Well Woman Exam CPT Codes 2026: Complete Guide for OBGYN Billing (With Pap & Without)

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. […]

Well Woman Exam ICD-10 Codes: Complete Guide for Accurate Billing

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 […]

Best OBGYN Billing Companies 2026: Compared for Obstetrics and Gynecology Practices

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 […]

Why Is OBGYN AR Aging Beyond 90 Days? The 2026 Causes and How to Recover It

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 […]

Is Texas Medicaid Managed Care Underpaying Your OBGYN Deliveries?

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 […]

Are Global Period Gaps Costing Your OB-GYN Practice?

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 […]

Are Global Bundle Write-Offs Higher Than Your Vendor Reports?

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” […]

What Is Causing Revenue Leakage in OBGYN Billing — and How Do You Stop It?

Revenue leakage in OBGYN billing is the leading cause of suppressed Financial Performance in practices collecting $1M to $5M or more per month — driven not by fraud, but by global period miscoding, missed complication billing, and split-care modifier errors that compound silently across every billing cycle. What Is Revenue Leakage in OBGYN Billing? Revenue […]

Are Payer Policies Complicating Gynecology Procedure Billing?

Yes, payer policies are complicating gynecology procedure billing—with OBGYN practices collecting $1M–$5M+ monthly experiencing 42–58% denial rates when variable payer policies create systematic confusion over global maternity package requirements, IUD insertion coverage, and Medicaid sterilization consent timing rules, costing $1.2M–$3.8M annually when practices apply single standardized workflows across all payers instead of payer-specific protocols, directly […]

Are Maternity Claims Increasing Payer Audit Exposure?

Yes, maternity claims are increasing payer audit exposure—with OBGYN practices collecting $1M–$5M+ monthly experiencing 42–58% audit rates on global obstetric billing when commercial payers scrutinize CPT 59400 claims for unbundling violations, delivery complications underdocumented creating medical necessity denials, and VBAC coding errors triggering systematic recoupment demands of $1.2M–$3.8M annually, directly suppressing EBITDA and net realized […]

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