The medical billing industry is entering a major transition in 2026 with the introduction of hundreds of new CPT codes focused on digital health, artificial intelligence (AI), and advanced care models. These updates, released by the American Medical Association, will directly impact how healthcare providers document services, submit claims, and receive reimbursement. For practices that fail to prepare early, these changes could lead to denied claims, underpayments, and compliance risks.
This update is especially critical for medical billing companies, practice managers, and healthcare providers who rely on accurate coding to protect revenue.
Why CPT Code Updates Matter in Medical Billing
CPT code changes are not just administrative updates. They define how services are reported and reimbursed by Medicare and commercial payers. When new codes are introduced, billing workflows, EHR systems, and staff training must be updated to ensure claims are submitted correctly from day one.
In 2026, the scale of change is larger than usual, with a strong focus on technology-driven healthcare delivery.
Key Highlights of the 2026 CPT Code Expansion
The 2026 CPT code set includes a significant number of new and revised codes that reflect how modern healthcare is delivered today. Key areas include digital health services, AI-supported clinical decision-making, and remote patient monitoring.
These changes align closely with evolving policies from Centers for Medicare & Medicaid Services, making compliance even more important for practices billing Medicare and Medicare Advantage plans.
Digital Health and Virtual Care Codes
New CPT codes expand how providers can bill for digital health services beyond traditional telehealth visits. These include:
Virtual check-ins and asynchronous communication
Remote data review and patient engagement
Ongoing digital care management services
Medical billing teams must carefully distinguish which services are time-based, which require provider interaction, and which are bundled under existing care management codes.
AI and Technology-Assisted Care
For the first time, CPT updates formally recognize services supported by artificial intelligence. While AI does not replace clinical judgment, new codes account for:
AI-assisted diagnostics
Algorithm-supported clinical decision tools
Data interpretation workflows that support provider care
From a billing perspective, documentation requirements will be strict. Claims must clearly show how AI tools supported care without violating payer guidelines.
How These Changes Impact Medical Billing Companies
Medical billing companies must act early to avoid revenue disruption in 2026. The most common risks include:
Incorrect code selection due to unfamiliarity
Missing documentation elements required for new CPT codes
Claim denials caused by outdated billing software
Underbilling for services that now qualify for reimbursement
Proactive billing partners can turn these changes into an advantage by helping practices capture revenue that was previously unbillable.
What Practices Should Do Now
To stay ahead of the 2026 CPT updates, healthcare practices and billing teams should:
Review upcoming CPT code changes in detail
Update billing software and EHR templates
Train staff on new digital health and AI-related codes
Audit documentation workflows before January 2026
Partner with an experienced medical billing company
How MABS Helps Practices Stay Compliant and Profitable
At Medical Accounting and Billing Services (MABS), we closely monitor CPT updates, Medicare policy changes, and payer guidelines to ensure our clients remain compliant and fully reimbursed. Our proactive approach helps practices adapt to digital health billing changes without operational stress or lost revenue.
If your practice plans to expand virtual care or technology-driven services in 2026, having the right medical billing partner is essential.
