There are situations that prevents us from billing the global fee. Examples:
Patient changes insurances mid-pregnancy
Patient transfers to another obstetrician mid-pregnancy
Patient does not carry baby to term
If one of these circumstances occurs we will bill out antepartum care based on the number of prenatal visits the patient had prior to the change of circumstance and then bill for the continued pre/postnatal care and delivery at the pro-rated fee.
Antepartum care is billed as:
1-3 prenatal visits are billed individually at $150.00 each 4-6 CPT: 59425 $1,200.00
6 or more CPT: 59426 $1,800.00
Note: IF a patient is billed 59425 or 59426, all succeeding prenatal visits will be billed as 99213 ($150). The delivery will be billed as follows:
59515 Cesarean delivery including postpartum care $ 8000.00
59410 Vaginal delivery including postpartum care $ 8000.00
We hope this information provided you with a better understanding of our maternity billing process.