A Practical Breakdown of New, Revised, and Deleted CPT Codes 2026 for Clinics

The CPT 2026 code set is now live, and it’s one of the most consequential updates in recent years for clinics that rely on accurate coding to keep revenue flowing and compliance risk low. With 288 new codes, 84 deletions, and 46 revisions, this year’s changes are not just housekeeping—they directly shape how you document visits, bill payers, and measure performance across single and multi‑location practices.

For physician groups, multi‑location clinics, therapy providers, and digital health–enabled practices using Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM), understanding CPT 2026 is now a core part of revenue strategy—not an annual afterthought.

This guide walks through what changed, why it matters, and how to prepare your clinic so your coding, RTM/RPM programs, and revenue cycle stay ahead of the curve.

What Is CPT 2026 and When Do the Changes Apply?

Current Procedural Terminology (CPT) is the standardized code set maintained by the American Medical Association (AMA) to describe medical, surgical, and diagnostic services. CPT codes are used universally in US claims to support billing, reimbursement, analytics, and regulatory reporting.​

Key points for 2026:

• The 2026 CPT code set is effective for dates of service on or after January 1, 2026.

• Claims for services performed in 2026 must use CPT 2026 codes, even if your internal templates still show older descriptors.

• CPT is part of the HIPAA standard code sets, so using outdated codes will result in rejections, denials, and potential compliance issues.​

For multi‑location clinics and networks, this isn’t just a coding update; it’s an operational change that touches scheduling, documentation, billing, and performance reporting.

The Scope of CPT 2026: How Big Is This Update?

According to AMA and multiple industry summaries, CPT 2026 includes:

• 288 new CPT codes

• 84 deleted codes

• 46 revised codes

• 418 total changes across the code set

A large portion of new codes are concentrated in:

• Digital health and remote services (RPM, RTM, virtual care)

• Augmented intelligence (AI)–enabled services

• Cardiovascular and vascular procedures

• Hearing device services

• Proprietary laboratory analyses (PLA)

For CliniQ’s audience—clinic owners, operations leaders, and RTM/RPM‑driven practices—the most relevant themes are:

• More granular codes for remote monitoring and hybrid care models

• Clarified descriptors that raise the bar on documentation quality​

• Deleted legacy codes that can no longer be used in 2026 and beyond

New CPT 2026 Codes: Where Clinics Should Pay Attention

New codes are designed to capture services that previously required vague or unlisted codes, especially in emerging areas like digital health.

1. Digital Health, Remote Monitoring, and AI

The 2026 code set continues the trend of expanding digital health coverage, including:

• New Category I codes for remote monitoring over shorter timeframes (2–15 days), complementing existing RPM/RTM codes that historically required 16+ days of data.​

• AI‑related service codes where augmented intelligence assists in image analysis, decision support, or risk stratification.

For clinics already using RTM and RPM—or planning to scale remote programs across locations—these codes:

• Increase billing specificity, reducing reliance on unlisted codes

• Enable more flexible reimbursement for shorter monitoring periods

• Improve data capture for outcomes and operations analytics

2. New Procedure and Service Codes by Specialty

Specialties seeing notable additions include:

• Cardiology and vascular procedures

• Surgical subspecialties

• Radiology and interventional imaging

• Hearing device–related services

• Emerging diagnostic technologies (especially in PLA codes)

Each new code represents an opportunity to align reimbursement with how care is actually delivered—if your documentation and charge capture processes keep up.

Revised CPT 2026 Codes: Small Words, Big Impact

Revisions don’t always introduce new codes, but they change the rules of the game by refining descriptors, bundling logic, and usage notes.

Typical revision themes include:

• Updated language to reflect current clinical standards

• Clarified bundling rules—what’s separately reportable vs included

• More precise time, scope, or anatomy definitions

Why this matters:

• Slight wording changes can change whether a service is billable separately or considered part of a larger procedure.​

• Revised descriptors may require more specific documentation to prove medical necessity.

• Continuing to code “the old way” with updated codes can quietly drive up denials and underpayments.

For example, 2026 updates in E/M, imaging, and bundled procedures follow the broader AMA trend: more specificity, more clarity—but also higher expectations for documentation and coding accuracy.

Deleted CPT 2026 Codes: What You Can’t Use Anymore

Deleted codes are just as important as new ones. The 84 deleted CPT codes in 2026 include:

• Outdated PLA codes

• Codes for procedures no longer commonly performed

• Codes that are now better represented by newer, more specific alternatives

If a deleted code is still on your superbills, templates, macros, or EHR picklists, you risk:

• Automatic denials when claims hit payer systems

• Rework and resubmissions, slowing cash flow

• Compliance flags, especially if deletions relate to misused or overused codes

A practical step for CliniQ‑type clinics: build a crosswalk that maps deleted codes to their 2026 replacements where applicable, and retire any services that no longer have a compliant CPT mapping.

