Important Update- Upcoming NYSDOH changes to Global Obstetric Codes for Antepartum Services
IMPACTED LOB’s: Medicaid, HARP, HIV-SNP
TO: Obstetricians and Perinatologists
Dear MetroPlusHealth Provider,
Effective January 1, 2027, the American Medical Association (AMA) and the American College of Obstetricians and Gynecologists (ACOG) will replace global obstetric (OB) codes with itemized, visit-level billing codes. These global obstetric codes will no longer be payable after the effective date. This change aligns with the goal of improving transparency into antepartum, labor, delivery, and postpartum care.
Providers are required to adhere to this change by billing the appropriate non-bundled antepartum, labor, and delivery codes, as applicable. New York Medicaid adopted these coding changes effective June 1, 2026 for members with an estimated delivery date on or after January 1, 2027. Providers must bill routine antepartum and postpartum care using the Evaluation and Management (E/M) codes listed below with the TH modifier for members with estimated delivery dates on or after January 1, 2027. In addition, providers are required to report Category II CPT Code 0500F on the claim for the initial antepartum visit.
For members with estimated delivery dates prior to January 1, 2027, providers must continue to bill using the existing global OB codes.
MetroPlusHealth will provide additional guidance in 2027, regarding labor management, delivery, and postpartum billing requirements as further information becomes available. We are prepared to support providers throughout the implementation of these changes. Please see the tables below for additional guidance.
| CPT Code | CPT Description |
|---|---|
| 99202 | Office or Other Outpatient Visit for New Patient |
| 99203 | Office or Other Outpatient Visit for New Patient |
| 99204 | Office or Other Outpatient Visit for New Patient |
| 99205 | Office or Other Outpatient Visit for New Patient |
| 99211 | Office or Other Outpatient Visit for Established Patient |
| 99212 | Office or Other Outpatient Visit for Established Patient |
| 99213 | Office or Other Outpatient Visit for Established Patient |
| 99214 | Office or Other Outpatient Visit for Established Patient |
| 99215 | Office or Other Outpatient Visit for Established Patient |
| 99341 | Residence Visit for New Patient with Straightforward Medical Decision Making |
| 99342 | Residence Visit for New Patient with Low Level Medical Decision Making |
| 99344 | Residence Visit for New Patient with Moderate Level Medical Decision Making |
| 99345 | Residence Visit for New Patient with High Level Medical Decision Making |
| 99347 | Residence Visit for Established Patient with Straightforward Medical Decision Making |
| 99348 | Residence Visit for Established Patient with Low Level Medical Decision Making |
| 99349 | Residence Visit for Established Patient with Moderate Level Medical Decision Making |
| 99350 | Residence Visit for Established Patient with High Level Medical Decision Making |
| 99417 | Prolonged Outpatient Service, Each 15 Minutes |
| CPT Code | CPT Description |
|---|---|
| 59400 | Vaginal delivery with antepartum and postpartum care |
| 59425 | Antepartum care only; four to six visits |
| 59426 | Antepartum care only; seven or more visits |
| 59510 | Cesarean delivery with antepartum and postpartum care |
| 59610 | Vaginal birth after cesarean delivery with antepartum and postpartum care |
| 59618 | Cesarean delivery after attempted vaginal delivery with antepartum and postpartum care |
If you have any questions or require additional clarification, please contact Provider Relations Operations at [email protected]