July 2026 Newsletter

We’ve assembled the latest news for healthcare revenue cycle leaders to help you stay on top of industry challenges and adapt your revenue cycle management services. We encourage you to fully review all original government sources for details, updates, and accuracy.

Clinical Diagnostic Laboratory Reporting Deadline Approaches

Independent laboratories, physician office laboratories, and hospital outreach labs that fall under applicable laboratory criteria for the Clinical Laboratory Fee Schedule must report data by July 31, 2026. This physician coding and hospital billing update includes applicable HCPCS codes, volume data, and associated private payor rates [1].  

DMEPOS Fee Schedule July 2026 Quarterly Update

CMS has issued guidance on using the KF modifier for HCPCS codes E0747, E0748, and E0760 for dates of service on or after May 18, 2026. This update impacts medical billing for physicians, suppliers, and other providers billing MACs for DMEPOS [2]. 

RCM Outsourcing Announced at 7 Health Systems 

As the RCM and medical billing landscape becomes more complex, more hospitals and health systems are increasingly outsourcing revenue cycle functions. Becker’s reports this month on entities in Iowa, Florida, Connecticut, Ohio, and other states that are outsourcing to various revenue cycle management companies [3].  

Cervical Cancer Screening with HPV Testing: Coding Reminder

CMS has published a medical coding informational update on Medicare coverage of cervical cancer screening with HPV testing for asymptomatic female patients. The allowable code is G0476 (infectious agent detection by nucleic acid, DNA or RNA); human papillomavirus (HPV), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening. It must be performed in addition to a Pap test [4].

Access to GLP-1s Expanded

A new CMS initiative expands access to certain GLP-1 medications for $50 per month through the Medicare GLP-1 Bridge. The agency has released a webpage for providers, a prescriber fact sheet, a prior authorization form, and additional information for medical coding in USA [5].  

Ambulatory Surgical Center Payment System July Update

CMS has issued USA medical billing updates for the new Hospital OPPS system device pass-through category for Ambulatory Surgical Centers. It includes new HCPCS codes, ASC payment indicator changes, and revised code descriptors [6].  

Change Request for Reporting Face-to-Face Encounter Conducted by a Hospice Physician or Hospice Nurse Practitioner 

CMS has issued a medical coding change request for implementing the Hospice telehealth provision that requires use of a modifier or G-code for the reporting of face-to-face encounters, when conducted by a hospice physician or nurse practitioner in cases of recertification through telecommunications tech on hospice claims [7].

2027 ESRD PPS Proposed Rule

CMS has issued a proposed rule that would impact healthcare revenue cycle solutions by updating payment rates and policies for Medicare End-Stage Renal Disease Prospective Payment system. It would impact renal dialysis services provided to Medicare beneficiaries on or after January 1, 2027. It also covers updates to the acute kidney injury payment rate for renal dialysis services [8].

New Hospital Price Transparency Guidance Released

To support improved clarity around hospital price transparency, CMS has issued new hospital revenue cycle guidance on encoding outlier contracting clauses in a hospital’s machine-readable file. The guidance was released June 26, 2026 and addresses difficulty in detecting and understanding outlier contracting clauses such as contract provisions that change payment methodology for unusually resource-intensive or high-cost cases [9].