global maternity billing question

[jebond123]

Hi
I understand that there is limited information thus far pertaining to the 2027 maternity coding changes but I am at a loss
of what to tell patients who are asking for a financial estimate. Does anyone have any solutions/work arounds for this?
We have patient's who are due at the beginning of the year and are asking how much they will owe. I have been periodically
checking the insurance websites and they don't have the 2027 allowables posted yet.
Thanks for any input.

 

[RCiscoObGyn]

Hi
I understand that there is limited information thus far pertaining to the 2027 maternity coding changes but I am at a loss
of what to tell patients who are asking for a financial estimate. Does anyone have any solutions/work arounds for this?
We have patient's who are due at the beginning of the year and are asking how much they will owe. I have been periodically
checking the insurance websites and they don't have the 2027 allowables posted yet.
Thanks for any input.

Hi,

I try to keep the explanation as simple as possible because I feel it's confusing for anyone who isn’t a coder or biller (it's confusing enough for me! LOL). I tell patients that maternity billing is changing nationwide in 2027, and right now the only estimate I can give is based on how it’s billed today. I explain that each visit will be billed separately instead of everything being charged at delivery, and that while we don’t expect a major difference in the total cost for routine prenatal care, delivery, and postpartum visits, we won’t know more until the 2027 prices come out. I also let them know that if they need more than routine care, their costs could be a little higher. I tell them to treat the estimate as a ballpark range, and as soon as we have updated information, we’ll reach out to them. I keep a spreadsheet of their contact info so I can return their calls once we know more.

 

[ayo@substrate.cc]

Hi
I understand that there is limited information thus far pertaining to the 2027 maternity coding changes but I am at a loss
of what to tell patients who are asking for a financial estimate. Does anyone have any solutions/work arounds for this?
We have patient's who are due at the beginning of the year and are asking how much they will owe. I have been periodically
checking the insurance websites and they don't have the 2027 allowables posted yet.
Thanks for any input.

This is pretty mixed and ambiguous. I've read several dozen policy updates at this point and almost all of them are either silent on the cost share question, or indicate that patient cost share should be unchanged (and that routine office visits for antepartum pregnancy care is considered preventative and has no cost share). examples

Focused Silver HMO: https://22health.com/wp-content/uploads/2025/11/focusedsilver06.pdf


Aetna: https://es.aetna.com/content/dam/aetna/pdfs/olu/officelink-updates-september-2026-olu.pdf