Upcoming billing change could make pregnancy pricier
Summary
Starting in January, doctors in the U.S. will bill separately for each pregnancy-related visit and service, instead of using one combined payment. This change aims to reflect the actual care provided but may lead to higher costs for some patients, especially those with high-deductible insurance plans.Key Facts
- The new billing codes will replace the current bundled payment system for maternity care.
- Doctors, including OB-GYNs, support the change to better match the care they provide.
- The previous system had a fixed number of prenatal visits and one payment for childbirth, regardless of complexity.
- New codes allow billing for varying numbers of visits and different services by multiple care providers.
- Patients with high-deductible plans might face higher out-of-pocket costs due to more separate charges.
- Insurance companies are concerned about the quick timeline to implement these code changes.
- The Centers for Medicare & Medicaid Services (CMS) is reviewing the new codes and will decide on their reimbursement levels.
- The American Medical Association is working to educate doctors and insurers about the new billing system.
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