OB/GYN Medical Billing Services

Obstetrics & Gynecology Medical Billing for Every Stage of Care

Global maternity packages, high-risk antepartum care, gynecologic surgery, colposcopy, LEEP, and contraceptive management, billed by a team that knows exactly when to bundle a claim and when to itemize it.

AAPC-Trained Mental Health Coders
Carve-Out Payer Routing Checks
HIPAA-Compliant Claim Handling
Works With Your Current EHR

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How We Help

How Thrive Supports OB/GYN Practices

OB/GYN billing sits at the intersection of two specialties inside one practice. We manage both sides: the global maternity cycle that runs from a patient’s first prenatal visit through her six-week postpartum check, and the itemized gynecologic side, annual exams, colposcopy, LEEP, IUD placement, and surgery, billed encounter by encounter.

Our coders are trained specifically on OB/GYN payer rules, not general E/M coding. Antepartum visit counts, delivery type, co-management splits, and device billing get documented and coded correctly the first time, which is what keeps global claims from being downcoded and gynecologic claims from being bundled incorrectly.

HIPAA-Compliant Billing Team
Certified Professional Coders
Nationwide Payer Coverage
Clean claims at first submission, backed by a 95%+ clean claim rate across our client base
Claims out the door within 48 hours of receiving your charge information
Accounts receivable held under 30 days on average, so maternity payments don't sit in limbo
A 30% average revenue increase once coding, denial follow-up, and reporting sit with one team
Scope of Work

What We Manage Across Your OB/GYN Revenue Cycle

Ob gyn medical billing and coding touches every stage of the patient relationship. Here’s what our team owns, split by the two sides of your practice.

Where Revenue Gets Lost
Maternity Benefits Verification
Confirming global maternity coverage and deductible status before the first prenatal visit, not after delivery.
Global vs. Itemized Decisions
Choosing the correct billing structure based on who actually provided antepartum, delivery, and postpartum care.
Prior Authorization
High-risk ultrasounds, non-stress tests, genetic screening, and scheduled cesarean deliveries.
Co-Management Billing
Correct modifier 54/55 splits when an attending OB and a maternal-fetal medicine physician share a delivery.
Gynecologic & Surgical Billing
Surgical Authorization
Prior auth for hysterectomy, endometrial ablation, and other scheduled gynecologic surgery.
Contraceptive Device Billing
Pairing IUD and implant procedure codes with the correct HCPCS device code so neither half goes unbilled.
Preventive & Diagnostic Coding
Well-woman exams, Pap and HPV screening, colposcopy, and endometrial biopsy coded to the correct payer edits.
Credentialing & Enrollment
Getting OB/GYN physicians and certified nurse midwives enrolled correctly on commercial and Medicaid panels.
Shared Across Both
Denial Management & Appeals
Correcting global downcodes, modifier 25 bundling denials, and duplicate-claim rejections, then appealing with the right documentation.
Patient Billing & Collections
Clear statements that separate the maternity global balance from any out-of-pocket gynecologic charges.
AR Follow-Up
Global maternity claims and gynecologic claims tracked separately so nothing ages past 30 days unnoticed.
Reporting
Denial trends broken out by antepartum, delivery, postpartum, and gynecologic claim types, not one blended number.
Coding Reference

OB/GYN CPT & HCPCS Coding Reference

Ob gyn medical billing and coding runs through two separate code families. Here’s how our team keeps them straight on every claim.

Obstetric & Maternity Codes

Global vaginal delivery

Antepartum care, vaginal delivery, and postpartum care under one physician or group

Global cesarean delivery

Antepartum care, cesarean delivery, and postpartum care under one physician or group

Global VBAC & repeat cesarean

Same global structure, billed after a prior cesarean delivery

Antepartum care only

4 to 6 visits (59425) or 7 or more visits (59426), used when a patient transfers care

Delivery-only codes

Used when one provider handles only the delivery, with or without postpartum care

Postpartum care only

Used when a separate provider manages the six-week postpartum visit

Obstetric ultrasound

First-trimester, second and third-trimester, and transvaginal fetal ultrasound, billed outside the global fee

Fetal non-stress test

Antepartum fetal surveillance testing, billed separately from the global package

Amniocentesis & version

Additional antepartum procedures excluded from the global bundle

What actually counts as "global" in a global maternity package?

Global billing means one CPT code covers all routine antepartum visits, the delivery, and postpartum care, as long as one provider or group under one Tax ID number manages the full pregnancy. Anything outside routine care, an unrelated illness, extra ultrasounds, high-risk monitoring, gets billed on its own.
Gynecologic & Surgical Codes

Colposcopy

Cervical exam with or without biopsy, endocervical curettage, or LEEP treatment

LEEP procedure

Loop electrosurgical excision for abnormal cervical tissue

Endometrial biopsy

In-office sampling of the uterine lining

Dilation & curettage

Diagnostic or therapeutic D&C

Abdominal & vaginal hysterectomy

Open and vaginal approaches, with or without removal of ovaries or tubes

Laparoscopic & robotic hysterectomy

Minimally invasive approaches, coded by uterine weight and technique

Endometrial ablation

Thermal or radiofrequency destruction of the uterine lining

IUD insertion & removal

Procedure codes only, device supply billed separately under HCPCS

Contraceptive implant

Subdermal implant insertion, removal, and removal with reinsertion

Well-woman exam

Age-based new and established patient preventive visits

Pap smear & cytology

Screening and diagnostic cervical cytology, often billed separately by the lab

Why does the same procedure sometimes need two codes?

