Payer policy record
Capital Blue Cross: the 2027 transition
Maternity billing source evidence for Capital Blue Cross. Verify the product, service, and effective date before applying a policy.
Confirmed 2027 guidance
What the source establishes
- Plan scope
- Pennsylvania programs listed in the administrative bulletins. Verify product and FP-01.011 applicability.
- Transition
- July guidance introduces visit-based reporting from September 1. A later bulletin updates modifier instructions effective November 1, 2026.
- Global billing
- Use the current FP-01.011 policy and both bulletins together; the September update changes earlier modifier guidance.
- E/M documentation
- The November update extends TH to maternity-related procedure codes beyond E/M. Check the source for applicable services.
Primary source documents
Capital Blue Cross · Published 2026-07-01 · Checked Sep 30, 2026
July 2026 administrative bulletin: FP-01.011“transitioning away from global obstetric codes in favor of visit-based service reporting.”
Capital Blue Cross · Published 2026-09-01 · Checked Sep 30, 2026
September 2026 update to FP-01.011“Providers must append HCPCS modifier TH to all maternity-related procedure codes”
Record history
Sep 30, 2026
Initial source record added
Primary-source research added to the resource center. Clinical review remains pending; this is not a payer policy change.