Global obstetric billing has long been the standard reimbursement model for maternity care. As it has been designed to allow OBGYN practices to report routine prenatal care, delivery services, and postpartum care under a single bundled payment structure.<\/p>\n\n\n\n
While this approach simplifies claims submission and reimbursement, it also requires a clear understanding of what services are included, excluded, and separately billable within the global package. <\/p>\n\n\n\n
As maternity care continues to evolve and with significant CPT coding changes scheduled for 2027, providers, practice administrators, and billing teams must prepare for a new era of obstetric reimbursement. This guide breaks down how global obstetric billing works, its limitations, and what the upcoming changes mean for OBGYN practices.<\/p>\n\n\n\n
Global obstetric billing is a reimbursement methodology used in OBGYN practices where a single CPT code is assigned to the entire episode of routine maternity care. When the same physician or group practice provides prenatal care, labor and delivery, and postpartum care, these services are bundled into one global claim rather than being billed individually.<\/p>\n\n\n\n
The intent behind this model is to standardize reimbursement, reduce administrative workload, and streamline payer processing for uncomplicated maternity cases across healthcare systems.<\/p>\n\n\n\n
Bundled reimbursement was intended to make the billing process easier for coverage of maternity care by combining multiple encounters into one claim from a revenue cycle perspective. This structure helps: <\/p>\n\n\n\n
For OBGYN practices, this reduces the need to submit separate claims for every prenatal and postpartum visit, creating a unified billing process for the entire care cycle.<\/p>\n\n\n\n
Under the global obstetric billing model, reimbursement is issued once the maternity episode is completed. When a patient is managed continuously by the same physician or group practice, all routine services are included under a single global CPT code.<\/p>\n\n\n\n
This usually includes:<\/p>\n\n\n\n
However, services that fall outside routine care, such as complications, high-risk management, transfers of care, or additional procedures, may be billed separately depending on payer rules and documentation.<\/p>\n\n\n\n
Here is an example which clearly illustrates the workflow clearly:<\/p>\n\n\n\n
A patient receives:<\/p>\n\n\n\n
If the same provider or group practice delivers all components of care, a single global CPT code is submitted at the completion of the pregnancy episode instead of billing each service individually.<\/p>\n\n\n\n
This bundled claim represents the complete maternity care cycle and forms the foundation of traditional obstetric reimbursement across most payer systems.<\/p>\n\n\n\n
The global maternity billing model is based on one episode of care that covers the entire pregnancy journey. This episode usually consists of three main care areas from a billing\/reimbursement perspective: antepartum, labor and delivery, and postpartum. Traditionally, each phase is a unique set of services, and is coordinated within a bundled 1 CPT code for the same physician or group practice. <\/p>\n\n\n\n
Antepartum care is the process of routine clinical care of a woman during her pregnancy before labour and delivery. In the global obstetric payment-for-service billable model, this component is a substantial part of the “bundled” payment and involves regular prenatal visits throughout pregnancy. <\/p>\n\n\n\n
Services typically include:<\/p>\n\n\n\n
From a billing perspective, these services are not individually reimbursed when the global package is applicable, as they are considered part of the bundled maternity episode.<\/p>\n\n\n\n
The labor and delivery phase represents the acute care component of the maternity episode and is one of the primary drivers of global obstetric reimbursement.<\/p>\n\n\n\n
This phase includes:<\/p>\n\n\n\n
In the global model, delivery services are subsumed in the single global cpt code if delivered by the same service provider or group of service providers. It is important to have documentation which clearly reflects the type of delivery carried out; this will be used to help identify codes to use and the value to be claimed for the delivery. <\/p>\n\n\n\n
Postpartum care is the next step in the maternity care continuum and is part of the global obstetric billing package when the same care provider or group practice provides it in the same global period of care. <\/p>\n\n\n\n
During this stage, there are usually the following: <\/p>\n\n\n\n
As far as the revenue cycle, the postpartum services are considered as ancillary services and are included in the global payment unless complications occur or extra non-routine services are delivered, at which point they may be billed separately according to the payer policy. <\/p>\n\n\n\n