Why Accurate CPT Coding Still Drives Revenue, Risk, and Operations

CPT 2026 isn’t just a technical update—it directly affects:

• Revenue integrity: Accurate codes = correct payments and fewer write‑offs

• Compliance and audit risk: Inconsistent or outdated coding patterns are a common trigger in payer and government reviews​

• Operational efficiency: Clean claims reduce staff time spent fixing denials and responding to audits

Common coding risks highlighted in compliance literature include:

• Upcoding (billing higher than documentation supports)

• Unbundling (separating services that should be billed together)

• Use of obsolete codes after new code sets are effective

These are not “just billing issues”; repeated patterns can be interpreted as non‑compliance and escalate to payer investigations or even False Claims Act scrutiny.​

For data‑driven clinics and networks, CPT accuracy also underpins:

• KPI dashboards and performance analytics

• Service line profitability analysis

• Payer contract negotiations and value‑based models

CPT 2026 Changes by Area: What Clinics Should Prioritize

While CPT 2026 touches almost every part of the code set, CliniQ‑type organizations should focus on areas that drive daily volume and revenue:

• Evaluation & Management (E/M) – Ongoing refinements to documentation and reporting expectations, building on recent multi‑year E/M changes

• Digital health, RPM, and RTM – New codes and thresholds, especially for 2–15‑day monitoring windows

• High‑volume procedures – Orthopedics, cardiology, imaging, and common outpatient procedures with revised or bundled rules

Pairing specialty‑specific CPT 2026 review with a solid understanding of CPT fundamentals remains crucial. Coders and clinicians need both:

• The big picture of how CPT fits into billing and compliance

• The 2026‑specific details that affect everyday encounters

Revenue Cycle, Documentation, and Compliance Impacts

CPT 2026 affects every stage of the revenue cycle:

1. Front‑end & documentation

   • Revised codes may require more detailed notes: time, laterality, technique, device, or AI‑assisted components.

   • Templates and macros must be updated so clinicians aren’t documenting to outdated standards.​

     
     

2. Charge capture & coding

   • New and revised codes must be linked correctly to services in EHRs and practice management systems.​

   • Bundling/parenthetical note changes can alter how encounters are coded and paid.

     
     

3. Claim submission & payment

   • Using outdated or incorrect codes increases denials and payment delays.​

   • Payer‑specific interpretations of new CPT codes may vary, especially in the first 6–12 months.

     
     

4. Audit exposure & compliance

   • Pattern‑level issues (persistent use of deleted codes, inconsistent adoption of new codes) are visible in payer analytics.

   • Digital health codes (RPM/RTM/AI) tend to attract extra scrutiny because they are newer and rapidly growing.

Automation and AI‑assisted coding tools are increasingly referenced as helpful for catching mismatches between documentation and codes and for enforcing new descriptor rules before claims go out.

How to Prepare Your Clinic or Network for CPT 2026

Use this practical checklist to operationalize CPT 2026 inside your clinic(s):

1. Map Impact on Your Top Codes

   • Pull a report of your most frequently used CPT codes and highest‑revenue procedures.

   • Cross‑check against 2026 additions, revisions, and deletions from AMA and trusted industry summaries.

     
     

2. Update EHR & Billing Systems Early

   • Load the CPT 2026 file into your EHR and practice management software.

   • Update claim edits, bundling rules, and charge capture logic.

   • Test sample claims with major payers if possible.

     
     

3. Train Coders, Billers, and Clinicians

   • Run focused sessions on:

     • New digital health / RPM / RTM codes

     • Revised E/M and high‑volume procedure codes

     • Deleted codes and their replacements

   • Emphasize documentation changes needed to support new descriptors.​

     
     

4. Align Templates and Clinical Workflows

   • Refresh note templates, smart phrases, and order sets to match CPT 2026 requirements.

   • For remote monitoring and hybrid care, make sure workflow captures:

     • Days monitored

     • Minutes of clinical time

     • Medical necessity and patient consent

       
       

5. Monitor Payer Policies and Go‑Lives

   • Most payers adopt CPT updates at the start of the year, but some publish payer‑specific nuances or phased implementation.

   • Track payer bulletins and adjust internal rules as necessary.

     
     

6. Audit Early (Q1 2026)

   • Perform internal coding and documentation audits within the first 1–2 quarters.

   • Look for:

     • Use of deleted codes

     • Misaligned descriptors

     • RPM/RTM documentation gaps

   • Correct patterns before they show up in payer audits.

Positioning Your Clinic for a Stronger Revenue Cycle in 2026

CPT 2026 is more than an annual coding refresh. For growing clinics, multi‑location networks, and organizations scaling RTM/RPM and hybrid care, it’s a chance to:

• Tighten documentation and coding discipline

• Reduce denials tied to outdated or vague coding

• Capture more accurate reimbursement for digital and in‑person services

• Strengthen audit readiness and compliance posture

Clinics that move early—updating systems, training teams, and aligning workflows with CPT 2026—will see smoother claims, fewer surprises from payers, and better visibility into operational and financial performance.

Now is the time to:

• Review your top CPTs against the 2026 changes

• Align RTM/RPM workflows and codes with the new digital health structure

• Reinforce coding accuracy as a core part of clinic operations and revenue cycle management, not a back‑office afterthought

Done well, CPT 2026 becomes a foundation for more predictable revenue, stronger data, and scalable clinic growth—not just another coding manual update.