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OB/GYN Billing Services
OB/GYN billing is global maternity versus a delivery-only claim — and a surgical package for gynecologic cases. Vector Medical Billing, in Jamaica, New York, tracks who provided antepartum care, the route of delivery, and the GYN global inside the EHR you already use.
98%Published NCR
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AHIMACertified coders
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50 StatesRemote billing nationwide
Monthly fee
What OB/GYN billing services include
Full-cycle RCM for obstetric and gynecologic practices — the maternity package is one decision, and the GYN case is another global.
The operating cycle matches medical billing services: eligibility and prior auth, charge capture from prenatal flow sheets and operative notes, ICD-10 / CPT / HCPCS coding, scrub, clearinghouse submission, payment posting, denial management, and A/R follow-up. The scrub watches global versus component maternity coding, delivery route including VBAC, same-group rules, ultrasounds and non-stress tests outside routine prenatal visits, gynecologic globals, and contraceptive device lines.
In scope: office and hospital E/M, global and split maternity, obstetric ultrasound when the practice owns the read, NST and other separately reportable obstetric procedures, colposcopy, LEEP, hysteroscopy, laparoscopy, hysterectomy professional claims, well-woman exams, and IUD or implant procedures with the device. Facility delivery charges stay on the hospital claim. Dedicated infertility laboratory billing is out of scope on this page unless separately engaged.
OB/GYN is priced as a percentage of net collections with other high-scrub surgical work. The written rate follows obstetric versus gynecologic mix on pricing. Global maternity codes in effect through 2026 are deleted January 1, 2027 and replaced with encounter-based antepartum and postpartum E/M plus new labor and delivery codes. We bill the code set in effect on the date of service. Credentialing, a retrospective coding audit, MIPS, and out-of-network / IDR stay separate engagements.
What sits on this OB/GYN fee
- Global versus delivery-only decided from who actually saw the patient
- GYN surgical globals and device lines scrubbed before submission
- HIPAA workflows, a signed BAA, and PHI limited to staff on the account
Where OB/GYN claims fail
Patterns maternity reimbursement policies and specialty OB/GYN RCM keep naming.
Prenatal visits plus the global
59400 or 59510 billed after the same group already submitted each prenatal visit as E/M to the same payer. Or a delivery-only code used when the group provided the full package.
Hub rule: global maternity versus a delivery-only claim — not both.
Wrong split or wrong route
59425 used for one to three visits. Antepartum codes billed per visit instead of one unit for the series. Vaginal global billed when the delivery was cesarean. 59610 and 59510 stacked for one attempted VBAC.
Count visits and match the route in the delivery note.
GYN package and same-day exams
Routine post-op after hysterectomy billed as a new visit. A problem visit with modifier 25 on a well-woman day when the note only documents the preventive exam. IUD insertion without the device HCPCS.
The surgical package and the preventive visit have their own rules.
Global · delivery-only
Global maternity versus a delivery-only claim
Hub language made operational: one group, the full course, one package — otherwise components.
Through 2026, when the same physician or same-specialty group under one tax ID provides routine antepartum care, delivery, and postpartum care, bill the global: 59400 vaginal, 59510 cesarean, 59610 successful VBAC, or 59618 when a VBAC attempt ends in cesarean. Do not also bill those prenatal or routine postpartum visits to the same payer. A planned vaginal delivery that converts to cesarean is the cesarean global, not both. Hospital facility fees are not on this professional claim.
Delivery-only codes (59409, 59514, and the VBAC delivery-only family) are for the physician or group that delivers but did not provide the antepartum package. Delivery plus postpartum, without antepartum, has its own codes. A transfer inside the same group is still global if that group delivers. A change of insurer, care that starts elsewhere, or a pregnancy that ends before a delivery package are reasons to split — not a preference to unbundle.
Package checklist
- Who provided antepartum, who delivered, who sees postpartum
- Route in the note matches 59400, 59510, 59610, or 59618
- Prenatal E/M not already paid by the same payer
Split antepartum and postpartum
Visit count decides the code. One unit covers the series.
