A change is coming to the codes OB-GYNs use to bill for maternity care services: Starting Jan. 1, 2027, we will shift from a bundled “global obstetric payment” to a fee-for-service model. This change impacts almost every U.S. family with a pregnancy. Under the current system, families receive a bill that does not distinguish the actual prenatal and postpartum costs from labor and delivery, which makes things incredibly confusing for patients.
In fact, the bundled payment’s impacts have been widespread: It has complicated billing for patients and clinicians, limited access to care, cut back the ability to provide patients with more personalized care, and slowed progress in better understanding U.S. maternal health outcomes.
In the current bundled payment structure, patients receive unclear and inconsistent cost-sharing information. Federal law bars most health insurance plans from charging patients for prenatal visits, screenings, and some postpartum services. Today, roughly 93% of U.S. health insurance plans are not allowed to require cost sharing or copayments for preventive services such as prenatal visits or screenings.
However, the global obstetric payment includes prenatal care, labor and delivery, and postpartum care together in one bundle. That bundle makes it difficult to determine which amount falls under the law, such as prenatal care and screenings, and which amount, including hospitalization and delivery, should have a copayment applied. And without oversight, some health insurance plans have been calculating copayments inconsistently and without transparency. It is not uncommon for health plans to erroneously charge copays or other cost sharing without calculating what preventive prenatal care should be exempt, and this has disadvantaged patients.
