Upcoming Billing Change Could Make Pregnancy Pricier

MONDAY, June 8, 2026 (HealthDay News) — Having a baby in the United States is about to get more complicated.

Under new billing codes that take effect in January, doctors who manage maternity care will start charging à la carte for visits and services related to pregnancy, childbirth and postpartum care. It’s an about-face from recent years, when doctors have often received a single “bundled” payment for maternity care they provided. 

Although OB-GYNs strongly back the change and have pushed for it for years, some patient advocates and employers say it’s an open question whether the new system will result in better care or increased patient costs.

The American College of Obstetricians & Gynecologists says the change is crucial to accurately reflect the care OB-GYNs currently provide, with expectant patients — some older and sicker than in decades past — more likely to have complex medical and social needs and receive care in multiple settings from multiple practitioners.

For example, under current bundled obstetrics coding, the number of prenatal visits is set at a fairly arbitrary 13, “which is not really what most people need,” said Dr. Lisa Hofler, chair of the Department of Obstetrics and Gynecology at the University of New Mexico and a member of the ACOG committee that developed the new codes in conjunction with the American Medical Association.

The new fee-for-service codes will better accommodate more or fewer visits, either in person or remotely, based on individual needs.

Under the current system, “if someone comes in for a birth, no matter how long or how short their labor or how complicated or uncomplicated their delivery, the global reporting is the same because we only have one code,” Hofler said.

The new, more precise codes will help the growing number of medical professionals who may play a role in maternity care — such as midwives, hospitalists focused on labor and delivery, and maternal-fetal medicine specialists — to account for, and get paid for, the range of services they provide.

For patients, however, especially the growing number with high-deductible health plans, the new system may result in higher out-of-pocket bills, some maternity experts say.

“The cost piece is really critical,” said Dr. Laurie Zephyrin, an OB-GYN and the senior vice president for the Achieving Equitable Outcomes initiative at The Commonwealth Fund, a health research nonprofit. “There will be more line items. Will that be passed along to patients, particularly those that are in commercial plans, in high-deductible plans?”

Whether families will pay more out-of-pocket “really comes down to how payers choose to implement these codes,” Zephyrin said.

Insurance industry representatives said they are concerned with the implementation timeline, which will require significant operational changes.