Billing of Obstetrical Global Fees

The obstetrical Global Fee was designed and calculated for those physicians’ services routinely performed during pregnancy. Components of these global fees should not be filed separately. When a separate claim is received for these component parts, the claim will be rejected as part of the Obstetrical Global Fee. If previous payments have been made which are considered a part of the Obstetrical Global Fee, a review of the patient’s claim history will occur and payments will be taken out of the physician’s global fee reimbursement.

Listed below are the components of the Obstetrical Global Fee:

• Office or outpatient visits
• Anesthesia for delivery when provided by the obstetrician or obstetrical group
• Antepartum/postpartum visits when provided by the delivering physician or obstetrical group
• External cephalic version
• Delivery of the placenta
• Hospital care visits

The provider rendering the service may bill labs separately.

Ultrasounds are not included in the global maternity fee. Up to two ultrasounds are considered medically necessary when performed in the outpatient setting (including the emergency department) during routine maternity care.

Additional ultrasounds may be considered medically necessary for non-routine (high risk) conditions. Refer to www.bcbsal.com under Medical Policies as referred to below for additional information. Blue Cross and Blue Shield of Alabama: Provider-Alphabetical Final Medical Policies.

Last Updated December 2008