As the industry continues to await the Centers for Medicare & Medicaid Services (CMS) final rule regarding maternity care coding for 2027, Cigna Healthcare^® continues to evaluate and refine potential coding implementation approaches.

We are working to provide clear and timely guidance so providers can adequately prepare for any billing and reporting changes that may be required beginning in 2027.

Pending the CMS final rule, the following updated guidance outlines Cigna Healthcare’s anticipated approach to maternity coding beginning January 1, 2027.

Potential changes for 2027

Scenario 1: CMS finalizes the proposed G-codes. If the currently proposed creation of 15 Healthcare Common Procedure Coding System (HCPCS) Level II G-codes is approved by CMS, Cigna Healthcare plans to adopt these codes on January 1, 2027. This would largely preserve the existing global maternity billing and reimbursement structure.

Scenario 2: CMS does not finalize the proposed G-codes. If the G-codes are not approved by CMS, Cigna Healthcare plans to adopt the American Medical Association’s (AMA) maternity coding and reporting framework on January 1, 2027. In this instance, providers should expect Cigna Healthcare to implement the AMA’s new maternity coding structure, as follows:

• Global maternity CPT® codes would no longer be used for services rendered on or after January 1, 2027. 
• Maternity care should be reported based on the specific services provided during the antepartum, labor management, delivery, and postpartum phases of care.
  • Routine antepartum and postpartum services are expected to be reported using the appropriate Evaluation and Management (E/M) code and any applicable diagnosis coding, modifiers, and reporting requirements as established in final Cigna Healthcare billing guidance. 
• Cigna Healthcare recognizes that some maternity episodes may span both 2026 and 2027. Additional transition guidance, including billing instructions for these scenarios, will be communicated after CMS publishes its final rule.

What applies in either scenario

• These coding changes are not intended to change customers’ eligibility for covered maternity services, which remains subject to applicable benefit plan terms.
• Provider billing, coding, and claims submission requirements will change. Cigna Healthcare will update applicable reimbursement policies and billing resources to reflect the finalized code set and communicate any policy updates before implementation.

2026 billing guidance remains unchanged

At this time, there are no changes to existing Cigna Healthcare maternity billing guidance, coding requirements, or reimbursement policies for services rendered through December 31, 2026. Until additional final guidance is issued, providers should continue to bill and report maternity services for patients with Cigna Healthcare benefit plans in accordance with existing contractual requirements, reimbursement policies, and current maternity coding and billing practices.

Additional details, implementation guidance, and provider education materials will be shared later this year after CMS publishes its final rule.

Questions?

The Provider Newsroom will be updated with the latest Cigna Healthcare maternity billing guidance as it becomes available. If you have any questions, please contact us at AMAMaternityCodes@CignaHealthcare.com.

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August 24, 2026

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, including reimbursement guidance for routine prenatal care rendered in 2026.

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.