In a recent national article, PYA physician compensation valuation expert Carol Carden, Managing Principal, explains the upcoming changes to the maternity care Current Procedural Terminology (CPT)(1) coding and how physician compensation could be impacted.
Effective January 1, 2027, maternity care will no longer be reported as a single global package. Instead, prenatal care, delivery, labor management, and postpartum care will be billed separately, with each prenatal and postpartum visit reported as its own evaluation and management service. The changes will alter how obstetric (OB) services are reported and billed, how physician productivity is measured, and how provider compensation plans may need to be designed.
In the article produced by Medical Economics, Carden describes the expected implications for physicians, laborists, advanced practice providers (APPs), and midwives and shares insights about the first year of the changes.
Although the Centers for Medicare & Medicaid Services (CMS) has not yet announced whether it will adopt the new codes, Carden advises practices to prepare now:
“We’re suggesting that people assume this is going to go forward….Think through what this means for your individual practice and your workflow. If something were to change and it didn’t go through, then it’s status quo, and you’re already prepared for that.”
The code unbundling is expected to have the greatest impact on hospital-employed obstetricians/gynecologists whose compensation is tied to work RVUs. As Carden explains, services that previously generated RVUs for physicians under the global package may now be billed directly by APPs or midwives who perform them, potentially affecting physician compensation and reimbursement.
While the American Medical Association intends the coding changes to be budget neutral, Carden says individual physicians could see financial impacts based on levels of complexity. For example, she shares that PYA’s modeling of an uncomplicated vaginal delivery found 4.03 fewer work RVUs than the current global code. Learn more about potential scenarios in PYA’s on-demand webinar: 2027 Maternity Care Coding Changes: Reimbursement, Productivity, & Compensation.
For the first year, Carden says health systems are evaluating options such as freezing compensation at 2026 levels, adjusting conversion rates, and implementing reconciliation guardrails to help manage the transition and avoid unintended over- or underpayment of physicians.
In the article, Carden also discusses ways to measure productivity if Medicare, commercial payers, and Medicaid handle the coding changes differently and offers insights about physician contract language.
Read the Medical Economics article.
Medical Economics is the leading practice management and finance multi-channel resource for physicians.
PYA’s Healthcare Provider Compensation Services experts are committed to helping healthcare organizations understand, prepare for, and strategically manage the impending maternity care coding changes to focus on providing quality care.
(1)Current Procedural Terminology (CPT) is a registered trademark of the American Medical Association.
