Question: How many visits are included in the payment for the maternity care package?

Answer: The global maternity package includes approximately 13 routine antepartum visits for an uncomplicated pregnancy: monthly visits up to 28 weeks, biweekly visits to 36 weeks, and weekly visits until delivery. Fewer than four prenatal visits do not qualify for global reimbursement and should be billed with individual E/M codes. If more than 13 visits are required due to complications or high-risk status, the additional visits may be reported separately at the time of delivery. CPT® does not define the number of routine visits because patients may enter the practice at different times in their pregnancy, 8 weeks, 12 weeks, or 16 weeks, and still be billed a global maternity code.

We published a coding guide on coding for maternity care services, from start to finish. You can download it here.

We also did a survey a few years ago about billing for extra visits. It’s pretty interesting, and I’m grateful for our members who took the time to answer it.

And finally, according to ACOG, change is on the horizon for this coding, but not until 2027. So, the current guidelines will be in effect for two more years.