Obstetric billing will shift from global codes to itemized services on January 1, 2027. The Health Care Authority (HCA) is working toward implementation of these changes in Apple Health (Medicaid).
Transition to itemized billing
Global obstetric codes will end on December 31, 2026. Itemized billing will begin January 1, 2027.
- Deleted codes will not be billable for dates of service after December 31, 2026.
- New codes will be billable only for dates of service on or after January 1, 2027.
Complete clinical policies for the new obstetric codes will be published in the January 1, 2027 versions of the Pregnancy-related services billing guide and Planned home births and births in birth centers billing guide.
Pregnancy care that spans 2026 to 2027
For clients whose pregnancy care starts in 2026 and continues into 2027, providers must wait until January 1, 2027 to bill for pregnancy services delivered in 2026.
At that time, the provider must review all the services the client received in 2026 and bill for those services using unbundling guidance in the October 1, 2026, billing guides. Each client’s situation will be unique depending on the gestation of the pregnancy and the number of services received in 2026.
