The Centers for Medicare & Medicaid Services has proposed new billing codes for maternity care that would keep the current global payment system in place. The American College of Obstetricians and Gynecologists says the plan could backfire, creating a dual billing system that adds administrative work and worsens care disparities. Reported by Contemporary OB/GYN during the week of July 13 to July 17, 2026, the proposal comes as the broader medical community continues adapting to ongoing shifts in how obstetric services are classified and reimbursed. Under the global payment model, a single bundled reimbursement covers prenatal visits, delivery, and postpartum follow-up, rather than requiring separate billing for each service. This structure aims to simplify billing and support full care. CMS has not explained why new codes are necessary instead of keeping the existing ones, leaving professional organizations to assess the potential impact independently.
Preserving Global Payments With New Codes
The proposed HCPCS G-codes are scheduled for 2027. They aim to preserve the existing bundled payment structure for obstetric services, where a single payment covers prenatal care, delivery, and postpartum follow-up. CMS has not detailed why new codes are needed instead of simply keeping the current ones. HCPCS G-codes are alphanumeric codes used primarily by Medicare to identify services and supplies not covered by standard CPT codes. Introducing new G-codes for obstetric global billing would effectively replace or supplement the current coding framework, though CMS has not specified whether existing codes would be retired or remain in use. This ambiguity raises the possibility that providers may need to handle two separate coding systems for the same service, and the transition period leading up to 2027 adds further uncertainty as practices must prepare without full clarity on final requirements.
ACOG’s concern centers on the practical effect. If providers have to submit both the new G-codes and existing procedural codes, the organization argues, billing becomes more complex. That complexity could lead to errors and delays in reimbursement. Billing errors in obstetrics can involve incorrect code selection or mismatched documentation, each carrying the risk of denied or delayed claims. For practices that depend on predictable cash flow, even short reimbursement delays can create financial strain. When billing staff must reconcile two sets of codes for each episode of care, the margin for error increases and paperwork time cuts into resources that could go toward patient care.
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For clinicians already stretched thin, more coding requirements mean less time with patients. The risk of worsening disparities is real if practices in underserved areas lack the resources to manage the added paperwork. That tension between preserving global payments and adding new codes lies at the heart of the disagreement. Underserved areas include rural communities, inner-city neighborhoods, and regions with low provider-to-patient ratios, where obstetric practices often operate with lean administrative teams and limited financial buffers. These practices may lack capacity to train staff on new coding protocols, invest in billing software updates, or absorb costs from denied claims. ACOG has emphasized that the administrative burden would not be distributed evenly, and those with fewer resources to adapt could see the greatest disruption to their operations.
Why ACOG Warns of Wider Disparities
The group specifically warned that the administrative burden would not fall evenly. Smaller practices and those serving low-income populations often have fewer resources for billing staff. A dual system could hit them hardest, potentially widening gaps in access to obstetric care. The proposal arrives during a period of active discussion across obstetrics and gynecology about improving care delivery and outcomes. During the same week that Contemporary OB/GYN reported on the CMS coding proposal, the publication also covered new research on biomarker screening to reduce NICU admissions in first pregnancies, a study on perimenopause awareness among women aged 35 and older, and real-world effectiveness data for zuranolone in treating postpartum depression. These stories show the range of challenges facing the specialty, from diagnostic delays and treatment access to the administrative systems that support care. ACOG’s warning about disparities reflects concern that the coding proposal could undermine progress in areas where access to obstetric care is already fragile and patients face the greatest barriers to receiving timely services.
The proposal comes as the medical community continues to handle changes in how obstetric services are coded and reimbursed. ACOG warned that the move could create a dual billing system that increases administrative burden and worsens obstetric care disparities. CMS has not responded publicly to the criticism. A dual billing system would require providers to submit both the new global G-codes and existing itemized procedural codes for the same episode of care, effectively doubling the coding workload for each maternity patient. This redundancy is what ACOG believes could backfire, leading to more claim denials, slower reimbursement cycles, and greater administrative costs for practices already operating on tight margins. Without a public response from CMS, the obstetric community is left to interpret the proposal’s intent and prepare for changes without guidance on implementation or whether safeguards will protect smaller and under-resourced practices from the disproportionate burden they are likely to face.
