UnitedHealthcare Has Said How to Bill Pregnancies That Run Into 2027. From January 1, Prenatal Visits Are Billed One at a Time.

For years, most practices that deliver babies have billed a pregnancy as one package. Prenatal visits went out as no-charge encounters, and the money arrived after delivery on a single global claim. That ends on January 1, 2027.

The AMA says CPT 2027 changes 35 maternity codes: 17 deleted, 12 new and 6 revised. The deleted codes are invalid for dates of service on or after January 1, 2027. Prenatal care, labor, delivery and postpartum care are reported in phases instead of as one global service. The hard question for a practice is the patient who is pregnant today and delivers next spring. UnitedHealthcare's October 2026 commercial reimbursement bulletin is one of the first payer notices to answer it.

What UnitedHealthcare's bulletin says

The bulletin updates UnitedHealthcare's Obstetrical Services Policy, Professional, for commercial plans, effective January 1, 2027. For pregnancies that span the two years, it says:

• Services on or before December 31, 2026 are reported under CPT 2026 rules, including 59425, 59426 or the applicable E/M services.
• Services on or after January 1, 2027 are reported with the appropriate E/M code. The antepartum-only global codes no longer apply to services in 2027 and later.
• Antepartum and postpartum services are reported with the E/M code, modifier TH and an obstetrical primary diagnosis.
• Dipstick urinalysis during the antepartum period is not paid separately.

The bulletin adds one condition. CMS has proposed its own maternity HCPCS G-codes for 2027. If CMS finalizes them as proposed, UnitedHealthcare says providers should report with those G-codes. If not, the phase-based CPT reporting above applies. UnitedHealthcare expects the CMS rule in November 2026 and says it may revise its guidance to match.

Why the date of service now decides the bill

Under the old model, a practice could wait for the delivery and bill everything at once. From January 1, each prenatal visit is its own claim, with its own E/M level chosen by medical decision making or time, and its own chance of a denial. A patient who started care in September 2026 will have visits billed under two sets of rules. The 2026 visits need to go out under the 2026 rules, and the 2027 visits as individual E/M claims.

That also changes cash flow. Revenue that used to arrive in one payment after delivery will now come in visit by visit, and so will patient cost-sharing. Front desk staff who have told patients for years that prenatal visits have no copay may need a new answer, depending on the plan.

Other payers may not match

UnitedHealthcare's bulletin covers its commercial plans. Medicare's approach depends on the final 2027 Physician Fee Schedule, which the AMA expects in early November 2026. CMS proposed 15 new G-codes that would keep a single-payment option for Medicare, and ACOG has objected to that option. Medicaid plans and other commercial payers may set their own transition rules. Until each payer publishes its policy, a practice should not assume another payer will follow UnitedHealthcare.

A check to run before January 1

This is general information, not legal or billing advice for your practice. A practice that delivers babies can prepare now:

• Pull a list of every patient with an expected delivery date on or after January 1, 2027, by payer. These are the pregnancies that cross the line.
• For each one, decide how the 2026 prenatal care will be billed under the 2026 rules, and make sure those claims are ready to go out for dates of service through December 31.
• Set up E/M charge capture for prenatal visits from January 1, with modifier TH and an obstetrical primary diagnosis (a Z34 or O-chapter code) where the payer calls for it.
• Remove dipstick urinalysis charges from prenatal visits for UnitedHealthcare commercial patients, since the bulletin says they won't be paid separately.
• Ask your top payers in writing how they will handle the transition, and file the answers where your billers can find them.
• Check payer contracts and fee schedules for rates tied to the deleted global codes. A rate that points to a deleted code needs a replacement.
• Watch for the Medicare final rule in early November and update your Medicare workflow if CMS finalizes the G-codes.

Practices that sort this out in November will spend January billing. Practices that wait will spend February working denials on prenatal visits.

One pregnancy, two rulebooks

The switch from one global claim to many visit claims means more claims, more chances for a missing modifier or diagnosis, and more patient balances to collect. VOSKPO helps practices set up and check those rules before the first claims go out. A revenue review can show where your current maternity billing is leaving money on the table.