OB/GYN Billing: How to Manage Global Maternity Care Packages

Managing OB/GYN billing for global maternity care is about balancing accuracy, efficiency, and compliance. From the first prenatal visit to the last postpartum check, your billing workflow needs to align with payer policies while keeping patient care uninterrupted. This guide breaks down global maternity billing into clear, easy-to-follow sections—helping you simplify claims, avoid denials, and protect your revenue cycle.

For more insight into improving claim management, read our post on Leading OB/GYN Billing RCM Denial Strategies.

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Table of Contents

Global Maternity Billing Explained: How It Works

In obstetrics and gynecology, a global maternity care package combines prenatal visits, delivery, and postpartum services into a single claim. This system simplifies reimbursement and reduces administrative work, but it also requires precise documentation and knowledge of each payer’s unique rules.

When handled properly, global maternity billing improves workflow efficiency and ensures fair reimbursement. When done incorrectly, it can lead to claim rejections, audits, and financial losses. Understanding when to use global billing and when to itemize services is essential for both compliance and profitability.

Impact on OB/GYN Practices

Global billing influences your revenue accuracy, compliance levels, and patient satisfaction. By understanding how your billing structure works, your practice can prevent payment delays and maintain transparent communication with patients and payers.

Key Components of the Global Maternity Package

A global maternity package covers the full cycle of pregnancy care—from the first prenatal appointment through postpartum follow-up. The most common CPT® codes used in this process include:

• 59400 – Vaginal delivery with antepartum and postpartum care

• 59510 – Cesarean delivery with complete care

• 59610 / 59618 – VBAC (vaginal birth after cesarean) deliveries

To better understand the correct use of OB/GYN codes, see our guide on OB/GYN CPT Codes in Claim Submission.

If one provider or group manages all phases of care, the global code applies. However, if a patient transfers, changes insurance, or develops complications, each phase—antepartum, delivery, and postpartum—must be billed separately.

What’s Not Included

Procedures like ultrasounds, fetal testing, or complex consultations typically fall outside the global package. These require separate billing and specific modifiers depending on payer policy.

When Global Maternity Billing Isn’t the Right Fit

Not every pregnancy qualifies for a global package. You should use itemized maternity billing when:

• The patient changes doctors or insurance mid-pregnancy

• The pregnancy ends early (miscarriage or termination)

• Complications require extra visits or procedures

• Another provider handles delivery or postpartum care

How Split Billing Protects Your Practice

Itemizing maternity services ensures that billing reflects the care actually delivered. It avoids payer disputes, provides a clear patient record, and prevents revenue leakage caused by inaccurate global submissions.

Understanding Payer Policies for Maternity Billing

Each insurance company defines routine maternity care differently. Some require a minimum of four prenatal visits before you can bill globally. Others exclude services like ultrasounds, non-stress tests, or genetic screenings from the bundled code.

Creating a Payer Reference Guide

To stay compliant, create a simple payer reference list that includes:

• Coverage and eligibility requirements

• Visit minimums for global billing

• Excluded or separately billable services

• Documentation and modifier rules

Having this quick guide on hand saves your billing team hours of confusion and helps avoid repeated denials.

Documentation Essentials in OB/GYN Billing

Clear, detailed documentation is the foundation of successful maternity care billing. Each prenatal visit should record gestational age, vitals, and care notes. Delivery records must specify the delivery type, any complications, and the provider who performed the procedure.

Postpartum Documentation Tips

Postpartum notes should confirm patient recovery, document any complications, and specify whether visits occur inside or outside the global period. If a visit happens beyond that window—or is unrelated to maternity care—it should be billed separately. Strong documentation ensures compliance and supports the medical necessity of each billed service.

Building a Clear and Efficient Billing Process

A smooth maternity billing process starts at the very first visit. Verify insurance benefits, confirm global maternity eligibility, and document all details upfront. Throughout the pregnancy, use your electronic health record (EHR) system to track visit counts and detect any coverage changes.

Step-by-Step Workflow

1. Verify benefits at intake

2. Track visits and update records

3. Confirm eligibility before submission

4. Audit postpartum care for additional billing opportunities

At delivery, confirm that your practice provided all three phases of care before submitting a global claim. During postpartum care, check whether additional visits fall outside the covered period. A structured workflow ensures consistency, fewer errors, and faster reimbursements.

