What's new in medical billing 2026

Medical billing in 2026 continues to evolve as practices adapt to new CPT coding changes, FY 2026 ICD-10-CM updates, revised remote monitoring rules, and important Medicare policy updates. For physician groups, specialty clinics, and multi-location organizations, the goal is not just compliance. It is making sure coding, documentation, and reimbursement workflows stay accurate enough to avoid denials and protect revenue. If your team is reviewing broader workflow support, this is also a good time to revisit your medical billing services strategy and operational processes. Source Source

CPT and ICD-10 updates practices should prepare for

The 2026 CPT code set includes 418 total editorial changes: 288 new codes, 46 revised codes, and 84 deleted codes. These updates reflect continued changes across evaluation and management, surgery, pathology, laboratory, radiology, and digital medicine. For billing teams, that means chargemasters, encoder tools, claim edits, and staff education all need timely review before outdated coding starts affecting reimbursement. Source

On the diagnosis side, FY 2026 ICD-10-CM updates remain just as important. CMS has published the FY 2026 ICD-10-CM files, including the code descriptions, addendum, conversion files, and official coding guidelines, with an additional April 1, 2026 update cycle. Industry reporting on the FY 2026 release notes 487 new diagnosis codes, 38 revised codes, and 28 deleted codes, so practices should make sure both coding teams and EHR templates are aligned with the current version in use. Source Source

For organizations managing multiple specialties, this is also a strong opportunity to standardize payer rules, specialty edits, and coding governance. Emerald’s guide to medical billing for multi-specialty practices is a relevant internal resource to support that process.

Remote monitoring changes are one of the biggest billing stories of 2026

One of the most important billing developments this year is the refinement of remote physiologic monitoring. AAPC highlights that CPT 2026 revises the descriptors for codes 99453 and 99454 and adds code 99445 for device supply plus daily recording or programmed transmission for two to 15 days in a 30-day period. That added flexibility matters for practices that do not always reach the longer monitoring threshold every month. Source

AAPC also notes that new code 99470 covers the first 10 minutes of remote physiologic monitoring treatment management, while codes 99457 and 99458 were revised as a result. This is an important distinction: the new 10-minute option does not mean CMS or CPT universally reduced the existing 20-minute requirement across the board. It creates an additional lower-threshold reporting option for appropriate scenarios. Practices involved in telehealth and virtual care should coordinate this with their broader telemedicine billing workflows and documentation standards. Source

Medicare telehealth flexibilities are still in effect through the end of 2027

The telehealth section of the original article needed the biggest factual update. Current federal guidance states that many Medicare telehealth flexibilities have been extended through December 31, 2027. That includes continued access to non-behavioral telehealth services from the patient’s home, no geographic restrictions for originating site in many cases, continued eligibility for a broader range of Medicare telehealth providers, and continued use of audio-only communication for certain Medicare telehealth services through that date. Source

Because of that extension, practices should not frame January 30, 2026 as the current cutoff. The more accurate message is that telehealth remains an active part of revenue-cycle planning in 2026, but practices still need to monitor payer-specific rules, documentation requirements, and future legislative changes. For teams focused on remote care reimbursement, Emerald’s article on new telemedicine codes and CMS reimbursement policies is a relevant internal link to include here.

Reimbursement changes still require close attention

CMS finalized a -2.5% efficiency adjustment to work RVUs and the intraservice portion of physician time for non-time-based services in CY 2026. CMS explains that this adjustment applies broadly to non-time-based services, while excluding categories such as E/M services, care management services, behavioral health services, services on the Medicare telehealth list, and certain maternity codes. Importantly, the CMS fact sheet does not verify the “nearly 7,700 codes” figure used in the current article, so that number should stay out unless you have a source that explicitly supports it. Source

For practices that rely heavily on procedures, imaging, or diagnostic services, even a targeted adjustment like this can affect revenue projections. That is why payer mix analysis, coding accuracy, and denial prevention remain critical. This paragraph is a natural place for an internal link to Emerald’s RCM services page.

How practices should respond to these 2026 billing changes

The most effective response is operational, not just informational. Practices should update fee schedules, coding software, EHR templates, and internal claim-edit logic; retrain coders and billers on revised CPT and ICD-10 rules; and make sure providers understand documentation expectations for remote monitoring and telehealth encounters. Source Source

It is also smart to audit denials and underpayments more aggressively during transition periods. When code families change, claim rejections often rise because of outdated templates, payer edits, or inconsistent documentation. A highly relevant internal link here would be Emerald’s post on medical claim rejections and proven solutions.

FAQ

Is Medicare telehealth still flexible in 2026?

Yes. Many Medicare telehealth flexibilities remain in place through December 31, 2027, according to current federal telehealth policy guidance. Source

Did CMS say the 2.5% work RVU adjustment affects 7,700 codes?

Not in the CMS fact sheet reviewed here. CMS describes the adjustment as applying to non-time-based services, with listed exemptions, but does not confirm that specific numeric count. Source

Did the new 10-minute treatment-management code replace the old 20-minute structure?

No. The new code creates an added lower-threshold option. It should not be described as a blanket reduction or replacement of the prior framework. Source