Long-acting contraception is billed in two parts. One CPT code covers the clinical work of inserting or removing the device, and a separate HCPCS code covers the device itself. Missing either half is one of the most common reasons LARC claims come back underpaid.
Where Revenue Leaks

Where OB/GYN Claims Actually Get Denied

These are real payer behaviors, not generic denial reasons. Each one shows up differently on a remit, and each one needs a different fix.

Incomplete Antepartum Visit Counts

A global claim submitted without documenting each antepartum visit gets downcoded to the lower antepartum-only rate, cutting reimbursement by hundreds of dollars per delivery.

Modifier 25 Language Overlap

Payers now compare the E/M note against the same-day procedure note. If the wording overlaps too closely, the E/M gets bundled into the procedure and paid at zero.

Missing Co-Management Split

When an attending OB and a covering physician both bill without modifiers 54 and 55, the second claim is treated as a duplicate and denied outright.

VBAC Conversion Mismatches

Billing a VBAC-attempt code without a clear conversion narrative gets repriced to the standard cesarean rate, often with no formal denial, just a lower payment.

Trimester-Mismatched Diagnosis Codes

Obstetric ICD-10 codes are trimester-specific. A code that doesn’t match the documented gestational week, or a missing weeks-of-gestation code, is an easy automated denial.

Split LARC Billing Errors

IUD and implant claims need both a procedure code and a separate device code. Submitting only one half of the pair leaves real money uncollected.

Unmarked Multiple Deliveries

Twin and higher-order deliveries need a distinct modifier on the second delivery code. Without it, payers assume duplicate billing and deny the second line.

Authorization Gaps on Major Surgery

Hysterectomy, endometrial ablation, and high-risk ultrasound often require prior authorization that front-desk staff miss, causing a full denial after the service is already performed.

Our Process

How We Fix It: Our OB/GYN Claims Process

Eligibility & Authorization Verification

Maternity benefits, device coverage, and surgical authorizations confirmed before the appointment, not after the denial arrives.

OB/GYN-Trained Coding & Bundling Review

Every encounter reviewed to decide global versus itemized billing, with the correct modifiers applied before the claim ever goes out.

Clean Claim Submission

Claims scrubbed against payer-specific maternity and gynecologic edits, then submitted within 48 hours.

Denial Root-Cause Review & Appeal

Every denial or downcode traced to its actual cause, documentation gap, modifier issue, or payer edit, then appealed with the right evidence.

AR Follow-Up & Reporting

Global maternity and gynecologic claims tracked separately so nothing sits unpaid waiting on the wrong phase of care.
Why Thrive

Why OB/GYN Practices Choose Thrive

OB/GYN-Trained Coders, Not Generalists

Our coders work maternity and gynecologic claims specifically, so they know the difference between a delivery-only code and a global package before your claim ever goes out.

Nationwide Payer Experience

Medicaid finances 41% of all U.S. births, and every state runs its own maternity billing rules. We bill OB/GYN claims across commercial, Medicaid, and Medicare payers nationwide.

Ready for the 2027 Coding Transition

We're already adjusting client documentation workflows ahead of the AMA's maternity coding overhaul, so the change doesn't interrupt your cash flow.

HIPAA Compliance & Audit Readiness

Every claim, note, and appeal is handled under strict compliance standards, with documentation ready if a payer ever requests an audit.

Transparent Reporting

You see denial trends broken out by antepartum, delivery, postpartum, and gynecologic claims, not one blended number that hides where revenue leaks.

One Accountable Team

No ticket queues or rotating contacts. The same team that codes your claims also works your denials and answers your questions directly.
Get Started

Talk to an OB/GYN Billing Specialist

Every OB/GYN practice bills a different mix of maternity and gynecologic volume, so we build a custom fee schedule around your actual claim mix rather than a flat industry rate. Start with a free 15-minute practice revenue review and see exactly where claims are being underpaid or delayed.

Book Your Free Revenue Analysis

Schedule a 15-minute meeting to review where anesthesia claims, denials, payments, and AR follow-up are slowing collections.

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Common Questions

Frequently Asked Questions

How much does OB/GYN medical billing cost?
Pricing is based on your claim volume and the mix of maternity versus gynecologic services you bill, not a flat industry rate. We build a custom fee schedule after reviewing your current claims. Start with a free 15-minute practice revenue review to get an accurate quote for your practice.
Most OB/GYN practices are fully onboarded within a week. We review your current claims, coding, and denial patterns first, then align our workflow to how your practice already operates, without disrupting patient scheduling or provider documentation habits.
Yes. We audit your open AR, including aged global maternity claims and unresolved gynecologic denials, and prioritize the claims closest to timely filing deadlines first, so you don't lose revenue during the transition to a new billing team.
Yes. Our coders decide global versus itemized billing based on who actually provided care, not a default setting. We're also actively updating client documentation workflows ahead of the AMA's 2027 maternity coding restructuring, so the transition doesn't interrupt your reimbursement.
Yes. Long-acting contraception requires two separate codes, one for the insertion or removal procedure and one for the device itself. We bill both halves and verify device coverage before the appointment, which is where most LARC underpayments start.
Every denial is traced to its actual cause, whether that's a documentation gap, a missing modifier, or a payer-specific edit, before we appeal. We don't resubmit blindly. Each appeal includes the specific documentation the payer needs to overturn the denial.
Yes. All billing, coding, and claims data is handled under HIPAA-compliant processes and access controls. Our coders and billers are trained on OB/GYN-specific documentation requirements, including sensitive reproductive health information, with the same compliance rigor across every claim.
Yes. We bill across commercial payers, Medicare, and state Medicaid programs nationwide. Since Medicaid finances a large share of U.S. births and every state sets its own maternity billing rules, our team tracks payer-specific requirements state by state.
Free Revenue Analysis

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