Billing for Prenatal and Delivery Services
Topics included in this section: Prenatal care billing information
Go to information on
billing for prenatal care:
- Individual visits (3 or less)
- Prenatal services only (no associated delivery)
- Prenatal with delivery and postpartum (7 or more prenatal visits)
- High-risk pregnancies
- Illness during prenatal period
Prenatal education billing codes
See the chart of
Prenatal education billing codes.
Delivery & postpartum care billing information
Go to information on
billing for delivery & postpartum care:
- Delivery only (no prenatal or postpartum care)
- Delivery and postpartum care (no prenatal)
- Postpartum care only (no associated delivery)
- Cesarean section
- Multiple birth deliveries
- Multiple births by Cesarean section
When additional information may be needed
Priority Health will return claims for additional information in some cases. Examples include:
- Member became effective with Priority Health during the pregnancy: Another insurance plan or the member would be responsible for the portion of the payment for services
- Member loses coverage during pregnancy
- Member changes from a Priority Health self-funded plan to a Priority Health fully funded plan, or vice versa (payor changes from the employer to Priority Health or vice versa)
