New billing codes likely to raise maternity costs
July 22, 2026
I have an op-ed in STAT News this morning on the likely cost impact of eliminating global professional billing codes for maternity care. My read is that employers and Medicaid programs will bear the brunt of higher costs, with no guarantee of better outcomes.
It’s accompanied by a counterpoint from Camille Clare and Lisa Hofler of the American College of Obstetricians and Gynecologists (ACOG), who argue that bundled billing has hurt rural hospitals, confused patients, and made it harder to study maternal health outcomes. I hope you’ll read both.
We agree the change won’t likely raise patients’ out-of-pocket costs. Where we differ: I’m skeptical of the assumption, shared by ACOG and the American Medical Association, that this will be cost-neutral for health plans. Separate billing codes already existed for prenatal-only, delivery-only, and postpartum-only care, so rural hospitals could already bill for their share when a patient was transferred before delivery. The bigger risk from unbundling is that it will encourage more procedures and higher billing intensity across the board.
I think it will change OOP costs in an important way because cost sharing will mean exposure at every visit
Thanks Neel. The prenatal and postpartum visits should be covered with no cost sharing, so I think this change will increase insurance costs, but that is likely not to be transmitted to members except through higher premiums in the future. Patients could face additional costs if the number of procedures billed increases - although I believe most people hit their out-of-pocket maximums in a year when they have a delivery.