eligibility at delivery +60 days so those claims keep flowing.
State Medicaid programs
Maternity fee schedules, visit-count rules, timely filing, managed-care carve-outs, and postpartum extension billing — managed state by state.
Commercial & managed care
Aetna, BCBS plans, Cigna, UnitedHealthcare, Humana, Medicare & Medicare Advantage — global policies, prior-auth lists, and reimbursement quirks tracked per payer.
Self-pay maternity patients
Compliant Good Faith Estimates under the No Surprises Act, global-package payment plans, upfront deposits, and scheduled balance billing that protects cash flow and patient trust.
End-to-End OB/GYN Revenue Cycle, One Accountable Team
Front-end
✦ Appointment scheduling support
✦ Patient registration & demographic capture
✦ Real-time eligibility & benefits verification
✦ Maternity-specific benefits checks (global vs. itemized)
✦ Prior authorization — hysterectomy, LEEP, hysteroscopy, imaging, devices
✦ Referral management
Mid-cycle
✦ Charge capture & review
✦ CPT / ICD-10 / HCPCS coding by OB/GYN-trained, CPC-certified coders
✦ Modifier accuracy audits
✦ E/M level audits
✦ Documentation-gap feedback loops to providers
✦ Claim scrubbing against OB/GYN-specific edits
Back-end
✦ Electronic claim submission via clearinghouse
✦ Payment posting & ERA reconciliation
✦ Denial management & root-cause analytics
✦ Appeals with clinical documentation support
✦ Underpayment recovery vs. contracted rates
✦ A/R follow-up & patient statements
✦ Weekly KPI dashboards
Credentialing & enrollment
CAQH profile setup and maintenance, payer enrollment, re-credentialing, and roster updates — typically a 60–90 day process we run in parallel with onboarding so you’re billable from day one.
Your EHR, our expertise
athenahealth, AdvancedMD, eClinicalWorks, Epic, NextGen, CareCloud, Practice Fusion, and 35+ more. We work inside your system — no rip-and-replace, no workflow disruption.
Compliance-first, always
HIPAA, CMS, NCCI edits, OIG guidelines, False Claims Act safeguards, and No Surprises Act / GFE workflows built into every process. Your data stays protected end to end.
Transparent Pricing — Because You Shouldn’t Have to Ask
Most OB/GYN billing companies hide pricing behind a sales call. Here’s how the market actually prices — and how we do it.
% of net collections most common for OB/GYN
Typically 4–9% of what we actually collect — scaled by monthly claim volume and services included. We only win when you collect, so incentives stay aligned.
Per-claim pricing
A flat fee per claim (common for low-volume gynecology-only practices). Predictable, but it can penalize high-dollar global claims — we’ll show you the math both ways.
Hybrid
Base fee + reduced percentage for practices that keep some functions in-house. You get enterprise-grade billing without enterprise overhead.
What’s always included at RevGen
No setup fees · no long-term contracts · no charge for denied-claim rework · credentialing support · weekly reporting · dedicated account manager. Exact pricing quoted after your free audit — based on your real volumes, not a generic rate card.
Why OB/GYN Practices Choose RevGen
👩⚕️ OB/GYN specialists, not generalists
Your account team bills maternity and gynecologic surgery daily — globals, splits, modifiers, and the 2027 transition are muscle memory, not a learning curve on your revenue.
🔔 2027 transition leadership
Charge-master remapping, dual-coding pilots, and payer policy tracking before the biggest maternity coding change in decades hits your claims.
📈 Radical visibility
Weekly KPI dashboards, denial root-cause reports, and monthly financial reviews. You’ll always know your clean-claim rate, A/R days, and collection trends.
🤝 Aligned incentives
Percentage-of-collections pricing, no lock-in contracts, and revenue we recover from underpayments and missed postpartum billing that in-house teams rarely have time to chase.
“[Placeholder — add a real OB/GYN client quote about clean claims, faster A/R, or the 2027 transition support.]”
[Name], [Role]
[Practice], [State]
“[Placeholder — add a second real client quote.]”
[Name], [Role]
[Practice], [State]
Frequently Asked Questions
Straight answers from billers who do this work daily. (This FAQ also ships with structured schema markup for search visibility.)
What is the global OB package?
Are newborn baby charges included in the delivery bill?
How does the 2027 maternity coding change affect my practice?
When should we split the global maternity package?
Does Medicaid cover postpartum care beyond 60 days?
Can services be billed during the OB global period?
How much do OB/GYN medical billing services cost?
What denial rate should a well-run OB/GYN practice expect?
Do you support telehealth billing for prenatal and postpartum visits?
Do you handle prior authorizations for OB/GYN procedures?
How do you handle self-pay maternity patients?
Can outsourcing OB/GYN billing actually save my practice money?
See Exactly Where Your OB/GYN Revenue Is Leaking — Free
We’ll audit your maternity claims, global payments, denials, and A/R — and show you the dollars you’re leaving on the table. No obligation, no sales pressure.
Request Your Free OB/GYN Billing Audit →Prefer to talk? Ask about our 2027 maternity coding transition assessment.