Eduardo Lara-Torre, MD, FACOG, on the transition to unbundled obstetric billing for 2027

The landscape of maternal healthcare reimbursement is set for a fundamental shift as the long-standing global billing model will carry on only through 2026. At the 2026 2026 American College of Obstetricians & Gynecologists (ACOG) Annual Clinical & Scientific Meeting in Washington, D.C., Eduardo Lara-Torre, MD, FACOG, pediatric gynecologist, University of North Carolina at Chapel Hill, discussed how the unbundling of obstetric services will better align physician compensation with the clinical intensity of modern care.

Restructured maternity care billing coming 2027

For decades, obstetricians have primarily utilized a global payment model that bundles all antepartum visits, delivery, and routine postpartum care into a single "lump sum" payment. However, beginning January 1, 2027, the Current Procedural Terminology (CPT) code set will transition to a granular framework that replaces this traditional bundled model with itemized codes for distinct phases of care.

Lara-Torre characterized this shift as a victory for fair compensation, noting that the new structure allows physicians to bill for the specific work performed at each encounter.

“We're going to be billing every visit like they were coming in for traditional care, for a clinical visit, and then the delivery itself is going to be a different fee,” Lara-Torre stated.

Capturing the complexity of high-risk care

One of the primary limitations of the legacy global model was its inability to account for the variability in patient acuity. Under the bundled system, a patient requiring frequent, intensive surveillance due to high-risk conditions generated the same reimbursement as a low-risk patient requiring standard visits.

“Some patients require a lot more care, more frequent visits, and a lot more intense care for the visit they're in because of their high risk. In the past, we got compensated the same way. Didn't matter how many times they saw us or how difficult their care was. So this is going to be a game changer,” he explained.

The future of obstetric reimbursement

The shift to unbundled billing is designed to reflect the realities of contemporary practice, including the increased use of telehealth and remote patient monitoring. By moving to a service-level reporting model, ACOG and the AMA aim to improve transparency and ensure that payment accurately follows physician effort.

Lara-Torre noted that ACOG has been a "champion" in pushing for these changes to ensure physicians are compensated fairly for their contributions to maternal health. While the transition requires significant operational preparation, the ability to bill for postpartum care according to "the complexity that they have" rather than as an included service marks a critical step forward in sustaining obstetric practices and improving maternal health outcomes.

“The unbundling of the obstetric codes has been long overdue and will finally offer relief to so many ob-gyns who viewed the global obstetric payment as a major pain point,” said ACOG President Steven J. Fleischman, MD, MBA, FACOG, in a statement. “This new code structure now aligns with clinical guidelines and will reduce administrative burden, improve data collection, and enable ob-gyns to provide more tailored, patient-centered care while also being paid fairly and equitably so we can sustain our practices.”

Reference:

Fitch J. AMA, ACOG announce restructuring of maternity care coding for 2027. Contemporary OB/GYN. Published April 23, 2026. Accessed May 11, 2026. https://www.contemporaryobgyn.net/view/ama-acog-announce-restructuring-of-maternity-care-coding-for-2027