Starting January 2027, OB-GYNs will ditch the old lump-sum "bundled payment" system and bill insurers à la carte for each maternity service they provide. The AMA's new coding system promises more personalized care — especially for high-risk pregnancies and postpartum patients — but critics warn it could drive up costs for families and insurers alike.
Starting January 2027, OB-GYNs will swap out the decades-old "bundled payment" model — a single lump sum covering prenatal visits, delivery, and postpartum care — for a new à la carte fee-for-service system. The American Medical Association's new billing codes, backed by the American College of Obstetricians and Gynecologists (ACOG), are designed to better reflect the complexity of modern obstetric care, where patients are older, sicker, and often need care from multiple providers across multiple settings.
Supporters say the change is long overdue. The old system capped prenatal visits at an arbitrary 13 and typically covered just one or two postpartum visits — even though more than half of pregnancy-related deaths occur within a year of birth. The new codes will allow physicians to tailor care to individual needs and get paid for doing so, including extended postpartum monitoring for conditions like depression, gestational diabetes, and cardiac changes.
By the Numbers:
Why it matters: The U.S. has the highest maternal mortality rate among peer nations, and this billing overhaul could unlock better, more personalized postpartum care. But the shift back to fee-for-service raises real concerns about cost inflation — for patients, employers, and insurers — making careful implementation critical.
