AMA modernizes maternity care coding to reflect today's obstetric care

CHICAGO - The American Medical Association (AMA) is making the most significant update to maternity care coding in decades to reflect how pregnancy care is delivered and improve the data needed to advance maternal health.

The revised Current Procedural Terminology (CPT®) codes replace the decades-old global maternity care bundle with a reporting framework that captures four distinct phases of care-antepartum care, labor management, delivery, and postpartum care. The changes will provide welcome transparency for patients and better reflect modern obstetric practice and provide more meaningful clinical information to support quality improvement, maternal health research, and future payment models. Importantly, it will not increase patient cost-sharing.

The AMA has been working to improve health in the United States, which has the highest maternal mortality rate among high-income nations. The current coding system provides insufficient insight for physicians and researchers looking to reduce and prevent rising rates of maternal mortality and serious or near-fatal maternal morbidity in the United States. The new maternity codes will help with much needed data to address the crisis.

The revisions were developed over nearly two years by a multidisciplinary workgroup convened by the CPT Editorial Panel, bringing together practicing obstetricians, family physicians, certified nurse midwives, and payers. The changes are supported by the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians, whose members provide the majority of maternity care in the United States.

For decades, maternity care has largely been reported through a single code representing approximately ten months of care. This approach fails to capture modern obstetric care where patients often receive care from multiple physicians and care teams. The new coding system will support a patient-centered approach with information about the specific services each pregnant woman needs instead of one-size-fits-all.

For the first time, physicians, researchers, and health systems will be able to analyze each phase of maternity care separately, providing a clearer picture of where complications arise and where quality improvement efforts can have the greatest impact.

"Physicians cannot improve what they cannot measure. These CPT revisions give physicians, researchers, and policymakers a clearer understanding of the care mothers receive throughout pregnancy and after delivery, helping identify opportunities to improve quality, strengthen accountability, and improve outcomes for mothers and babies," said AMA President Willie Underwood III, MD, MSc, MPH.

An analysis conducted using data from more than 650 physicians and certified nurse midwives, together with clinical and payer data, found that the revised coding framework will not increase costs compared with the existing global maternity care codes.

The revised maternity care CPT codes take effect Jan. 1, 2027, giving physicians, health systems, payers, and technology vendors time to prepare for implementation. The AMA is working closely with physicians, the Centers for Medicare & Medicaid Services, payers, and electronic health record vendors to support a successful transition.

"Better information leads to better care," Dr. Underwood said. "Modernizing how maternity care is reported gives physicians a clearer picture of every stage of pregnancy and postpartum care, helping physicians improve outcomes for mothers and babies and laying a stronger foundation for maternal health research and quality improvement."