What changes did the American Medical Association announce?
The American Medical Association (AMA) announced a major restructuring of Current Procedural Terminology (CPT) codes for maternity care services, effective January 1, 2027.[1],[2] The changes will unbundle pregnancy episode services, leading to impacts on reimbursement and wRVU attribution and existing provider compensation plans.
Under the current model, maternity care is largely reported using global codes that encompass all of the pregnancy visits and associated care as a single “packaged” service at delivery.[2],[3] Intended to reflect the shifts in care delivery, the AMA confirmed that “beginning in 2027, maternity care services will be reported more granularly across four phases of care: antepartum, labor management, delivery, and postpartum.”[2],[3]
As a complicating factor, the Centers for Medicare and Medicaid Services (CMS) Calendar Year (CY) 2027 Medicare Physician Fee Schedule[4] is seeking comments regarding the potential adoption of the new AMA codes versus the potential establishment of 15 new HCPCS[5] G-codes that mimic the historical codes and related work relative value units (wRVUs). CMS states it is concerned that adopting the AMA changes may be disruptive and is seeking comments until September 14 to inform the path it will take.
Regardless of CMS’ decision, the impacts will extend beyond billing. For organizations that compensate physicians or advanced practice providers based on wRVUs, professional collections, or other productivity-based measures, the coding change will affect how obstetrics and gynecology (OB/GYN) care is measured, attributed, and paid for.
What is changing about OB/GYN CPT codes?
In total, AMA identified approximately 35 maternity care code changes, including 17 deleted codes, 12 new codes, and 6 revised codes.3 Several key changes include
- Traditional global maternity CPT codes will be deleted and replaced with phase-specific codes.[2],[3]
- Antepartum and postpartum care will generally be reported using evaluation and management (E/M) codes.[2],[3]
- Labor management will be reported using new codes that distinguish between initial and subsequent days and between straightforward and complex labor management.
- Delivery codes will differentiate between routine and complex vaginal or cesarean births, and post-delivery care will also be reported separately.[2],[3]
According to the AMA, the purpose of the change is to better reflect contemporary obstetric care, which is often team-based and may involve multiple providers and locations and varying levels of clinical complexity and effort. Instead of bundling the entire pregnancy episode into one global service, the new structure is intended to create more accurate reporting of who provided care, when the care occurred, and the level of work that was required.[2],[3]
Why do the OB/GYN reimbursement changes announced by AMA matter?
The current global billing model can obscure differences in care delivery. For example, one physician may provide prenatal care; another may manage labor; and another may perform the delivery. Under the global model, the reimbursement and wRVU credit are typically attributed to the billing physician associated with the delivery, even though other members of the care team contributed meaningfully throughout the pregnancy episode.[2],[3]
Recognizing this limitation, many OB/GYN compensation models historically included mechanisms to allocate credit or compensation to other care team members, such as point systems, visit-based credit, shared productivity pools, call stipends, or other effort-based adjustments. With the 2027 changes by AMA, organizations will no longer manually identify who performed which component of the global service because it will be clearly identified through the discrete codes in each phase.
What do AMA’s OB/GYN changes mean for physician compensation models?
Private Practice
Private practices may need to reassess how maternity revenue and productivity are allocated among physicians and other clinicians. Under the current model, a large portion of reimbursement is tied to the delivery event. Under the new structure announced by AMA, revenue will be generated throughout the pregnancy and the postpartum period. This could affect partner compensation formulas, income distribution models, and call coverage arrangements.
Employed OB/GYN Physicians
Health systems and medical groups that compensate employed OB/GYN physicians based on wRVUs should evaluate how the coding changes may affect productivity targets, compensation thresholds, and benchmark comparisons. While the wRVUs associated with this change are anticipated to be budget neutral in the aggregate, shifts in the wRVUs assigned to each code plus changes in the provider(s) reporting the various components are likely to be impactful on an individual provider basis.
For example, more wRVUs may be attributed to midwives or advanced practice providers who support prenatal, labor, or postpartum care outside of the actual delivery. Because benchmark survey data will lag the coding change, published benchmarks may not fully reflect these attribution shifts for several years. Organizations may need to update compensation formulas and compliance guardrails as productivity patterns shift under the new coding structure.
Laborists and Hospitalists
Laborist and obstetric hospitalist models may be particularly affected by AMA’s changes because the new coding structure separates labor management, delivery, and other maternity care services. Specifically, predelivery labor management, delivery, and subsequent labor management will be distinct segments. As a result, credit that was historically concentrated around a single delivery code will now be separated into multiple codes and could be distributed across multiple providers. Laborists paid under a productivity (per-wRVU) model could experience compensation changes if productivity targets, conversion factors, or other plan terms are not adjusted to reflect the new attribution methodology.
How PYA Can Help
PYA can help hospitals, health systems, and medical groups assess and plan for the impact the adoption of the AMA codes will have on compensation, operations, financial management, and documentation and coding requirements. Our Healthcare Provider Compensation Valuation and Design team can help estimate the potential impact on reimbursement and wRVU attribution; evaluate existing physician, laborist, advanced practice provider, and midwife compensation plans; and develop transition strategies that are consistent with fair market value, commercial reasonableness, and organizational goals. As productivity benchmarks adjust over time, PYA can help organizations establish new compensation guardrails and prepare for a smoother transition to the new coding structure.
What’s Next?
PYA will be publishing additional articles and webinars addressing the critical impacts these changes will have on OB/GYN practices. Stay tuned for deeper dives on provider compensation, operations, financial management, documentation and coding requirements, care delivery, and patient experience related to the changes in maternal care codes. In the meantime, organizations interested in submitting comments to CMS regarding its considerations are encouraged to do so before the September 14 deadline.
[1] “CPT 2027 Maternity Care Service Codes Changes”, <https://www.ama-assn.org/practice-management/cpt/cpt-2027-maternity-care-services-code-changes>, accessed June 24, 2026.
[2] “CPT 2027 FAQs: CPT 2027 Maternity Care Services Code Changes”, <https://www.ama-assn.org/practice-management/cpt/faqs-cpt-2027-maternity-care-services-code-changes>, accessed June 24, 2026.
[3] “AMA Creates New Maternity Care Coding System”, <https://www.healthcaredive.com/news/ama-maternity-code-overhaul-pregnancy-obgyn-cpt/813363/>, accessed June 24, 2026.
[4] https://www.federalregister.gov/documents/2026/07/16/2026-14327/medicare-and-medicaid-programs-cy-2027-payment-policies-under-the-physician-fee-schedule-and-other
[5] Healthcare Common Procedure Coding System
