Cotiviti says 2027 maternity coding changes require major health plan preparations

PUBT · 3d ago
Cotiviti says 2027 maternity coding changes require major health plan preparations
  • Health plans face substantial claims-processing changes as American Medical Association maternity coding shifts away from bundled services on January 1, 2027.
  • Payment policies, provider contracts and claims-editing systems need updates to accommodate encounter-based reporting across maternity episodes.
  • CMS is considering 15 Medicare-specific codes to preserve global maternity payments; ACOG opposes the proposal, leaving Medicare implementation uncertain.
  • Providers are encouraged to report prenatal care through evaluation and management services during 2026 for pregnancies continuing into 2027.
  • More detailed claims data could improve quality measurement, risk adjustment and maternal outcomes analysis.


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