What the 2027 Physician Fee Schedule Means for OB/GYNs | ACOOG
What the 2027 Physician Fee Schedule Means for OB/GYNs
Medicare adopts the new maternity care codes on January 1, 2027. Payment rates go down, and the same-day visit rules change for office procedures.
On November 4, the Centers for Medicare & Medicaid Services (CMS) released its final Calendar Year 2027 Medicare Physician Fee Schedule. For obstetric care, the big news is the codes. Starting January 1, 2027, Medicare will recognize the new American Medical Association (AMA) Current Procedural Terminology (CPT) maternity care code set, which retires the global bundled maternity codes and replaces them with codes for separate services, including evaluation and management (E/M) codes for prenatal visits.
The 15 G-codes CMS floated in its July proposal, which would have kept a global-style payment structure in place for Medicare, didn't make the final rule.
The new maternity codes
Under the old global codes, nearly ten months of care sat inside one payment. The new structure lets patients see what their maternity care costs, including which prenatal and postpartum visits carry no copay.
CMS got a lot of input before it decided. The July draft drew 44,287 public comments, and the AMA, the Ob Hospitalist Group and the American College of Obstetricians and Gynecologists all asked CMS to adopt the new codes without a parallel G-code set.
Pregnancies that cross into 2027
The Department of Health and Human Services (HHS) is letting health plans accept the 2026 CPT maternity codes in 2027 when care began in 2026 and ends in 2027. Any pregnancy with a first prenatal visit in 2027 goes on the new codes.
Payment changes
Both conversion factor cuts are deeper than the July proposal projected.
$32.63
Down 2.31%
Conversion factor for physicians outside a qualifying advanced alternative payment model (APM), down from $33.40.
$32.95
Down 1.83%
Conversion factor for qualifying APM participants, down from $33.57.
20%
Same-day reduction
Cut to the lower-paid service when an E/M visit with modifier 25 falls on the same day as a 0-day global procedure.
July's proposal projected cuts of 1.68% and 1.19%. Most of the drop comes from the end of the one-year 2.5% increase Congress gave physicians for 2026.
If your practice does office gynecology procedures, look closely at the same-day visit policy. It applies when the same physician, or a physician of the same specialty in the same group, bills both services. CMS had proposed a 50% cut that also reached 10- and 90-day global procedures, and it scaled back after comments.
A few other changes reach most OB/GYN offices:
- G2211, the visit complexity add-on, becomes modifier B1 and raises the E/M payment 16% at every visit level.
- Traditional Merit-based Incentive Payment System (MIPS) reporting ends with the 2031 performance period, so you have through 2030 to move to MIPS Value Pathways or an advanced APM.
- Medicare telehealth flexibilities run through December 31, 2027, under the Consolidated Appropriations Act, 2026.
Before January 1
January 1 is eight weeks out. Start with these four steps.
List your crossover pregnancies
Work with your billing team to list every patient whose care started in 2026 and will end in 2027, since plans are allowed to take those claims on the 2026 codes.
Check prenatal visit notes
Each prenatal visit now bills with an E/M code, so each note needs to support that code on its own.
Call your largest payers
Ask your commercial and Medicaid plans how they're handling the transition and when their 2027 fee schedules will reflect the new codes.
Size the same-day change
If you bill a lot of same-day visits alongside office procedures, run last year's claims against the 20% reduction to see what it costs you.
The final rule publishes in the Federal Register on November 9, 2026.
On-demand CME · Free for members
The New Obstetric Codes: Preparing Your Practice for the 2027 Maternity Care Transition
Walk through the four-phase code structure, prenatal E/M reporting and the documentation you'll need. Earn 1 AOA Category 1-A credit and 1 AMA PRA Category 1 Credit™. Available through December 31, 2026.
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