Choosing the right OBGYN EHR in 2026 comes down to one test most practices skip: does the system understand obstetric global packages, high-risk maternal coding, and L&D interoperability, or was it built for general primary care and adapted after the fact? A generic EHR can chart a visit. An OBGYN-ready EHR protects the reimbursement behind […]
OB-GYN global package denials are increasing in 2026 because Medicare Advantage plans are applying algorithmic claim review to maternity codes at rates 37% higher than 2022 — and the documentation standard that cleared payer review last year is no longer sufficient to protect antepartum, delivery, and postpartum revenue in the same billing cycle. The financial […]
Yes — global maternity code denials are climbing in 2026 despite the CMS RVU exemption, because the fee schedule protection preserves the allowable rate but does nothing to prevent payer-level claim edits targeting antepartum visit documentation, co-management modifier usage, and VBAC medical necessity narratives. The 2026 CMS Physician Fee Schedule preserved OBGYN global maternity codes […]
The correct well woman exam CPT codes 2026 depend on patient age, whether a Pap smear is collected, and payer type. Established patients aged 18–39 bill CPT 99385/99395 (new/established); Pap collection adds G0123 or G0101 for Medicare. Mixing preventive and problem-focused E/M in the same encounter requires Modifier 25 and precise documentation to avoid denial. […]
The well woman exam is one of the most commonly billed preventive services in OBGYN and primary care practices, yet it remains one of the most frequently miscoded encounters in outpatient settings — making correct ICD-10 selection the single most important factor protecting your preventive visit revenue per billing cycle. Selecting the correct well woman […]
OBGYN billing is not general medical billing performed on reproductive health claims. It is a distinct revenue cycle discipline built on the dual-track reimbursement model — global obstetric packages and fee-for-service gynecologic procedure billing — governed by payer-specific maternity benefit structures, trimester-based antepartum visit counting rules, and modifier-dependent surgical coding logic that differs fundamentally from […]
OBGYN AR aging beyond 90 days is driven by four compounding causes specific to obstetrics and gynecology billing: global period miscoding generating systematic denials, prior authorization failures on advanced gynecologic procedures, Medicaid maternity bundling disputes, and payer-specific timely filing mismatches on split-episode claims. According to MBC’s 2026 RCM services analysis across 140 OBGYN practices, the […]
Yes—Texas Medicaid Managed Care is underpaying OBGYN deliveries by $1,200–$2,800 per case when managed care organizations (MCOs) apply incorrect global package rates, deny separately billable high-risk services claiming they’re “included in maternity,” and bundle diagnostic ultrasounds that contract language allows separately, destroying 18–32% of potential revenue on complicated pregnancies where additional services beyond routine care […]
Yes—global period gaps are costing your OB-GYN practice $830,880 per 12 months when global maternity packages bundle services that should bill separately, post-global encounters get written off incorrectly, and diagnostic ultrasounds go unbilled despite payer contracts allowing separate payment. Your practice loses $1,680 per high-risk pregnancy, $420 per post-global visit, and $1,840 per complication requiring […]
Yes—global bundle write-offs are 3–5× higher than vendor reports show because billing companies track only documented adjustments (services denied as bundled) while hiding the larger revenue loss from services you performed but never billed (knowing payers would bundle them). Practices collecting $1M–$5M+ monthly lose $1.2M–$3.8M annually when vendors write off global maternity services “at submission” […]
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