{"id":7059720,"date":"2026-09-17T06:49:15","date_gmt":"2026-09-17T06:49:15","guid":{"rendered":"https:\/\/peraltafinancing.com\/business\/insurance\/maternity-billing-is-changing-in-2027-but-the-bigger-story-may-be-the-opportunity\/"},"modified":"2026-09-17T06:49:15","modified_gmt":"2026-09-17T06:49:15","slug":"maternity-billing-is-changing-in-2027-but-the-bigger-story-may-be-the-opportunity","status":"publish","type":"post","link":"https:\/\/fivemor.com\/?p=7059720","title":{"rendered":"Maternity Billing Is Changing in 2027, But the Bigger Story May Be the Opportunity"},"content":{"rendered":"


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Beginning January 1, 2027, professional maternity care billing will change significantly. For decades routine prenatal, delivery, and postpartum professional services have generally been grouped within a global maternity bill.\u00a0 According to a recent article from the American Medical Association<\/a>, under the new structure, professional care will be reported separately across four phases: prenatal care, labor management, delivery, and postpartum care.<\/p>\n

For employers, this is more than just a billing change. Claims may appear earlier and at more points throughout the maternity period, potentially affecting claim timing, cash flow, reporting, and administration. The added detail may help employers recognize needs sooner, evaluate maternity resources, and make better-informed health plan decisions.<\/p>\n

What is Actually Changing?<\/h4>\n

A common misconception is that maternity care is moving from one claim to dozens of separate claims that will inevitably increase costs. Employers already see separate claims for certain parts of maternity care.<\/p>\n

For example, delivery accounts for approximately 60% of spending across the prenatal, delivery, and 12-month postpartum periods according to a study conducted by the Health Care Cost Institute<\/a>. Many hospital, anesthesia, and other delivery-related claims are already visible. Laboratory tests, ultrasounds, and other imaging also appear separately.<\/p>\n

What will be different is the reporting of routine professional maternity care.<\/strong> The American Medical Association article\u00a0states that prenatal visits, labor and delivery management, and postpartum care previously grouped within the global maternity bill will appear as individual claims. More claims will not necessarily mean more care or higher total maternity costs. Previously grouped services may simply appear separately.<\/p>\n

What This Could Mean for Health Plans and Members?<\/h4>\n

Pregnancy remains a significant and variable healthcare event for employer-sponsored health plans. Among more than 440,000 births covered by employer-sponsored insurance, average spending across prenatal care, delivery, and 12 months postpartum was $25,669 according to the Health Care Cost Institute study. Although actual plan experience will vary, the new billing structure may change how and when maternity spending appears.\u00a0 Employers may see:<\/p>\n