BT2026180

Indiana Health Coverage Programs (IHCP) Bulletin BT2026180, issued October 27, 2026, announces mandatory changes to maternity CPT codes taking effect for dates of service on or after January 1, 2027. The changes are driven by the American Medical Association's revision of the CPT code set, which eliminates longstanding obstetrical global billing codes and replaces them with unbundled, service-specific codes. The bulletin states that all current maternity CPT codes listed in Tables 1 and 2, including global codes 59400, 59410, 59510, 59515, 59610, 59614, 59618, and 59622, as well as delivery-only codes 59409, 59425, 59426, 59430, 59514, 59525, 59612, and 59620, will be nationally end-dated and invalid for any DOS on or after January 1, 2027. Beginning January 1, 2027, prenatal care must be billed using E/M codes 99202-99215 and 99341-99350, accompanied by modifier TH and one of three trimester modifiers: U1 for the first trimester (0 through 14 weeks, 0 days), U2 for the second trimester (14 weeks, 1 day through 28 weeks, 0 days), or U3 for the third trimester (28 weeks, 1 day through delivery). Postpartum care must be billed using appropriate E/M codes with modifier TH and modifier U4. Effective for DOS on or after January 1, 2027, any E/M code billed with modifier TH but without an applicable U modifier (U1, U2, U3, or U4) will be denied. New labor management codes 59080 through 59083 are introduced to distinguish initial and subsequent day labor management services as either straightforward or complex, billed per day. New delivery codes include 59431 (vaginal delivery), 59432 (vaginal delivery after previous cesarean delivery), 59502 (primary cesarean delivery), 59503 (repeat cesarean delivery), 59504 (subtotal or total hysterectomy after or during cesarean delivery), and 59623 (uterine tamponade). Labor management codes are not to be billed for planned or scheduled cesarean deliveries. Professional claims for obstetrical deliveries continue to require one of three delivery timing modifiers: UA, UB, or UC. Additional policy changes include: elimination of the $10 add-on for high-risk prenatal care visits, with providers instead required to bill E/M codes at the appropriate complexity level; prohibition on separate E/M billing for concurrent medical conditions during the same episode of care; and continued prohibition on separately billing drug or vaccine administration codes on the same DOS as a maternity E/M visit. The IHCP began accepting prenatal services billed under the new E/M and modifier structure for claims with DOS on or after October 1, 2026.