Antepartum only
One to three visits use E/M, not a maternity bundle. Four to six visits are 59425, one unit. Seven or more are 59426, one unit. Bill when antepartum ends or care transfers — not once per appointment. A single visit to confirm pregnancy is not “prior antepartum” that forces a split if your group then provides the rest of the package and the delivery.
Postpartum only
59430 is postpartum care only, one unit, when your group did not bill the global or the delivery-plus-postpartum code. Do not add an E/M for the routine postpartum visit on top of 59430 or on top of a global. An unrelated problem during the postpartum period can be an E/M with modifier 24 when the note supports a problem that is not routine postpartum care.
What routine prenatal visits do not include
Testing and procedures outside the usual prenatal check can be separate lines.
Ultrasound and NST
Obstetric ultrasound (76801, 76805, and related) is not the prenatal E/M. Use 26, TC, or global based on who owns the machine and the interpretation. Non-stress tests (59025) and biophysical profiles bill when performed and documented — not as a default on every visit. A missing image or tracing is a scrub hold.
Procedures outside the package
Cerclage, amniocentesis, and external cephalic version are not routine prenatal visits. They can be separately reportable when the note supports them. Cerclage removal the same day and place as delivery is often included in the delivery package — do not add it by habit. High-risk medical problems may support extra E/M when they are not the routine obstetric check.
January 1, 2027
CPT deletes the global maternity and antepartum-bundle codes effective January 1, 2027. Antepartum and postpartum care move to encounter E/M. New labor-management and delivery codes replace today’s globals. Dates of service in 2026 still use 59400 and the component codes above. We do not mix the two code sets on one date of service.
Gynecologic surgery, preventive visits, and devices
A surgical package is not the maternity global, and a well-woman exam is not a problem visit.
GYN surgical package
Hysterectomy, laparoscopy, hysteroscopy, LEEP, and similar procedures follow their own 0-, 10-, or 90-day globals — not the maternity package. Routine related post-op stays inside that global. Modifier 24 is an unrelated E/M. 58 is staged, 78 an unplanned return to the OR, 79 an unrelated procedure. Colposcopy add-ons (biopsy, ECC) need the specimens the note describes. Do not bill an office visit with 25 on a procedure-only day.
Well-woman and contraception
A preventive visit and a significant, separately identifiable problem the same day can both be billed, with modifier 25 on the problem E/M only when the note supports both. Medicare screening uses G0101 and Q0091 rather than a commercial preventive code. IUD or implant insertion is the procedure CPT plus the device HCPCS. The device is not assumed inside the insertion code.
OB/GYN code families this service works
Illustrative anchors for dates of service through 2026 — the flow sheet and delivery note decide the claim. 2027 dates use the new code set.
| Work type | Example | What to check | Common failure if skipped |
|---|---|---|---|
| Global vaginal | 59400 | Full package, one group | Prenatal E/M also billed |
| Global cesarean | 59510 | Route in the note | 59400 after conversion |
| VBAC | 59610 / 59618 | Success vs cesarean | Both codes one delivery |
| Delivery only | 59409 / 59514 | No antepartum by this group | Used after a full package |
| Antepartum 4–6 | 59425 × 1 | Not per visit | E/M stacked on the bundle |
| Antepartum 7+ | 59426 × 1 | Visit count | 59425 for a long series |
| 1–3 prenatal visits | E/M | Not 59425 | Bundle under-counted |
| Postpartum only | 59430 | One unit | Plus routine E/M |
| Ultrasound / NST | 76805 / 59025 | 26/TC; tracing saved | Buried in the prenatal visit |
| GYN surgery | Hysterectomy / LEEP families | Own global | Post-op billed as new |
| Well-woman | Preventive ± 25; G0101 | Problem is separate | Habit-25 |
| IUD / implant | Procedure + device HCPCS | Both lines | Device omitted |
This page does not invent an OB/GYN denial percentage. The free audit reads your global-versus-component choices and GYN post-op visits on the sample you send.
