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Automated monitoring of CMS billing code regulations. Get alerted when codes that affect your portfolio are updated — before they take effect.

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Billing Code Watch

CMS Code Change Digest

July 2026 — 5 updates this cycle

5 code changes this cycle: 2 high, 3 medium impact

🔴 High Impact

CPT HIGH 0765T Remote therapeutic monitoring (new code) ▼
Effective: October 1, 2026
REVENUE: New billable code for remote therapeutic monitoring services. Estimated $45-85 per session. Practices should prep EHR templates before Oct 1.
ACTION: Add CPT 0765T to charge master and train clinical staff on documentation requirements for remote therapeutic monitoring.
View analysis

This is a completely new category III CPT code. Unlike the existing remote patient monitoring codes (CPT 99453-99458), 0765T specifically covers therapeutic interventions delivered remotely — not just data collection. CMS is signaling expansion of telehealth coverage.

HCPCS HIGH G2211 Visit complexity add-on code — payment revised ▼
Effective: July 1, 2026
← Old: $16.42 add-on payment for office/outpatient E/M visits
→ New: $18.73 add-on payment (14% increase), expanded to include telehealth visits
ACTION: Update fee schedule. Verify payer adoption — some commercial payers may not cover the telehealth expansion.

🟡 Medium Impact

CPT MEDIUM 99454 RPM device supply — payment decreased 8% ▼
Effective: January 1, 2027
REVENUE: Payment decreasing from $62.18 to $57.20 per device per month. Estimate $300-600 annual revenue loss per 100-patient RPM program.
ACTION: Model the financial impact on your RPM program. Consider negotiating device supply costs with vendors to offset the cut.
CPT MEDIUM 98980-98981 RPM treatment management — code descriptors clarified ▼
Effective: July 1, 2026
← Old: "Remote monitoring of physiologic parameter(s)"
→ New: "Remote physiologic monitoring treatment management services" — clarified that clinical staff time must involve treatment decisions
ACTION: Review documentation workflows. Ensure clinical staff are documenting treatment-related activities, not just data review.
Modifier MEDIUM Modifier 95 Telehealth guidance updated for audio-only encounters ▼
Effective: July 1, 2026
REVENUE: Audio-only encounters now eligible for the same payment as video visits for behavioral health and certain E/M services. Potential revenue recovery of $15-35 per encounter for audio-only visits.
ACTION: Update billing workflows to apply Modifier 95 to audio-only encounters. Train schedulers to identify eligible encounters.
View analysis

CMS has permanently adopted the audio-only telehealth expansion for behavioral health and specific E/M services. This reverses the previous position requiring video for all telehealth. Practices with significant audio-only volume should see immediate revenue improvement.

View full dashboard: jamesrodriguez.dev/billing-code-watch

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How It Works
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01

Monitor

Continuously scans CMS publications, Federal Register, and billing code databases for changes.

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02

Analyze

Identifies which codes changed, what the impact is, and whether they apply to your portfolio.

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03

Alert

Sends a digest with affected codes, before/after comparisons, and recommended actions.

Key Features
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CMS Auto-Scanning

Automatically crawls CMS updates, NCD/LCD changes, and Federal Register billing code notices.

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Targeted Alerts

Only notified about codes that matter to your portfolio — no noise from irrelevant changes.

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Before/After Diff

See exactly what changed in each code: language differences, reimbursement rates, and effective dates.

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Email Digest

Weekly or daily email summaries with all relevant changes, impact analysis, and action items.

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Portfolio Tracking

Track which codes apply to which properties or business lines — customized alert groups.

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Forward-Looking

See proposed and upcoming changes before they take effect, giving you time to prepare.

Tech Stack
Python Web Scraping CMS API Email Engine Supabase Cron Automation