These updates aim to streamline the reporting of evaluation and management (E/M) services delivered via telehealth—whether through synchronous audio-video or audio-only communication.
Effective for discharges and encounters from October 1, 2025, through September 30, 2026, this release introduces 487 new diagnosis codes, 38 code revisions, and 28 code deletions.
This decision, rooted in the Improvement Activities Suspension Policy finalized in the CY 2021 Physician Fee Schedule Final Rule, signals a possible shift in CMS’s long-term priorities for clinician performance evaluation.
For billing professionals, coders, and compliance leaders, this isn’t just a policy issue—it’s a practical one with real consequences in documentation, audits, and reimbursement integrity.
Risk-adjusted payment is no longer just a Medicare Advantage concern—commercial insurers are reshaping how coding, documentation, and compliance strategies must evolve.
From coding and billing errors to practice management missteps, we explore the root causes of revenue leakage and provide practical tools to protect your revenue.