Reviewed by certified coders + a maternal-fetal medicine physician / Updated for 2026
OB Coding Guide
Guide

The Global OB Package, explained

The global obstetric package bundles routine maternity care into a single code. Knowing exactly what falls inside that fee, and what you can bill separately, is where OB practices win or lose revenue. Here is the line.

2027 change The global package ends January 1, 2027: CPT 2027 deletes the entire code family and unbundles maternity care into per-encounter billing. Everything on this page applies through 2026 dates of service. Read the unbundling guide →
Inside the global fee 59400
Routine antepartum visits (roughly 13 for term)
Initial and subsequent history and physical exams
Admission to the hospital for delivery
Vaginal delivery and routine care
Routine postpartum care
Billed separately
Obstetric ultrasounds (76805, 76811)
Fetal non-stress test (59025)
Lab and screening tests
Management of high-risk conditions beyond routine
Additional inpatient E/M for complications
External cephalic version, sterilization

Scenarios that break the package

Twin pregnancy 59400 + delivery

Global maternity care applies, with additional delivery components. Report the delivery-only code for the second twin per payer rules rather than a second full global package.

Transfer of care 59425 / 59426

When you provide only antepartum care and do not perform the delivery, bill 59425 for 4 to 6 visits or 59426 for 7 or more visits instead of the global code. The delivering practice bills the delivery and postpartum components.

Split care Component billing

When no single practice provides all three phases, bill each component separately: antepartum, delivery, and postpartum care each carry their own code.

The delivery code family

Three global codes cover the full package depending on delivery route, and each has delivery-only and delivery-plus-postpartum siblings for when the package splits:

CodeCovers
59400 Global package, vaginal delivery
59409 Vaginal delivery only
59410 Vaginal delivery + postpartum care
59425 Antepartum care only, 4–6 visits
59426 Antepartum care only, 7+ visits
59510 Global package, cesarean delivery
59610 Global package, VBAC

Package composition follows current ACOG maternity care coding guidance and payer policy. When a high-risk patient is referred out mid-pregnancy, the referring practice moves from the global fee to antepartum-only billing, the economics both sides should price in. Co-management keeps the global package with the primary practice while the consulting specialist bills separately.

Reviewed by
SH
Sina Haeri, MD, MHSA
Board-certified OB/GYN · MFM
MW
Millie Woodard, CPC
CPC · COBGC · CPMA
Drafted July 2026 · coder review pending

Educational reference only. Not billing, legal, or medical advice. Confirm all codes, modifiers, and rates against current payer policy before submitting claims.