Global Maternity Billing Overview: What’s Bundled—and What’s Not

May 31

What’s bundled—and what’s not

If you've ever submitted a maternity claim and been hit with a confusing denial, you're not alone. Global maternity billing is one of the most misunderstood parts of our work—and it’s costing practices time, money, and sanity.

Whether you're a midwife managing care at a freestanding birth center or a doula navigating OHP and T codes, understanding what is included in global billing—and what’s not—is key to getting paid fairly for the care you provide.

Let’s break it down together.

What is Global Maternity Billing?

Global maternity billing refers to a bundled payment that covers routine maternity care from the first prenatal visit all the way through postpartum. Most insurers use CPT code 59400 for this bundle (though not all payers follow the same rules—more on that later).

This “global package” is meant to keep billing simple… but only if you know exactly what’s inside that bundle.

What’s Usually Included

Here's what’s typically covered under a global maternity package:

Initial prenatal intake
Routine prenatal visits (usually 12–14 total)
Labor and vaginal delivery
Postpartum care through 6 weeks

Think of this as the standard care pathway for an uncomplicated pregnancy—but that doesn’t mean everything else is automatically included.

What’s Not Included (But Should Be Billed!)

This is where things get tricky. A lot of services fall outside the global package—and if you don’t bill them separately, you’re leaving money on the table.

Here are the most common services that should be billed in addition to global maternity care:

Services Commonly Billed Separately

Initial OB Visit with Problem-Focused Exam
CPT: 99204–99205
For new or diagnostic-focused OB clients before routine care begins.
Ultrasounds
CPT: 76801, 76805, 76815
Depends on type, trimester, and payer policy.
Lab Work & Specimen Collection
CBC, glucose testing, GBS, urinalysis, and more.
Non-Routine or Complicated Visits
CPT: 99214 or 99215
For issues like abnormal bleeding, hypertension, or emotional health concerns.
Labor Support (Home/Birth Center)
CPT: 59899 (Medicaid) + diagnosis code
T1033 for doulas under THW certification.
Postpartum Depression Screening
CPT: 96127
A must for continuity of care and reimbursement.
Lactation Support, Feeding Visits, and Weight Checks
CPT: 99401, 99402
Especially important in early postpartum care.

Pro Tips from the Admin Side

Here’s what I always tell my clients:

✔ Document clearly and consistently. Even routine visits should be well-charted in case you need to justify additional billing.
✔ Use your modifiers. -25, -59, SG—these help payers separate bundled vs. standalone care.
✔ Double-check payer policies. Each one treats maternity a little differently. Of course they can’t make it easy!
✔ Track visits by gestational week. You’d be surprised how often something slips outside the global timeline.
✔ Don’t be afraid to appeal. Many denied services should have been paid—and often are after a well-documented appeal.

The Bottom Line

Global billing was designed to make maternity billing easier—but only if you know what’s actually inside the box. The truth is, you’re doing a lot more than the minimum, and you deserve to be reimbursed accordingly.

With a little strategy and the right support, you can stop second-guessing your billing and start getting paid for the full, life-changing care you provide.

Need help reviewing your claims or building clean systems? That’s what I do!
📩 Harley Skaggs, CPC, CPB
harley@elitemasolutions.net

Disclaimer:
The content in this blog post is intended to offer general guidance and educational insight based on current billing practices and industry standards. Because insurance policies and coding requirements can vary by payer—and may change over time—it's important to verify details directly with each insurer. While I do my best to provide accurate and up-to-date information, Elite MedAdmin Solutions and Harley Skaggs, CPC, CPB, cannot be held responsible for billing outcomes or decisions made based on this content.

Harley Skaggs