September 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.

AMA Releases New 2027 Medical Billing Code Set 

The American Medical Association has released its new 2027 CPT set. The new code set includes 299 new codes across medical, surgical, and diagnostic services. Key updates fall under maternity care services, ventricular assist device procedures, hernia repair, and prostate biopsy [1].

Arkansas Announces Hospital Revenue Cycle Grant Recipient Under Rural Health Transformation

Delta Memorial Hospital announces its Home Health Revenue Cycle Alignment grant, intended to improve claims submission, home health billing, legacy accounts receivable, denial management, financial sustainability, and hospital revenue cycle dashboards [2].

Quarterly SNF Consolidated HCPCS Codes Posted

CMS has posted updates to the list of HCPCS codes that fall under the consolidated billing provision of the SNF PPS and that impact medical coding service across the country. This update also includes correction to assignment of certain therapy HCPCS codes that were included in the Part B SNF CB Files incorrectly [3].

Multiple States Expanding Rural Access to Billable Services 

States are announcing their plans to expand services that fall under billable categories including telehealth, preventive screening, surgical robotics, and specialty care. These states include Arkansas, Georgia, Hawaii, and Virginia [4].

What this means for your revenue cycle team: If you are impacted by these expansions, now is the time to assess whether your team is prepared to expand medical coding, billing, and follow-up for new services.

Ascension Hospitals Could Lose Medicare Contracts

Pharmacy errors are directly affecting the revenue cycle in Tennessee. Ascension Saint Thomas Hospital Midtown and Saint Thomas West could lose their Medicare provider agreements. After a medication error for joint replacements in August, the health system failed to submit an acceptable safety plan. The plans that were submitted were determined to be unacceptable by state and federal regulators [5].

Change Request Updates Medicare Secondary Payer System Rules

Designated CARCs will automatically trigger rejections or Return to Provider status, which will mandate immediate corrective billing actions. The change falls under CR 14553, effective January 1, 2027 [6]. 

What this means for your revenue cycle team: Revenue cycle leaders should be prepared to update medical billing workflows and claim scrubbing software.

New ICD-10-PCS Released

CMS has announced that new ICD-10-PCS codes will be effective as of October 1, 2026 for medical coding in the USA. These codes will impact discharge dates from October 1, 2026 through March 31, 2027 and patient encounters from October 1, 2026 through March 31, 2027. Diagnosis codes are effective for discharges from October 1, 2026 through September 30, 2027 and patient encounters from October 1, 2026 through September 30, 2027 [7].

UnitedHealthcare Eliminates Prior Auth for 1,700 Codes

In response to public pressure, UnitedHealthcare has announced that it will be cutting prior authorization requirements for about 1,700 medical codes. The changes begin in October and impact codes across oncology, cardiology, orthopedic procedures, and home health services [8]. 

What this means for your team:  If your team hasn’t updated workflows for United prior authorization, especially under home health billing and coding, now is the time. Leadership should also consider tracking impact on healthcare accounts receivable management and claim processing metrics for this payer specifically.

DMEPOS Fraud Scheme Gets CMS Attention

CMS has reported discovering 11 medical supply companies accused of fraudulent billing practices. These activities occurred in 2025 and 2026 and involved receiving future Medicare Advantage Part C and Part D payments. The accused fraud includes improper billing processes, billing for deceased beneficiaries, and billing equipment for beneficiaries who never received or requested it [9].