2026 CPT Updates

Here’s what you need to know for the year 2026

The American Medical Association (AMA) has released the 2026 CPT code set with 288 new codes, 84 deletions, and 46 revisions.

The changes reflect evolving care delivery (digital/remote monitoring, AI/augmentative services), new technologies, and restructuring of existing procedure codes to better match modern workflows.
From a practical standpoint, coders and billing teams should begin preparing now — code sets will take effect January 1, 2026, for many Category I changes.

Digital Health and Remote Care Take Center Stage

The expansion of Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) continues to grow. New codes now allow reporting for shorter data collection periods—as few as 2 to 15 days—rather than the previous 16-day minimum.

A new code will also cover 10 minutes of clinical staff time spent managing a patient’s remote data in a 30-day period, giving more flexibility for practices with lower-volume monitoring needs.

Coding Tip: Document exactly how many days of data were collected, which device was used, and how much time was spent reviewing or managing the results.

AI and Algorithm-Assisted Services Enter the Mainstream

Artificial intelligence is no longer just a tech buzzword—it’s now part of the CPT code set. New AI-assisted service codes recognize algorithms that support clinicians by analyzing medical data and producing insights such as:

• Perivascular fat analysis to assess cardiac risk

• Coronary plaque assessment via CT

• Multispectral imaging for burn depth and wound healing

• AI-based cardiac function analysis using ECG or acoustic data

Coding Tip: To report these services, the documentation must identify the algorithm or software used, describe how it assisted the clinician, and include the physician’s interpretation and final decision.

• Codes added for AI/algorithmic services that assist clinicians (e.g., non-invasive burn wound healing classification, perivascular fat analysis for cardiac risk, coronary plaque assessment via AI) to reflect “augmentative and assistive AI services”.

• This signals that coders and practices must begin familiarizing themselves with how to document use of AI/augmented tools and assign the new codes appropriately.

Expansion & Restructuring of Procedural Codes

• Significant restructuring in certain specialty areas — especially interventional radiology/vascular, lower-extremity revascularization, prostate biopsy, endovascular therapy, thoracic branch endografts.

• For example, the set of codes 37220-37235 (lower extremity revascularization) will be deleted and replaced with ~46 new codes organized by vascular territory.

• In imaging/radiology: new head & neck CTA codes; CTP codes replacing older Category III; irreversible electroporation (IRE) of liver & prostate getting new Category I.

Proprietary Laboratory Analyses (PLA) & Emerging Technologies

• A large portion of new codes (≈ 27 %) are for proprietary laboratory analyses.

• Also, new Category III codes (for emerging services/technologies) have been introduced/expanded.

• Key Specific Changes to Watch

Here are some of the most material changes that will affect coding, billing, and documentation.

Major Overhaul: Vascular and Interventional Radiology

One of the largest restructurings in years occurs within lower extremity revascularization. The long-standing code family 37220 – 37235 will be deleted and replaced by roughly 46 new codes organized by specific vascular territories—iliac, femoropopliteal, tibial-peroneal, and inframalleolar.

This change aims to clarify reporting by vessel and intervention type, but it will require extensive retraining for coding and clinical teams.

Coding Tip: Documentation should clearly describe:

• Which vessels were treated

• The approach used (open vs. endovascular)

• The specific techniques performed (angioplasty, stent, atherectomy)

• Imaging guidance details

• Codes 37220-37235 (older “group”) will be deleted for 2026. They will be replaced by 46 new codes (37X xx series) that specify vascular territory (iliac, femoral/popliteal, tibial/peroneal, inframalleolar). 
  Implication: Practices doing revascularization must update all their systems (EHR, billing, pre-auth, templates) and train physicians/documentation so that the new structure is captured correctly (territory, approach, device, imaging guidance) to avoid revenue cycle disruption.

Imaging, Radiology, and Endovascular Updates

Radiology sees numerous updates across CTA, CTP, and ablation procedures.
New Category I codes replace older Category III entries for head and neck CTA and CT perfusion imaging.
New codes are also introduced for irreversible electroporation (IRE) of the liver and prostate, while thoracic branch endograft procedures receive their own structured reporting options.

Expect bundling and guideline changes affecting imaging guidance (fluoro, CT, ultrasound) and embolization/occlusion procedures.

Coding Tip: Always verify which imaging modality was used and whether it’s separately reportable under 2026 rules.

