CPT 2026 New Codes & Guidelines: Full Breakdown for US Medical Coders
Welcome To Medico Pediaa : The CPT 2026 updates are finally here, bringing important changes that every medical coder, biller, auditor, and healthcare professional needs to understand. As the U.S. healthcare system continues to evolve, accurate coding has become more important than ever for clean claims, proper reimbursement, and compliance with CMS and private payer guidelines.
The 2026 CPT code set includes new procedure codes, revised descriptions, deleted codes, and updated guidelines designed to improve clarity and reduce coding errors. Whether you work in physician coding, outpatient facilities, ASC billing, radiology, surgery, or telehealth, these changes will impact your day-to-day workflow.
In this article, we break down all major CPT 2026 changes in a simple and practical way so you can stay compliant, avoid denials, and keep your coding knowledge up-to-date. This guide is perfect for medical coders in the USA and India who work with U.S. healthcare standards and want to stay ahead in the industry.
The American Medical Association (AMA) has released its CPT 2026 code set, reflecting significant shifts in medical technology, care delivery, and innovation. According to the AMA, the 2026 update includes a total of 418 changes: 288 new codes, 84 deletions, and 46 revisions.
One of the most notable trends is the broader adoption of remote services, including new codes for short-duration remote physiologic monitoring (RPM) over 2–15 days within a 30-day period. A new code supports RPM treatment management when cumulative monthly time reaches 10–19 minutes, while 99457 and 99458 continue to apply for 20 minutes or more.
Revised reporting rules clarify that RPM and RTM device supply codes (99453, 99454; 98984–98986) may be billed when monitoring occurs on at least two days in a 30-day period. Telehealth coding, including hybrid audio/video and remote visits, continues to expand with more granular options.
AI- and Algorithm-Assisted Services
AI- and algorithm-assisted services are also more prominent in 2026. Documentation must increasingly reflect algorithm involvement, human oversight, versioning, and decision logic.
New Category III cardiology codes include 0992T and 0993T for analysis of perivascular fat to assess cardiac risk, with 0993T incorporating a concurrent CT scan. New Category I code 0710T supports noninvasive arterial plaque analysis, and 93799 may be used for other emerging cardiovascular services.
Additional codes relevant to neurology and systemic health risk assessment include new ECG algorithmic analysis codes such as 0902T and 0903T–0905T, a new code for algorithm-assisted detection of cardiac dysfunction, and Category I code 83884 for neurofilament light chain testing.
New codes for beta-amyloid and tau testing (82233, 82234, 84393, and 84395) support expanded evaluation of dementia and neurodegenerative diseases. Other specialties also see AI-driven additions, including chest imaging codes 0877T–0880T for CT-based diagnostic classification of interstitial lung disease and 0898T for noninvasive prostate estimation mapping using AI analysis.
Proprietary Laboratory Analyses (PLA)
A significant share of the updates, about 27 percent of all new codes, falls within the Proprietary Laboratory Analyses (PLA) category, reflecting rapid growth in genomics, advanced assays, and specialty diagnostics.
These alphanumeric PLA additions include areas such as oncology, obstetrics/gynecology, and infectious disease. Examples include:
0524U for preeclampsia testing
0543U for solid tumor profiling
0556U for respiratory infection identification
Practices and laboratories should carefully review these new codes, verify payer recognition, and update ordering, billing, and documentation workflows. Monitoring early 2026 denials will be essential to quickly resolve payer-specific issues.
Radiology and Procedural Coding Revisions
Several major revisions highlighted by the American College of Radiology take effect in 2026. Lower extremity revascularization coding undergoes a complete redesign, with deletion of legacy codes 37220–37235 and the introduction of approximately 46 new codes that reflect lesion complexity and multiple vascular territories, including inframalleolar interventions.
New Category I codes are also added for CTA of the head and neck, CT perfusion studies, and procedures such as Irreversible Electroporation, which now has dedicated reporting options.
Surgical and interventional practices must review how their workflows map to the new structure, ensure accurate use of modifiers and lesion-territory documentation, and update charge masters, encoder logic, and payer crosswalks.
Audiology and Hearing-Device Coding Overhaul
January 1, 2026 also brings a comprehensive overhaul to CPT coding for hearing-aid and hearing-device services. Legacy codes 92590–92595 will be deleted and replaced with 12 new codes that better align with contemporary audiology care.
Examples include 92628 for the first 30 minutes of hearing-aid candidacy evaluation, with time-based add-on code 92629. Other codes address:
Device selection (92631/92632)
Fitting (92634/92635)
Post-fitting follow-up and behavioral verification (92636–92638)
Electroacoustic verification (92641)
Audiology practices should audit current usage of the retiring codes, map each service component to the new structure, update documentation templates, and review payer policies to ensure proper alignment.
Time-Based Coding for Many Services
Several of the new services are time-based: you bill based on minutes spent.
Example:
92628 = Evaluation for candidacy, first 30 min (threshold: 16–37 min)
+ 92629 = Additional 15-min blocks (for the same service)
92631 / +92632 = Hearing aid selection (first 30 min + add-on)
92634 / +92635 = Hearing aid fitting (60 min base, then 15-min add-on)
92636 / +92637 = Post-fitting follow-up (30 min + 15-min add-on)
Non–Time-Based / Add-on Codes
In addition to time-based services:
92638: Behavioral verification (like aided thresholds, functional gain, speech-in-noise)
92639: Probe-microphone verification (i.e., real-ear or similar mic-measure)
92641: Electroacoustic analysis / verification of the hearing device
92642: Fitting services for hearing assistive / supplemental devices, e.g., FM / remote mic systems, alerting devices
Deletions, Revisions, and Guideline Changes
Across the full code set, the AMA reports 84 deletions and 46 revisions, many of which affect bundling logic, guideline language, and descriptor terminology.
For example, vascular coding transitions from an anatomy-based structure to a complexity and territory based model, while radiation oncology and endovascular therapy codes such as 77014 and 77385/77386 are being deleted.
Revised guidelines introduce updated service-level hierarchies and remove outdated “simple/intermediate/complex” terminology. Billing teams should conduct a full gap analysis within their most frequently used code families, identify deleted codes lacking direct replacements, and update documentation, workflow expectations, and vendor tools before the new year.
Conclusion: CPT 2026 Update
The CPT 2026 update marks one of the most significant revisions in recent years, introducing major advancements, expanded code families, and modernized guidelines that reflect today’s rapidly evolving healthcare landscape. With 288 new codes, 84 deletions, and 46 revisions, the update ensures that medical coding accurately represents the latest technologies, procedures, and clinical workflows.
A major highlight of CPT 2026 is the introduction of territory-based lower extremity revascularization codes, replacing older codes with a more precise, anatomy-driven structure to support accurate documentation and reimbursement. Similarly, the update strengthens coding for AI-enabled diagnostic tools, digital health, and remote patient monitoring, enabling coders and healthcare providers to align with the growing use of virtual care and intelligent technologies. New code sets in audiology, radiology, cardiology, and interventional medicine further enhance coding clarity and support modern therapeutic approaches.
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