Coding Updates Every Provider Should Expect in 2026

CPT, ICD-10, and HCPCS Changes That May Influence Your Revenue

Each January, the new calendar year brings a flood of code updates that impact how providers bill, document, and get reimbursed for services. And 2026 will be no exception.

From CPT code additions to ICD-10 reclassifications and evolving HCPCS modifiers, providers must stay alert to ensure accurate claims and timely payments. For independent practices with leaner administrative teams, missing these changes can lead to rejected claims, payment delays, and compliance risk.

Here’s what every healthcare provider should prepare for as 2026 approaches—and how a strategic billing partner like NCDS can help you stay ahead of the curve.

Why Staying Current with Coding Changes Matters

• Inaccurate codes = denied or delayed claims
• New services often require updated or newly added codes
• Old codes may be deleted or reassigned each year
• Coding updates often reflect regulatory and payer policy changes

The American Medical Association (AMA), the Centers for Medicare & Medicaid Services (CMS), and the World Health Organization (WHO) each release annual updates to CPT, HCPCS, and ICD-10 respectively. These updates don’t just tweak the language—they shift how services are described, categorized, and reimbursed.

Confirmed Coding Trends & Updates for 2026

1. CPT Code Additions for Digital Health & AI Services

The AMA continues to expand the CPT code set for remote monitoring, digital therapeutics, and artificial intelligence-assisted diagnostics.

What’s coming:

• More Category I CPT codes for AI-powered tools and digital therapeutics
• Consolidation of temporary Category III codes as emerging tech becomes mainstream

Source: AMA CPT Editorial Summary of Panel Actions (February 2024)

“The CPT code set is evolving to reflect how technology is changing the delivery of care,” said AMA President Jesse Ehrenfeld, MD, in a 2024 update.

2. ICD-10 Code Expansions for Mental & Behavioral Health

The ICD-10-CM update effective October 1, 2025 (for FY 2026) will likely include new and revised codes to reflect growing demand for behavioral health services.

Examples to watch for:

• Codes related to social determinants of health (SDoH)
• Expanded classifications for anxiety subtypes and trauma-related disorders

Source: Centers for Disease Control and Prevention (CDC), FY 2026 ICD-10-CM Updates (expected)

3. HCPCS Modifier Updates for Telehealth and RPM

CMS is expected to continue refining HCPCS Level II codes and modifiers for remote patient monitoring (RPM) and virtual services as telehealth policy matures post-pandemic.

What to expect:

• Revised use of modifier 95 for audio-visual telehealth
• Continued emphasis on POS 10 vs POS 02 for telehealth place-of-service
• New codes/modifiers for hybrid models and asynchronous care

Source: CMS CY 2024 Physician Fee Schedule Final Rule

3 Common Provider Pitfalls During Coding Updates

1. Failing to update EHR templates and dropdowns
   Even with updated codes, many practices forget to revise documentation templates—leading to mismatches and rework.
2. Using deleted or revised codes from the previous year
   This is a leading cause of claim denials each January.
3. Inadequate staff training
   Coders and billers need refreshers on what’s changed and why—especially when new documentation rules apply.

Best Practices for a Smooth Coding Transition

• Review AMA, CMS, and CDC updates by Q4 2025
• Update billing software and EHRs before January 1, 2026
• Educate coders, billers, and providers through team-wide sessions
• Verify payer-specific code adoption timelines and interpretations

💡 Tip: Even when CMS approves a code, commercial payers may delay adoption or apply unique criteria. Always double-check.

How NCDS Helps You Navigate Annual Code Changes

At NCDS, we don’t just react to code updates—we anticipate them.

Our certified coders monitor every CMS and AMA release, translate those changes into provider-friendly guidance, and ensure your systems, workflows, and claims are aligned. Whether it’s a new telehealth modifier or a diagnostic code reclassification, we make sure you’re ready before it hits your bottom line.

Our approach includes:

• Annual client code update briefings
• EHR audit and configuration support
• Real-time denial tracking tied to new codes
• Modifier usage analysis
• Staff Q&A and education support

Key Stats to Keep in Mind

• 349 new, 70 deleted, and 93 revised CPT codes were released in 2024
  Source: AMA CPT 2024 Summary
• CMS has confirmed continued use of Modifier 95 and POS 10 for non-facility telehealth through 2025 and potentially beyond
  Source: CMS Final Rule CY 2024
• ICD-10 has added over 70 new mental health–related codes since 2021, with more proposed for FY 2026
  Source: CDC ICD-10-CM Updates

Ready for 2026 Coding Updates?

Don’t let outdated codes or overlooked modifiers cost you revenue in 2026.

NCDS helps practices stay compliant, optimize reimbursement, and avoid rework—without the guesswork.

Learn more about our Certified Coding services.

Questions?