Billing for Prenatal/Postpartum Visits

As announced in November 2024, claims using global bill codes for prenatal and postpartum services provided to New York state Medicaid members must have a Category II CPT code in addition to the global code starting April 15, 2025. 

The following Category II CPT Codes must be included on a claim: 0500F (Initial Prenatal Visit), 0502F (Subsequent Prenatal Visit), or 0503F (Postpartum visit) for each corresponding visit provided to the patient within the obstetric global period being billed. Claims submitted without the appropriate Category II CPT codes will be denied. For details, see EmblemHealth’s Coding Edits Reimbursement Policy.

JP 68975 04/2025