• New Category I codes for head & neck CTA; CTP; IRE of liver/prostate; thoracic branch endograft services; prostate biopsy codes revised; sacroiliac arthrodesis updates.

• Revised guidelines for “vascular embolization/occlusion”, “endovascular therapy”, and bundling of some imaging guidance codes (61624/61626), etc.
  Implication: Documentation must clearly reflect new descriptors, capture imaging guidance, approach, vascular territory, and device types. Coders must delete old codes and map to new ones effective January 1, 2026.

Modern Hearing Device Services

The 2026 code set modernizes hearing-related services, replacing outdated terminology with codes that better match real-world practice. New options include:

• Assessing visual, dexterity, and psychosocial factors

• Validating device performance

• Training patients on smartphone-connected devices

Coding Tip: Capture the type of device used, testing performed, and counseling provided during the visit.

• New codes for hearing device services (12 codes) reflecting modern approaches (assessing visual/dexterity/psychosocial factors, validating device performance, training support for smartphone-connected devices).

• New AI-assisted service codes (e.g., perivascular fat analysis for cardiac risk, coronary plaque assessment via CT, multispectral imaging for burn wounds, detection of cardiac dysfunction via algorithmic acoustic/ECG analysis). 
  Implication: Documentation must include the fact that the service is algorithm/AI-assisted, the clinical input by the physician, the device/software used, and the output (e.g., risk score or image classification) so coders can determine eligibility for the new codes vs. standard services.

Radiation Oncology and Category III Migrations

Outdated radiation treatment codes are being retired, and the “simple/intermediate/complex” terminology will disappear. Meanwhile, several Category III procedures—once considered experimental—are graduating to Category I status after widespread adoption and supporting data.

Coding Tip: Review every Category III service you report to see if it’s being replaced by a new Category I code in 2026.

Deleted and Revised Codes: Clean Up Before January 1

Hundreds of existing codes will be deleted or revised for clarity, bundling, or obsolescence. Old codes often linger in EHR templates, charge masters, or provider favorites—creating a major compliance risk if not removed before the new year.

Action Steps:

• Build crosswalks between deleted and replacement codes.

• Lock down outdated codes in your billing software.

• Educate your entire team before January 1, 2026.

• Several codes will be deleted due to bundling or redundancy. Example: 0042T (CT cerebral perfusion) will be deleted/replaced.

• Radiation oncology treatment delivery codes (77014, 77385, 77386) will be deleted; the terminology “simple/intermediate/complex” will be retired.

• The Category III code list: addition of 38 new codes (0988T-1025T), among others. 
  Implication: Coders must validate that their codebooks/billing systems are updated. Using deleted codes after their effective dates can lead to denials or incorrect payments.

Documentation & Billing Impact

• With the proliferation of new codes, practices must revise documentation templates to include the new required elements (e.g., vascular territory for LE revascularization, days of data for RPM, algorithm/AI support for services, guidance imaging used, device supply).

• Billing systems must be updated for code mapping, crosswalks from old to new codes, and payers must be notified if using proprietary or AI-services.

• Pre-authorisations / medical necessity justification may become more complex, especially for new territory-specific codes or AI/augmented services. Physicians need to capture the rationale for why the service (e.g., IRE of prostate, AI perivascular fat analysis) was medically necessary.

• Coding education will be critical: coders and billers must be trained on new descriptors, effective dates (some Category III codes have July 1 2025, implementation).

• Revenue cycle risk: If older codes are deleted and not replaced with the new, correct ones, claims may be denied or down-coded. For example, the LE revascularization structure overhaul is a major risk area.

Implementation Timeline & Effective Dates

• Category I codes for 2026 take effect January 1, 2026.

• Some Category III codes (emerging technology) may have July 1, 2025, effective dates (six-month implementation) for the 2026 cycle.

• Practices should target finishing internal updates (EHR, billing, education) by year-end 2025 to avoid disruption on January 1.

• Also note, the proposed changes to the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule for CY 2026 are relevant to CPT changes (conversion factors, reimbursement changes) — so coders/billers should stay aware of that overlap.

Why This Matters for You (Coder / Auditor / Practice Manager)

• Compliance and accuracy: Using outdated codes means risk of non-compliance, denial, or audit.

• Revenue optimisation: The new codes better align with modern services (shorter durations, digital/remote care, AI services). Capturing them correctly can ensure appropriate reimbursement.

