How OB-GYNs Get Paid Is Changing for the First Time Since the 1990s.

Starting in January, OB-GYNs will be able to bill insurers for individual services rather than the single bundled payment that has covered prenatal care, delivery, and postpartum since the 1990s. The change comes through new billing codes issued by the American Medical Association, and it represents the first structural overhaul of obstetric payment in more than three decades.

The bundled payment model, known as the global fee, was designed to simplify billing. In practice, it created a flat rate for pregnancy care regardless of a patient’s complexity. A routine delivery and a high-risk delivery carried the same reimbursement. An extra postpartum visit for a patient with severe preeclampsia was not separately billable, so in many practices it simply did not happen.

The new codes are designed to reward providers for doing more when patients need more. Whether that is what actually happens is the central debate this change has opened.

Supporters point to a stark statistic: more than half of pregnancy-related deaths in the United States occur in the year after birth. The postpartum period is where the greatest unmet clinical need sits, and it has historically been the least reimbursed. The new codes, in theory, allow practices to schedule and bill for extended postpartum follow-up for patients who need it, creating a financial case for care that the global fee made impractical.

Critics are less optimistic. Unbundling a service that was previously all-inclusive gives providers the mechanism to bill separately for every visit and procedure that was once folded into one payment. Whether that drives better care or higher patient costs depends on insurer contracts, practice incentives, and a regulatory environment that has not yet caught up to the change. Patients should expect these new codes to appear on explanation-of-benefits forms beginning next year.

Source: Axios, July 2026. New AMA billing codes take effect January 2027.