This edition of “Spotlight on CPT” focuses on antepartum care coding, an area that will see significant change with the 2027 CPT code set.
Antepartum care refers to the period of pregnancy prior to the onset of labor. Historically, maternity care coding has relied heavily on global codes that captured large portions of pregnancy care under one reporting structure. The 2027 changes move away from that global approach and instead focus on the specific phase of care being provided.
Under the revised structure, antepartum care will be reported with evaluation and management codes rather than the current antepartum care-only codes. This change allows the code assignment to better reflect the location and level of service provided. Office, hospital, observation, home, residence, telemedicine, and critical care services will each be captured through the appropriate E/M code family.
For office or outpatient antepartum visits, codes 99202-99205 and 99211-99215 may be used. Telemedicine services may be reported with codes 98000-98015 or 98016, while home or residence services may be reported with codes 99341-99350. Hospital inpatient and observation services continue to be captured with the applicable initial, subsequent, or same-day admission and discharge codes. Critical care, when supported, may be reported with 99291 and 99292.
A key coding concept involves patients who are evaluated at one site and then admitted to the hospital or placed in observation. For example, a patient may first be seen in the office or emergency department before being sent to the hospital for additional monitoring or treatment. In these cases, it is appropriate to report the service at the initial site separately when supported by documentation. Modifier 25 should be appended to the separately identifiable E/M service.
The 2027 transition will also affect patients whose antepartum care spans both 2026 and 2027. For services provided in 2026, current CPT coding still applies, including 59425 for four to six antepartum visits and 59426 for seven or more visits. For one to three antepartum visits, the appropriate E/M codes are reported. Beginning in 2027, antepartum care will be reported per visit using E/M codes.
The antepartum procedures and fetal invasive services section is also being restructured. Code 59050 for fetal monitoring during labor by a consulting physician with written report is deleted. Code 59051 remains available for fetal heart tracing interpretation and report. Several codes are also pulled into the antepartum procedure section, including cervical cerclage, external cephalic version, multifetal pregnancy reduction, and removal of cerclage suture under anesthesia.
These revisions reflect the changing way maternity care is delivered. Not all patients receive every phase of care from the same physician or qualified health care professional. Patients may receive antepartum care from one provider, labor management from another, and delivery or postpartum care from yet another. The revised CPT structure allows each phase of care to be reported more accurately.
Now, light has been shed on antepartum care coding in the 2027 CPT maternity care revisions.
Antepartum care refers to the period of pregnancy prior to the onset of labor. Historically, maternity care coding has relied heavily on global codes that captured large portions of pregnancy care under one reporting structure. The 2027 changes move away from that global approach and instead focus on the specific phase of care being provided.
Under the revised structure, antepartum care will be reported with evaluation and management codes rather than the current antepartum care-only codes. This change allows the code assignment to better reflect the location and level of service provided. Office, hospital, observation, home, residence, telemedicine, and critical care services will each be captured through the appropriate E/M code family.
For office or outpatient antepartum visits, codes 99202-99205 and 99211-99215 may be used. Telemedicine services may be reported with codes 98000-98015 or 98016, while home or residence services may be reported with codes 99341-99350. Hospital inpatient and observation services continue to be captured with the applicable initial, subsequent, or same-day admission and discharge codes. Critical care, when supported, may be reported with 99291 and 99292.
A key coding concept involves patients who are evaluated at one site and then admitted to the hospital or placed in observation. For example, a patient may first be seen in the office or emergency department before being sent to the hospital for additional monitoring or treatment. In these cases, it is appropriate to report the service at the initial site separately when supported by documentation. Modifier 25 should be appended to the separately identifiable E/M service.
The 2027 transition will also affect patients whose antepartum care spans both 2026 and 2027. For services provided in 2026, current CPT coding still applies, including 59425 for four to six antepartum visits and 59426 for seven or more visits. For one to three antepartum visits, the appropriate E/M codes are reported. Beginning in 2027, antepartum care will be reported per visit using E/M codes.
The antepartum procedures and fetal invasive services section is also being restructured. Code 59050 for fetal monitoring during labor by a consulting physician with written report is deleted. Code 59051 remains available for fetal heart tracing interpretation and report. Several codes are also pulled into the antepartum procedure section, including cervical cerclage, external cephalic version, multifetal pregnancy reduction, and removal of cerclage suture under anesthesia.
These revisions reflect the changing way maternity care is delivered. Not all patients receive every phase of care from the same physician or qualified health care professional. Patients may receive antepartum care from one provider, labor management from another, and delivery or postpartum care from yet another. The revised CPT structure allows each phase of care to be reported more accurately.
Now, light has been shed on antepartum care coding in the 2027 CPT maternity care revisions.
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