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OB-GYN Billing · Washington

OB-GYN billing and revenue cycle for Washington providers.

Washington operates 771 OB-GYN provider organizations registered in NPPES, representing 3.1 percent of the U.S. OB-GYN billing footprint. Washington is a major OB-GYN billing market. OB-GYN revenue cycle blends global OB package management, delivery coding, well-woman preventive billing, LARC + contraception billing, and pelvic surgery coding. Washington OB-GYN practices need coders with depth across all of these.

771
NPPES orgs in WA
3.1%
of US market
#12
national rank
90%+
Realization target
Free WA OB-GYN billing audit →OB-GYN billing services
Last updated: May 31, 2026 · Authored by ASP-RCM Solutions Team

What good OB-GYN billing execution looks like for Washington providers.

The Washington OB-GYN billing market has its own quirks. Here is the operating discipline we install on every Washington engagement.

  1. Global OB package billing and antepartum visit trackingGlobal OB package (59400, 59510, 59610, 59618) bundles antepartum, delivery, and postpartum care. Washington OB-GYN practices need accurate antepartum visit tracking to determine global vs separate billing.
  2. Newborn delivery coding for vaginal vs C-sectionVaginal delivery (59409 with global, 59410 with postpartum) vs C-section (59514, 59515) carry distinct codes. Twin and complex deliveries add code complexity.
  3. Ultrasound and antepartum diagnostic billingOB ultrasound (76801-76817) and BPP, NST, and antepartum surveillance billing require precise study-type coding and appropriate modifier use.
  4. Annual well-woman visit + preventive codingAnnual well-woman visit (99396-99397, plus G0101 / Q0091 for Medicare screening pap) bills distinctly from problem-oriented visits. Modifier 25 needed when same-day E/M occurs.
  5. LARC and contraception codingIUD insertion (58300), removal (58301), and Nexplanon (11981-11983) plus device J-codes (J7297, J7298, J7300, J7301) require accurate placement and inventory billing.
  6. Pelvic surgery and laparoscopic procedure codingHysterectomy, myomectomy, oophorectomy, and pelvic floor procedures carry complex code stacks with bundling rules. Washington OB-GYN practices doing surgery need specialty coders.

State rule map · Washington

Washington OB claims change on January 1, 2027.

Apple Health ends the global obstetric codes on December 31, 2026, and the payer can change mid-pregnancy, so each claim needs the right payer and the right date.

Apple Health OB billing timeline
  1. Global codes 59400, 59510, 59610, 59618 when one provider gives all care. Bill only after all care is complete.
  2. Wait until January 1, 2027, then bill the 2026 visits unbundled under the October 1, 2026 guide.
  3. Itemized billing only. Deleted global codes are not billable in ProviderOne. No overlap period and no proration.
Antepartum care only · billed once per pregnancy
ProviderOne · antepartum only
1 to 3 visitsE/M code with modifier TH for each visit
4 to 6 visits59425, 1 unit, dated the last antepartum visit
7 or more59426, 1 unit, dated the last antepartum visit
First visit0500F at $0.01 with a pregnancy diagnosis
Rules on every Apple Health OB claim
365 days and 24 monthsFirst claim within 365 days; corrections within 24 months (WAC 182-502-0150).
Payer changeFee-for-service pays its months, the plan pays after enrollment. Unbundle and bill each one.
Before 39 weeksEarly elective delivery is not paid. Medically needed: EPA 870001375. 39 weeks or later: EPA 870001378.
Consent formsSterilization: HHS-687, procedure on day 31 to 180. Hysterectomy: HCA 13-365.
What we check before every claim goes out
  • ProviderOne plan check per date of service
  • Unbundle on payer change
  • Global held until care is complete
  • EPA number on every delivery
  • Consent form attached
  • January 2027 cutover plan
Free WA OB-GYN billing audit →

More West state guides.

Sister West state pages for OB-GYN billing.

AK→ AZ→ CA→ CO→

FAQ: OB-GYN billing in Washington.

How many OB-GYN providers operate in Washington?

NPPES lists 771 OB-GYN provider organizations in Washington, representing 3.1% of the U.S. footprint. Top concentrations are in Seattle (156), Tacoma (50), Vancouver (42).

Does Apple Health cover OB-GYN billing services?

Yes. Apple Health covers OB-GYN billing services for eligible beneficiaries, with plan-specific authorization rules and rate structures that vary by year.

What commercial payers cover OB-GYN billing in Washington?

All major national commercial payers cover OB-GYN billing in Washington, including UnitedHealthcare/Optum, Aetna, Cigna/Evernorth, the dominant Washington Blue Cross Blue Shield plan, and (where active) Humana.

Does ASP-RCM serve OB-GYN providers in Washington?

Yes. ASP-RCM Solutions provides OB-GYN and women's health billing services for providers in Washington and across all 50 states. Senior partners on every account. Request a free RCM audit.

How do I get started?

Request a free RCM audit. We assess your current state, identify revenue leakage, and produce a written prioritized recommendations list.

Free RCM audit for Washington OB-GYN providers.

Send us your last 90 days of claim data. We will send back a 4-page audit with prioritized recommendations and dollar estimates.

Request audit →Talk to a senior partner

All Washington city guides.

Every Washington city with a dedicated OB/GYN billing and credentialing guide. 9 cities covered.