New and Updated Reimbursement Policies – February 2026

IMMEDIATE ACTIONS (By Feb 23, 2026): Billing team must update billing system to process CPT codes 76376 and 76377 as non-separately reimbursed bundled services for all Commercial and Medicare Advantage claims. Remove CPT G0071 from active billing codes effective Feb 2, 2026 (already in effect). Review and implement new Remote Patient Monitoring (RPM) policy RP-084 guidelines for RPM-specific CPT codes to determine reimbursement eligibility. MARCH 2026 UPDATES (By March 2, 2026): Update fee schedules in billing system to reimburse CRNA services at 85% of fee schedule allowance for Commercial plans. By March 30, 2026: Implement Modifiers 52 and 53 policy changes for Medicare Advantage claims in affected regions (WPA/NEPA, CPA/SEPA, DE, WV). Activate Emergency Evaluation and Management (EM) coding guidelines for professional claims submitted to emergency departments in DE, PA, and WV. APRIL 2026 UPDATES (By April 27, 2026): Remove After-Hours Codes section from Modifier policy (RP-009) and redirect direction to RP-041. Update RP-041 to add CPT codes 99050, 99051, 99053, 99056, 99058, 99060, 99288, 96041, 99485, 99486, and G2211 as non-separately reimbursed. Remove CPT codes 92921, 92925, 92929, 92934, 92938 from non-separately reimbursed list. Implement Emergency EM coding guidelines for professional claims in New York (WNY, NENY). Update Medicare Advantage direction for venipuncture and lab services in RP-047. CONSEQUENCES: Failure to implement these changes will result in claim denials, payment delays, and potential overpayment recoupments. Providers must be notified of deadline dates and updated billing procedures.