What a free audit line looks like
Illustrative composite only — not a client result and not a promised recovery.
| Field | Example entry |
|---|---|
| Documented service | Same group provided 11 prenatal visits and a cesarean after a planned vaginal labor; routine postpartum visit at 6 weeks; NST documented twice in the third trimester |
| Billed codes | Each prenatal visit as 99213, plus 59400, plus 59430, NSTs omitted |
| Issue found | Global unbundled into visit codes; vaginal global used for a cesarean; postpartum duplicated; NSTs never charged |
| Recommended correction | Bill 59510 only for the package to that payer; drop the prenatal E/M and 59430; add 59025 for each documented NST |
| Related check | Hospital facility claim is separate; 2027 dates of service will not use 59510 |
| Why it matters | Unbundled prenatal visits recoup against the global — caught in scrub or flagged in the free audit |
Request a Free Audit with recent flow sheets, delivery notes, claims, and denials. We map global versus delivery-only on your file — not this composite.
How Vector runs OB/GYN billing
Who provided each phase first — then the same revenue cycle.
1
Assign OB/GYN
Coder and biller who already split global maternity from delivery-only and from GYN globals.
2
Reconcile and code
Charge entry and coding from the flow sheet and delivery note — queries when the visit count or route is unclear.
4
Post and report
835 posting, denial work, A/R aging, monthly RCM report by maternity package versus GYN surgery.
Not inside the OB/GYN percentage
Related work stays separate so the quote matches the job.
Hospital delivery fees
Facility charges for labor, delivery, and the newborn stay on the hospital claim. We bill the professional maternity and gynecologic services.
Credentialing / audit
Credentialing and a retrospective coding audit of global maternity coding are separate engagements when scoped.
Underpay / OON
Underpayment recovery and OON / IDR stay separate when the dispute path is not ordinary denial work.
How OB/GYN billing is priced
Percentage of dollars that land — not a flat fee per delivery that ignores unbundled prenatal recoupment.
Written rate
OB/GYN is priced as a percentage of net collections because maternity packages, split care, and gynecologic globals take more scrub and follow-up time. No setup fee on the monthly cycle. Month to month. The written rate follows obstetric versus gynecologic mix and how much of the cycle you hand over.
See pricing or request a written rate after the free audit.
What we need to start
EHR access, monthly delivery and GYN surgery census, whether you share prenatal care with another group, open A/R if you are leaving another biller, and a sample of global or unbundling denials. Switching usually overlaps so claim submission does not stop. See EHR integration if access setup needs a separate quote.
Audit the maternity claims that bill the visits and the global
Send monthly delivery volume, whether prenatal care stays in your group, EHR name, and a sample of package denials. We reply with what the open A/R shows, whether the monthly fee fits, and a written rate — without inventing a clean-claim percentage.
Written
Monthly rate
98%
Published NCR
50
US States
BAA
Every Client
OB/GYN billing questions
Straight answers tied to the sections above.
What does OB/GYN billing include?
Global and split maternity, separately reportable obstetric tests and procedures, gynecologic surgery, well-woman and problem visits, contraceptive procedures and devices, scrubbing, submission, posting, denials, and A/R.
How much do OB/GYN billing services cost?
The fee is a percentage of net collections. No setup fee on the monthly cycle. The written rate follows obstetric versus gynecologic mix.
When do you bill global maternity instead of delivery-only?
When the same group provides routine antepartum care, the delivery, and postpartum care. Delivery-only is for the group that delivers without that antepartum package. Do not bill both to the same payer.
How are 4 to 6 prenatal visits coded when you do not deliver?
59425, one unit for the series. Seven or more visits are 59426, one unit. One to three visits are E/M codes.
What happens to global codes in 2027?
CPT deletes the global maternity package effective January 1, 2027 and replaces it with encounter-based antepartum and postpartum E/M plus new labor and delivery codes. We bill the set in effect on the date of service.
Do we have to change our EHR?
No. Billers work in the system you already use — see EHR integration. Compatibility is confirmed before you commit.
Where does Vector provide OB/GYN billing?
The office is 15717 85th St, Jamaica, NY 11414-2620. Work is remote for OB/GYN practices in all 50 states. See the specialties hub.
Is Vector Medical Billing HIPAA certified?
HHS does not certify billing companies. Vector signs a BAA, limits PHI to staff on the account, and follows HIPAA workflows. A HIPAA security risk analysis is a separate engagement when scoped.