Global Maternity Financial Policy
Maternity care is billed as a global fee at the end of the pregnancy at the time of childbirth. Labs, ultrasounds, fetal non-stress tests, blood draws, and complications/problem visits are not considered to be part of the global fee and are billed separately at the time of service. Depending on your insurance coverage, you may be responsible for a portion of these charges.
** Please remember that you may have a deductible that will have to be met. If this is the case, you may have additional charges that will be your responsibility. Deductibles cannot be collected upfront. The claims must go through the insurance first. **
Co-pays: Most insurances do not charge a copay per visit AFTER your initial visit. They do, however, charge copays for any testing or visit outside of the “Routine Prenatal Care”. Specialized testing, such as non-stress testing, will require copays. Copays are due at the time of service.
Please keep in mind that although your insurance quotes benefits regarding pregnancy, there is no guarantee of payment. Insurances consider many factors when claims are being adjudicated or processed. Any questions regarding an insurance payment must be directed to your insurance company.
Below is a sample listing of maternity-related expenses (with CPT codes). The routine OB care/delivery fee is $10,000.00, however, since this fee does not encompass all expenses (as outlined above) the patient may owe additional. Since many variables exist with maternity care, we are unable to provide the exact total cost of care until the end of the pregnancy when all services have been rendered.
| CPT: |
Description:
|
Charge Amount: |
| 59400 |
Routine OB care/Vaginal delivery
|
$10,000.00 |
|
or
|
||
| 59510 |
Routine OB care/Cesarean
|
$10,000.00 |
| 59412 |
External Cephalic Version
|
$800.00 |
| 54160 |
Circumcision
|
$600.00 |
| 59000 |
Amniocentesis
|
$500.00 |
| S2410 |
Cord Blood Collection
|
$250.00 |
| 76805 |
14 Weeks Transabdominal
|
$425.00 |
| 76815 |
Limited OB Sonogram
|
$275.00 |
| 76818 |
Fetal Biophysical profile
|
$600.00 |
| 76819 |
Fetal BPP w/o NST
|
$300.00 |
| 59025 |
Fetal Non-Stress Test
|
$250.00
|
| 99213 |
Sick Office Visit
|
$150.00 |
| 36415 |
Venipuncture (blood draw)
|
$35.00 |
A good faith deposit of $2000 is required during the 2nd prenatal visit from patients with out of network insurance providers.
SELF PAY patients are required to complete a prepayment plan as follows:
- New OB confirmation Appt: $600
- 2nd Prenatal Visit: $2000
- Monthly: $1000
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 occur 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 $ 8,000.00
59410 Vaginal delivery including postpartum care $ 8,000.00
We hope this information provided you with a better understanding of our maternity billing process.
Global Maternity Financial Policy
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