Improving OB/GYN Billing Accuracy with Technology

Modern medical billing technology helps practices manage global maternity care more effectively. Automated alerts can flag changes in insurance coverage or identify when a patient switches providers. Dashboards track visit counts and postpartum follow-ups, keeping your billing aligned with payer requirements.

Automation for Better Results

As more payers extend postpartum coverage to 12 months, technology ensures you don’t miss revenue opportunities from extended care, like lactation support or postpartum depression screening. Automation not only saves time but also keeps your claims compliant and accurate.

The Changing Landscape of Maternity Care Billing

The maternity care environment continues to evolve. Telehealth prenatal visits are now part of routine pregnancy care, and insurers are still determining how they fit within the global billing model. Additionally, value-based care programs are rewarding OB/GYN practices for early prenatal engagement and thorough postpartum follow-ups. For more detailed information on coding standards and clinical concepts related to obstetrics and gynecology, refer to this comprehensive guide on OB/GYN coding.

Preparing for the Future

Stay proactive through regular staff training, timely payer updates, and internal audits. A flexible approach keeps your billing system compliant and competitive as regulations and payer requirements shift.

For comprehensive support, explore our OB/GYN Billing and Coding Services to enhance your practice efficiency.

Conclusion: Confident and Compliant Maternity Billing

Managing global maternity care billing requires attention to detail, teamwork, and the right tools. By combining strong documentation, structured workflows, and modern billing technology, OB/GYN practices can minimize claim errors and maximize reimbursement—without sacrificing patient care.

Ready to simplify your OB/GYN billing process? Request a free quote today and discover how expert maternity billing support can strengthen your revenue cycle and boost practice efficiency.

FAQs: OB/GYN Billing – Global Maternity Care Packages

1) What is global maternity billing in OB/GYN?+

Global maternity billing refers to a single, bundled claim that includes prenatal care, delivery, and postpartum visits provided by the same OB/GYN practice. Instead of billing each appointment separately, all services are billed together under a global maternity care package code, improving efficiency and reimbursement accuracy.

2) Which CPT® codes are used for global maternity care?+

The most common OB/GYN CPT codes for global maternity billing are:
- 59400 – Vaginal delivery with antepartum and postpartum care
- 59510 – Cesarean delivery with full care
- 59610 / 59618 – VBAC (vaginal birth after cesarean) deliveries

The code you select depends on the delivery type and whether the same provider manages all phases of care.

3) What services are not included in a global maternity package?+

Services typically not included in the global maternity package are ultrasounds, fetal testing, amniocentesis, and unrelated medical visits. These services must be billed separately using appropriate modifiers and payer-specific guidelines to ensure full reimbursement.

4) When should maternity care be billed separately instead of globally?+

You should use itemized maternity billing when:
- The patient changes insurance or providers mid-pregnancy
- The pregnancy ends early (miscarriage or termination)
- Complications require additional visits or procedures
- Another provider handles delivery or postpartum care

Separate billing ensures compliance and accurate reimbursement.

5) How can OB/GYN practices reduce maternity billing denials?+

To reduce OB/GYN billing denials, practices should verify insurance at every stage, maintain clear documentation, apply the correct CPT codes and modifiers, and follow payer-specific policies. These steps improve maternity revenue cycle management (RCM) and prevent claim rejections.

6) How does technology improve global maternity billing accuracy?+

Modern medical billing software automates eligibility checks, monitors visit counts, and flags discrepancies in global maternity claims. Automation ensures compliance, speeds up reimbursements, and minimizes human errors in OB/GYN billing processes.

7) Why should OB/GYN practices outsource maternity billing services?+

Outsourcing OB/GYN billing and coding services allows providers to focus on patient care while experts manage claim accuracy, compliance, and reimbursement. Professional billing teams improve cash flow, optimize workflows, and ensure compliance with global maternity billing regulations.

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Ready to simplify your OB/GYN billing? Request a personalized quote today to see how our experts can help you optimize reimbursements and improve efficiency. Get in touch now and let us help you build a stronger, more profitable maternity billing process.