In anticipation of the transition from the global obstetric codes to the 2027 maternity services codes going into effect January 1, 2027, claims and documentation for patients presenting for their first prenatal visit after confirmation of pregnancy on or after September 1, 2026, will require the use of evaluation and management (E/M) codes, along with the appropriate ICD-10-CM codes, including weeks of gestation (Z3A) codes to identify the gestational age of the pregnancy.
Documentation must support the reported service based on medical decision making (MDM) or time, consistent with current CPT guidelines.
Quartz recommends HCPCS modifier “TH” be appended to prenatal and postpartum obstetrical treatments/services.
| Timeframe for first prenatal visit | Coding guidance |
|---|---|
| Prior to 5/15/2026 | Continue using the current global obstetric package codes, as these patients are expected to deliver in 2026. |
| 5/15/2026 – 7/14/2026 | Report 59436 (7 or more antepartum visits) with the appropriate delivery code—either the current delivery-only code for deliveries occurring in December 2026 or the new maternity services codes for deliveries in 2027. |
| 7/15/2026 – 8/31/2026 | Providers may report 59425 (4–6 antepartum visits) for antepartum care provided in 2026, as these patients are expected to deliver in 2027 and will likely have 4–6 prenatal visits during 2026. |
| On or after 9/1/2026 | For patients whose first prenatal visit after confirmation of pregnancy occurs on or after this date, transition to reporting E/M codes for prenatal visits (generally fewer than three visits in 2026), consistent with current CPT guidelines. |
