Specialties
Medical billing for OB/GYN
Most obstetric care is billed as one package after delivery, months after the first visit. Anything that changes along the way, such as insurance, provider or risk, changes the claim.
What makes OB/GYN billing hard
- The global obstetric package. Routine prenatal visits, the delivery and postpartum care are usually billed together as a single service after delivery.
- Split care. When a patient changes practice or insurance during pregnancy, the package has to be split into prenatal, delivery and postpartum parts, each billed by the right provider to the right payer.
- Services outside the package. Ultrasounds, lab work, and visits for problems unrelated to routine pregnancy or for high-risk conditions can be billed separately when documented.
- Insurance changes mid-pregnancy, including new Medicaid coverage, which pays for a large share of births.
- Gynecology. Preventive visits, screenings and office procedures each follow their own coverage rules.
How we work it
Each pregnancy is tracked from the first visit, with eligibility rechecked through the pregnancy. Services outside the global package are billed as they happen, not left for delivery, and split-care cases are billed in their separate parts so each payer receives the right claim.
Common questions
What happens if a patient transfers to another practice mid-pregnancy?
The global package can no longer be billed. Each practice bills the prenatal visits, delivery or postpartum care it actually provided, using the separate codes for each part.
Can ultrasounds be billed separately from the obstetric package?
Yes. Ultrasounds aren’t part of the global package and are billed when performed, with a diagnosis that supports them.
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