Traditional MedicareBilling CodesHigh impact
R13929CP: Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - October 2026 Update
Medicare/CMS - Transmittals·CMS Transmittal
Effective date
Jan 1, 2026
We identified it
Aug 28, 2026
Summary
CMS is updating the Medicare Physician Fee Schedule Database (MPFSDB) effective January 1, 2026, with implementation by October 5, 2026. This quarterly update adds new HCPCS codes (G0685, 87638, A9613, J0643, J0644, J0871, J1757, J1818, J1946, J1947, J1957), revises existing codes (A9595), and deletes obsolete codes (J0640, J1941, J1953). Medicare contractors must retrieve updated payment files and notify providers 30 days before implementation; practices must update billing systems and encounter forms accordingly.
Action Required
By September 5, 2026 (30 days before implementation on October 5, 2026): Billing team must (1) retrieve updated MPFS payment data from the cloud service upon email notification from Medicare contractor, (2) update billing system to recognize new codes G0685, 87638, A9613, J0643, J0644, J0871, J1757, J1818, J1946, J1947, and J1957, (3) remove or inactivate deleted codes J0640, J1941, and J1953, (4) update code descriptor for A9595 in billing software, and (5) notify all providers of these changes. Do NOT retroactively deny or manually search for claims already paid under old codes. Update encounter forms and clinical documentation templates to reflect new code options. Claims submitted with deleted codes after October 5, 2026 will be denied.