Earlier this year, the American Medical Association (AMA) published a new maternity coding framework and guidelines that represent a significant shift in how maternity care services are to be reported and billed beginning, January 1, 2027.

The new AMA framework replaces the traditional global maternity package with more detailed Current Procedural Terminology (CPT®) coding across all phases of maternity care. The AMA has indicated these changes are intended to improve transparency, support team-based care, enhance data quality, and better align coding with today’s obstetric care delivery models.

The latest industry guidelines

The Centers for Medicare & Medicaid Services (CMS) recently released the Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule, which outlines two proposed approaches to maternity care coding beginning in 2027:

1. Implement the new AMA maternity care CPT coding framework, including proposed Medicare payment values for those codes; or
2. Create 15 new Healthcare Common Procedure Coding System (HCPCS) Level II G codes, which would largely maintain the current global maternity coding and reimbursement structure.

CMS is seeking public comments on both approaches and has not yet made a final decision.

Cigna Healthcare billing guidelines

During this transition period, Cigna Healthcare® believes maintaining the current billing guidance is the best way to promote access to care, minimize administrative burden, and avoid unnecessary disruption for providers and patients.

Therefore, Cigna Healthcare is not changing its current maternity billing guidance at this time.

For patients whose initial prenatal visits occur on or after September 1, 2026, in order to avoid payment delays or unnecessary claims reprocessing:

• Do not submit the American College of Obstetricians & Gynecologists (ACOG) proposed and AMA-recommended prenatal care Evaluation and Management (E/M) CPT codes.
• Continue to bill and report maternity services in accordance with existing contractual requirements and Cigna Healthcare reimbursement policies.
• Continue to use the same maternity billing processes used today.

We will continue to monitor industry developments and provide additional 2027 billing guidance later this year.

Questions?

The information in the Provider Newsroom will remain up-to-date and include information on the latest Cigna Healthcare billing guidance. If you have any questions, please contact us at AMAMaternityCodes@CignaHealthcare.com.