What this session covers
Starting January 1, 2027, CPT® reports maternity care by phase of service instead of as one bundled episode. Antepartum care, labor management, delivery, and postpartum care each carry their own codes, and wRVU credit follows the clinician who performs each phase. The new values were designed to be budget neutral in total. That does not make them neutral for every clinician or every organization.
In this 45-minute session, Eric Leafgreen of Ludi and Ben Minnis of VMG Health walk through what moves when the global code goes away: who receives credit, when that credit lands, and how much each clinician is credited for the same care. They cover which roles change the most, from continuity OBs and laborists to certified nurse midwives and other advanced practice clinicians, and why pools, crediting rules, wRVU thresholds, conversion factors, and fair market value support all need a second look.
The session closes with a measurement plan. Re-map at least 12 months of historical claims to the 2027 code set before January 1, check the first quarter of 2027 data in April, and bring six-month findings to your compensation committee. The speakers’ central advice: measure the impact before redesigning any compensation plan, and document every decision along the way.
Key takeaways
- Credit follows the work. Today the physician who delivers bills the global code and receives the episode’s wRVUs. In 2027, antepartum and postpartum visits are reported as E/M services, labor management has its own codes, and credit goes to the clinician who performed each phase. Credit also lands closer to when the care happens, which changes monthly productivity reporting.
- Certified nurse midwives and other advanced practice clinicians are likely to see the largest change. Visit work that was invisible inside the global becomes visible. Laborists receive credit for labor management for the first time, and continuity OBs receive delivery credit only when they deliver their own patients.
- The fee schedule choice can move wRVUs on its own. Organizations valuing wRVUs on an older fee schedule have to decide whether to adopt the 2027 schedule or load the new codes as house codes. Eric has found that choice to be one of the biggest drivers of change.
- Measure before you redesign. Pools, laborist carve-outs, crediting rules, wRVU thresholds, and conversion factors were all calibrated to the global code. The speakers do not recommend redesigning plans on January 1. Model the impact first, then document each decision to support fair market value.
- The work continues into 2027. Ben expects compensation surveys not to reflect the change until 2028, so a Q1 check, six-month findings, and comparison with peer organizations will tell you more than the next survey cycle.
Questions this session answers
What changes in maternity coding on January 1, 2027?
Maternity care moves from one global package to four separately reported phases: antepartum care, labor management, delivery, and postpartum care. Antepartum and postpartum visits are reported as E/M services, labor management has new codes, and delivery uses streamlined vaginal and cesarean codes.
If the change is budget neutral, will physician wRVUs still change?
Yes, for many physicians and clinicians. The values were designed to be budget neutral in total, but credit follows whoever performs each phase of care. A delivering physician who received the full global credit may see less, while clinicians who handle antepartum, labor, or postpartum care may see more.
Which clinicians are most affected by the 2027 OB coding changes?
The speakers expect certified nurse midwives and other advanced practice clinicians to see the largest change, because the antepartum and postpartum visits they perform will carry their own credit. Laborists gain credit for labor management. Continuity OBs keep credit for their own visits and receive delivery credit only when they deliver.
Should we redesign OB compensation plans before January 1?
Not yet. The speakers recommend modeling the impact before January 1, then measuring actual 2027 data before changing plan terms. Pools, crediting rules, wRVU thresholds, and conversion factors all need review, and every change should be documented to support fair market value.
How do you measure the impact of the 2027 maternity code changes?
Start with at least 12 months of claims-level data from before the transition began, covering every physician and clinician in the practice. Map each global code to the expected 2027 codes and rules, recompute wRVUs by clinician and specialty, and flag the people and plan terms most affected. Then check Q1 2027 data in April and review six-month findings after Q2.
In the full recording
- One pregnancy, four clinicians: an example showing who receives credit today and who receives it in 2027
- Exposure by role for continuity OBs, laborists, certified nurse midwives and other advanced practice clinicians, and pooled groups
- How claims-level data, billing and rendering attribution, and fee schedule choices change the result
- A four-step baseline re-mapping approach and a timeline for the first six months of 2027
- A five-step readiness checklist for January 1
- Live Q&A on midwives and doulas, crediting when two clinicians manage labor on the same day, coverage agreements between practices, and pregnancies that start in 2026 and deliver in 2027
Related reading
January 2027 Maternity Coding Changes: The Compensation Blind Spot Hospitals Are Missing, by Eric Leafgreen