Global obstetric billing is a standardized collection of CPT codes that define the full, continuum of maternity care services, provided by the same physician or group practice. These codes are designed to be a group of codes associated with antepartum, labor and delivery, and postpartum services all covered by one claim for an uncomplicated pregnancy. <\/p>\n\n\n\n
A code selection standpoint, appropriate code selection is the key to the revenue cycle since it affects the accuracy of reimbursements, the acceptance from payers, and adherence to documentation requirements. <\/p>\n\n\n\n
Commonly used Maternity CPT codes internationally are: <\/p>\n\n\n\n
Every code is a full maternity care package which is chosen according to the actual delivery result and course of pregnancy. <\/p>\n\n\n\n
In global obstetric billing, CPT selection is primarily driven by:<\/p>\n\n\n\n
Global coding may not be appropriate if the care is not rendered entirely by the same practice or the pregnancy episode is not fully completed within a single provider group, and other billing options (antepartum-only \/ delivery-only) may be used. <\/p>\n\n\n\n
It is important for clinical documentation to be accurate to support global obstetric coding. Typically, payers will want to see evidence of: <\/p>\n\n\n\n
One of the most frequently occurring reasons for claim delays, denials or underpayment in obstetric billing workflow is inadequate documentation. <\/p>\n\n\n\n
From a reimbursement and compliance standpoint, one of the most critical aspects of global obstetric billing is understanding exactly what is bundled into the global package and what must be billed separately. Payers expect strict adherence to these definitions, and improper separation of services is a common source of denials and audit exposure in OBGYN practices.<\/p>\n\n\n\n
In most cases, the global obstetric code will cover all routine, medically necessary services that are needed for an uncomplicated maternity experience throughout the entire span of pregnancy. <\/p>\n\n\n\n
These generally include:<\/p>\n\n\n\n
From a billing perspective, these services are not itemized individually when the global package is active, as reimbursement is consolidated into a single payment.<\/p>\n\n\n\n
Some of these services are not covered by the global maternity package and can be charged separately if adequately documented and as per the guidelines of the payers. <\/p>\n\n\n\n
Common exclusions include:<\/p>\n\n\n\n
These services are time-consuming and require their own coding and documentation, and are necessary to establish the medical necessity of the service to ensure compliance with reimbursement. <\/p>\n\n\n\n
Ensuring that practices are not underpaid by payers requires accurate identification of included and excluded services for OBGYN practices. Underpayment can occur through over-inclusive global billing and inappropriate unbundling can result in payer audits or recoupment action. <\/p>\n\n\n\n
Strong documentation practices and consistent coding workflows are critical to ensure that services are appropriately categorized within or outside the global maternity package.<\/p>\n\n\n\n
When it comes to obstetric revenue cycle management, knowing when to use global billing and when to use non-global<\/a> (itemized) billing is crucial to getting accurate reimbursement and compliance. The differences lie mostly in continuity of care, number of visits offered and whether the entirety of the maternity episode takes place within the same provider or under a group practice. <\/p>\n\n\n\n Global billing is used when a single physician or group practice has been hired to care for the entire maternity care episode from antepartum through delivery and postpartum follow-up. <\/p>\n\n\n\n Key characteristics include:<\/p>\n\n\n\n This model is typically used for uncomplicated pregnancies where care is continuous and not transferred between providers.<\/p>\n\n\n\n When the maternity care episode does not meet global-bundling criteria, it is billed as non-global. Rather, services are charged individually or partially (under the partial maternity codes). <\/p>\n\n\n\n Common scenarios include:<\/p>\n\n\n\n In such cases, providers can submit antepartum-only codes, delivery-only codes, and postpartum visits as separate services according to the guidelines of the various payers. <\/p>\n\n\n\nGlobal Maternity Billing (Bundled Model)<\/h3>\n\n\n\n
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Non-Global (Itemized) Maternity Billing<\/h3>\n\n\n\n
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Global vs Non-Global Billing Comparison<\/h3>\n\n\n\n