AMA publishes 2026 medical codes

Diving brief:

• The American Medical Association published new medical codes for 2026 in the midst of an increasing debate on the question of whether the medical group could have too much influence on the coding system of health care.
• The AMA removed 84 codes, revised 46 and added 288 news for next year, including codes that reflect new progress in medicine, the doctor’s hall announced on Thursday.
• This includes advanced laboratory tests, which constituted the largest proportions of new codes, as well as codes for emerging medical services that regulators use to consider government approval.

Diving insight:

The AMA refreshes the thousands of digital codes in its current procedural terminology, or CPT, the system each fall for the coming year. CPT codes provide a standardized way to speak and charge medical services, and are deeply anchored in American health care – including the government, which uses the CPT system to code health services and procedures in federal programs.

Updates next year include new codes for digital health services such as patient remote monitoring, including a shorter period. The additions of code will allow providers to charge the management of patient conditions outside the clinic, even for a few days, said the AMA.

The new codes also include medical services involving artificial intelligence, such as algorithmic analysis of the registration of the electrocardiogram to detect heart problems or the use of the software to assess the severity of the burning wounds.

Despite trembling efficiency and lukewarm confidence in technology, more and more doctors rely on AI. According to an AMA survey, almost two thirds of doctors said they used AI health last year, in particular to help them diagnose.

The AMA has also introduced 12 new codes to reflect the new services of hearing aids and updated the revealing codes of the legs, surgery that restores the blood flow to the legs. The association has removed the revascularization codes of the previous legs and added 46 news to their place to reflect more care being increasingly on an outpatient, as well as technological progress in space, said the AMA.

The AMA has designed and published CPT codes since the 1960s. But there is growing dissatisfaction among some politicians and health stakeholders to have so much power in the hands of an industrial group.

On the one hand, companies that use codes must pay license fees, which, according to AMA, is aimed at the costs of creating and maintaining codes. But the monopoly of the association on the CPT system has proven to gain: “Raches and accreditation products”, a budgetary category which includes but is not limited to the products and services linked to the CPT, reported $ 326 million for AMA in 2024. This represents more than half of the AMA total annual income.

In addition, the CMS uses CPT codes and the recommendations of a powerful panel of AMA doctors to decide on the amount of medication for medical services. This creates a potential conflict of interest, in which a doctor’s hall exerts an influenced influence in the quantity of paid doctors, according to criticism.

The government does not have to accept the committee’s recommendations, but made between 60% and 77% of the time, according to the Government Accountability Office.

Critics also underline how the payment system rewards more expensive services such as surgeries on preventive care and primary care, thrust doctors in more lucrative specialties and the worsening of the shortage of primary care physicians in the country.

In Thursday’s press release, AMA defended its role by supervising the coding process, saying that it is “unique” as the largest association of doctors and medical students in the country.

The AMA brings “the unequaled scale, expertise and legitimacy to normalize the definitions of medical services”, said the press release, adding that the process is supervised by the AMA editorial committee with “a large contribution from the health, government and industry community”.

However, the Trump administration could be interested in combating medical billing far from AMA, the Washington Post reported at the end of last year, coinciding with the Crusade of Secretary HHS, Robert F. Kennedy Jr., to eliminate the influence of companies in the federal government.

Although the HHS has not yet taken concrete measures to kill the influence of the AMA, the CMS proposed a payment rule of Medicare this summer which reduces the reimbursement of specialized services. The rule was considered a small step towards limiting the entrance to the AMA.