{"id":443893,"date":"2023-12-16T03:45:25","date_gmt":"2023-12-16T08:45:25","guid":{"rendered":"https:\/\/www.billingparadise.com\/blog\/?p=443893"},"modified":"2026-03-13T06:48:11","modified_gmt":"2026-03-13T11:48:11","slug":"postpartum-care-billing-after-initial-outpatient-visit-the-fourth-trimester","status":"publish","type":"post","link":"https:\/\/www.billingparadise.com\/blog\/postpartum-care-billing-after-initial-outpatient-visit-the-fourth-trimester\/","title":{"rendered":"Postpartum Care Billing After Initial Outpatient Visit: The Fourth Trimester"},"content":{"rendered":"
[vc_custom_heading text=”Effective Billing Strategies for OBGYNs During the Fourth Trimester: Navigating Postpartum Care After the Initial Outpatient Visit” font_container=”tag:h2|font_size:36px|text_align:left|color:%23ef652f|line_height:1.1″ google_fonts=”font_family:Roboto%3A100%2C100italic%2C300%2C300italic%2Cregular%2Citalic%2C500%2C500italic%2C700%2C700italic%2C900%2C900italic|font_style:700%20bold%20regular%3A700%3Anormal”]

The world of healthcare billing and coding is ever-evolving, and the realm of obstetrics and gynecology (OBGYN) is no exception. The American Rescue Plan Act, enacted on March 11, 2021, introduced significant changes, particularly in the area of postpartum care billing. These changes, especially relevant to the ‘fourth trimester’\u2014a critical period following childbirth\u2014are reshaping how healthcare professionals approach billing for postpartum services.<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/section>

[vc_custom_heading text=”Understanding the Fourth Trimester in OBGYN” font_container=”tag:h3|font_size:34px|text_align:left|line_height:34px” google_fonts=”font_family:Roboto%3A100%2C100italic%2C300%2C300italic%2Cregular%2Citalic%2C500%2C500italic%2C700%2C700italic%2C900%2C900italic|font_style:500%20bold%20regular%3A500%3Anormal”]

The fourth trimester, a term becoming increasingly recognized in obstetrics and gynecology, refers to the first twelve weeks following childbirth. This period is critical for new mothers, demanding continuous medical attention and care. However, traditional medical billing practices have not always recognized the unique needs of this phase.<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/section>

[vc_custom_heading text=”Changes Brought by the American Rescue Plan Act” font_container=”tag:h3|font_size:34px|text_align:left|line_height:34px” google_fonts=”font_family:Roboto%3A100%2C100italic%2C300%2C300italic%2Cregular%2Citalic%2C500%2C500italic%2C700%2C700italic%2C900%2C900italic|font_style:500%20bold%20regular%3A500%3Anormal”]

The American Rescue Plan Act’s introduction has been a game-changer for postpartum care billing<\/a>. It opened a new pathway for states to extend Medicaid coverage to one year postpartum. This extended coverage, effective from April 1, 2022, necessitates a revised approach to medical billing, particularly for services rendered during the initial outpatient visit and subsequent fourth trimester period.<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/section>

[vc_custom_heading text=”Billing for Initial Outpatient Visit and Beyond” font_container=”tag:h3|font_size:34px|text_align:left|line_height:34px” google_fonts=”font_family:Roboto%3A100%2C100italic%2C300%2C300italic%2Cregular%2Citalic%2C500%2C500italic%2C700%2C700italic%2C900%2C900italic|font_style:500%20bold%20regular%3A500%3Anormal”]

The initial postpartum period, typically covering the first 12 weeks after birth, traditionally fell under the umbrella of global maternity codes. However, under the new guidelines, care provided after this period should not be billed using these global codes but instead should be charged using the appropriate Evaluation and Management (E\/M) or procedure codes.<\/span><\/p>\n

The global maternity codes (59400, 59510, 59610, 59618) include routine hospital and office visits, but the comprehensive postpartum office visit, especially after the initial outpatient visit, demands a more nuanced approach. A typical comprehensive postpartum office visit (coded as 99214) includes a range of services:<\/span><\/p>\n