By Franklin Delgado
In case maternal care and hospitalization is no longer expensive in the United States, the implementation of new billing codes starting in January 2026 will mean that These services, previously billed globally, will be charged individually. This change seeks to more accurately reflect the care provided, although it raises concerns about costs to patients.
As expected, obstetricians and gynecologists support the new structure, arguing that it allows the number of visits and care to be adapted according to individual needs. They argue that, for example, the number of prenatal visits could be increased, which is currently set at 13, a figure they consider quite low, he says. KFF Successfully Being Filescited by C.B.S..
However, patient advocates warn that the change could result in higher out-of-pocket bills, especially for those with high-deductible health plans. “I’m always concerned about anything that further fragments our health care system,” said Caitlin Donovan, senior director of the Patient Recommend Foundation, a nonprofit that provides case management services for sick people in the U.S.
Financial implications
The concern revolves around how insurers will implement these new codes and whether this will result in increased insurance premiums.
The American Medical Association (AMA) plans to educate providers and payers about the new structure, while the Medicaid system may not be affected for a significant percentage of deliveries.
Supposed improvement in postpartum care
The new codes will allow doctors to charge for the long-term follow-up needed after childbirth, addressing crucial medical issues in the postpartum period.
Despite the potential benefits, there are fears that the per-service approach could incentivize unnecessary testing and increase costs.
This new billing will mark a turning point in maternity care in the United States, and its impact will be monitored by health experts and policymakers.
Prenatal and postpartum care alternatives
There are several alternatives in the United States for women facing high costs for prenatal and postpartum care:
Medicaid and state programs
- Medicaid: Offers full prenatal coverage to low-income pregnant women. In many states, benefits are available regardless of immigration status.
- CHIP: Provides care for pregnant women and children in families who do not qualify for Medicaid, but have limited income.
- Prenatal and postpartum care is covered, including visits, exams, delivery, and breastfeeding counseling.
Community Health Centers (Community Successfully Being Facilities)
- Clinics that offer prenatal and postpartum services to reduced or free costsdepending on income.
- You can find a center near you on the website of the Successfully being Resources and Products and services Administration (HRSA).
- Services include: care by nurse practitioners and doctors, ultrasounds, prenatal classes, laboratory and family planning.
Charity programs and hospitals with help
- Some hospitals have programs for pregnant women without health insuranceoffering free or low-cost prenatal care and essential services.
Non-profit organizations
- Migrant Clinicians Network and March of Dimes: They offer information and assistance to access prenatal services.
- These organizations particularly help migrant and low-income women.
WIC Program
- WIC (Particular Supplemental Nutrition Program): Provides nutritional support, dietary advice, and medical referrals to low-income pregnant and lactating women.
Midwives and obstetric nurses
- Many women can choose between licensed midwives, certified nurse-midwives and other providers who typically have lower costs than traditional obstetricians.
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