Billing Obstetric Telehealth Visits: What Practices Need to Know

Medically reviewed by Sina Haeri, MD, MHSA, maternal-fetal medicine physician.

Billing an obstetric telehealth visit is not the same problem as billing a general telehealth visit, and the reason is the global maternity package. A routine prenatal visit is already inside a bundled payment, so moving it to video does not create something separately billable. That is the constraint most practices run into first, and it is the one that changes at the start of 2027.

Why the global package is the whole difficulty

Under the structure in force through the end of 2026, routine antepartum visits are bundled into the global obstetric package. Whether a given visit happened in the office or over video does not change that. A practice can deliver prenatal care by telehealth, and many do, but it is delivering care that is already paid for rather than adding a billable encounter.

Care outside the routine package behaves differently. Problem visits, management of conditions beyond a normal pregnancy, and consultations that fall outside routine maternity care are billed separately today and can be delivered by telehealth on the same terms as any other visit, subject to payer policy.

What changes on 1 January 2027

The CPT Editorial Panel accepted a restructuring of maternity care coding in September 2025, effective 1 January 2027, that deletes the global obstetric codes and reports care across four phases. Under the new structure antepartum care is reported per encounter using evaluation and management codes, and the guidelines name the telemedicine evaluation and management code family and virtual check-ins among the codes available for that purpose. The same applies to outpatient postpartum care on dates after delivery.

The practical effect is that a prenatal or postpartum telehealth visit stops being absorbed into a bundle and becomes separately reportable. Whether it is separately paid is a payer question, and for Medicare specifically it is unresolved: CMS has proposed creating its own G-codes that would preserve the current global structure. What is decided and what is still proposed →

AMA CPT Editorial Panel, Summary of Panel Actions, September 2025, Tab 30, and the AMA maternity care codes and guidelines document. Descriptor language is still in copyediting; confirm against the CPT 2027 Professional Edition when it publishes.

Place of service, and what is stable

For Medicare, the place-of-service convention is unchanged: one code for telehealth provided somewhere other than the patient's home, and another for telehealth provided in the patient's home, which pays at the non-facility rate. Nothing in the CY2027 proposed rule changes that convention.

Modifier requirements are where practices most often get inconsistent guidance, and they differ by payer. Confirm your own payers' current requirements against their published policy rather than against a general reference, including this one.

On the statutory side, 2027 is a stable year. Medicare telehealth flexibilities were extended through 31 December 2027, so the expiry a practice should have in its planning horizon is 1 January 2028, not the start of 2027.

CMS Telehealth FAQ, updated 26 February 2026. Flexibilities extended by the Consolidated Appropriations Act, 2026.

Payer policy diverges, and yours is the one that governs

Medicare, state Medicaid programs and commercial payers each set their own telehealth policy, and obstetrics is not usually carved out for special treatment. Coverage of audio-only visits, originating-site rules, and which visit types may be delivered remotely all vary. For a practice with a Medicaid-heavy obstetric book, the state program's policy matters more than anything Medicare does.

What to confirm before you start

Where Ouma fits

Ouma is a physician-led practice delivering obstetric and maternal-fetal medicine care by telehealth across all 50 states, so these are questions we work through with practices rather than questions we answer in the abstract. We are not a billing company, and coding decisions stay with your revenue cycle team.

Related: High-risk pregnancy care · 2027 maternity coding changes · Ouma for clinics

CPT is a registered trademark of the American Medical Association. Descriptions here are written by Ouma Health and are not the official CPT descriptors. This is general information, not coding or billing advice. Verify current codes and payer policy before submitting claims.