• Documentation burden: May increase slightly because new codes often require additional qualifiers (territory, days, software use, device supply). Advance training reduces surprise.

• System changes: EHR and billing systems will need to incorporate the new code descriptors and guidelines. Crosswalks from old to new codes should be prepared.

• Payer awareness: Educate payers (especially commercial/private insurers) about the new codes, particularly in less familiar areas (AI/remote monitoring) to anticipate coverage and reimbursement issues.

• Education & training: Coders should study the “CPT Changes 2026” materials, attend webinars, and update in-house cheat sheets/quick references.

Action Plan Checklist

Here’s a suggested checklist for your team to prepare:

1. Obtain the official CPT 2026 codebook (Professional Edition) and “CPT Changes 2026: An Insider’s View”.

2. Review the major areas of change relevant to your specialty (e.g., imaging, cardiology, remote monitoring) and create a “top changes” list for your practice.

3. Update documentation templates (EHR) to capture required qualifiers for new codes (e.g., days of data for RPM; vascular territory for revascularization; software/algorithm name for AI-services).

4. Update billing system crosswalks: mark deleted codes, map to new codes, create alerts for use of correct codes after Jan 1, 2026.

5. Educate coders, billers, and providers: hold training sessions covering the new code sets, effective dates, and common pitfalls.

6. Audit/monitor first-quarter 2026 claims closely: review whether new codes were used appropriately, check payer responses, and identify denial patterns.

7. Communication with payers: especially for newer services (AI-assisted, hearing device services, remote monitoring) prepare to support medical necessity and device/software descriptions.

8. Monitor RVU and reimbursement impacts: Given the conversion factor/proposed fee schedule changes for CY 2026 (e.g., separate conversion factors for qualifying APMs), your revenue cycle team should understand how these code changes intersect with payment policy.

Deletions, Revisions & Compliance

Deleted, Revised, and Renumbered Codes

• Many codes are deleted or revised for clarity, bundling, or obsolescence. Key risk areas:

  • Deleted codes still sitting in EHR templates or charge capture tools

  • Staff using “old favorites” out of habit

• Action steps:

  • Build crosswalks from deleted codes to new ones

  • Lock down old codes in the charge capture systems

  • Educate coders and providers before January 1, 2026

What This Means for Coders

These changes bring both opportunity and challenge. On one hand, the CPT 2026 updates better capture how healthcare is actually delivered in 2026—digitally, remotely, and with advanced technology. On the other hand, coders and billers must stay sharp:

• Update documentation templates early.

• Retrain staff in affected specialties (especially interventional, radiology, and digital care).

• Verify payer readiness and coverage for new AI and remote-care codes.

• Audit first-quarter 2026 claims to confirm correct code usage.

Key Challenges & Considerations

• Transition risk: With major code deletions (e.g., LE revascularization set) and new codes, the potential for miscoding is high. Mistakes may lead to revenue loss or compliance issues.

• Payer variability: Some payers may lag in recognizing new codes, particularly emerging technology/AI codes. Be prepared with backup documentation and possibly step-through appeals.

• Workload & documentation burden: While the aim is better specificity, the additional qualifiers may add documentation time. Staff workload should be factored into planning.

• System readiness: EHR and billing platforms must be updated timely manner. Delays can lead to claims being rejected with outdated code sets.

• Education depth: Particularly for specialties heavily impacted (radiology/interventional), the code restructuring is “the most extensive in years”. Coders will need deeper training than usual.

• Monitoring/payor audits: New codes may attract attention from payers/check-audit units; proper documentation will help defend claims.

Putting It All Together

The CPT 2026 update is more than an incremental change—it reflects meaningful shifts in how services are delivered (digital, remote, AI), how procedural specialties are coded (territory-specific vascular codes), and how documentation/billing must evolve. For medical coding professionals, being ahead of this change is a competitive and compliance necessity.

By following the action plan, aligning documentation and billing systems, and educating your team proactively, you can minimise risk, optimise reimbursement, and support providers in delivering the documented reality of modern health care.

Coding Clarified’s Takeaway

The CPT 2026 code set reflects where healthcare is heading—data-driven, digital, and precision-based. Preparing early means smoother billing, fewer denials, and continued compliance in a rapidly evolving field.

Coders who understand the why behind each change won’t just keep up—they’ll lead.

ICD-10-CM 2026 Updates 

AMA Releases the 2026 Code Set