The CPT coding used to support reporting of the Prenatal and Postpartum Care (PPC) measure is being updated. Beginning January 1, 2027, certain bundled prenatal and postpartum CPT codes will be retired and replaced with revised and new phase-specific codes.
The coding changes take effect January 1, 2027. Retired codes should not be reported for dates of service on or after that date.
35 total codes were changed, including 17 deleted codes, 12 new codes and six revised codes.
The updates align with CMS guidance and support more accurate, consistent reporting of prenatal and postpartum care. Phase-specific coding helps identify services at the appropriate stage of care and supports quality measurement for the PPC measure.
The update includes 17 retired codes, six revised codes, and 12 new codes. Providers should review the retired, revised, and new CPT code tables included in this communication and update internal billing, coding, and reporting processes accordingly.
Yes. Providers should coordinate with their billing, coding, and electronic health record vendors to ensure systems, templates, workflows, and reporting processes are updated before the effective date.
No. Retired codes should not be reported for dates of service on or after January 1, 2027. Providers should use the appropriate revised or new phase-specific codes based on the service provided and applicable coding guidance.
Yes. The changes are intended to support more precise reporting for the PPC measure by capturing prenatal and postpartum services at the appropriate stage of care.
Providers with questions should contact their Provider Account Executive or the Provider Services department at 1-888-599-1479.
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