Following CMS regulations, the updates below will take effect on January 1, 2026. For a more in-depth breakdown of Medicare’s Final Rule, please watch the recording of our recent webinar.
2026 Financial Thresholds
- Conversion Factor: $33.40
- PT & SLP Threshold: $2,480 (Combined)
- OT Threshold: $2,480
- KX Modifier Alert: $2,280
New RTM & Clinical Codes CMS has introduced new codes for Remote Therapeutic Monitoring (including 2–15 day device supply) and Hearing Evaluations. Additionally, WebPT now supports Extremity Ultrasound codes (76881–76883) for PTs and OTs.
Required Action Items
- Enable Codes: All new CPT codes default to Off/Inactive. You'll need to manually enable them in Fee Schedules to use them in the Billing tab.
- Billing Restriction: CPT codes 98979 and 98980 cannot be billed in the same calendar month. Please monitor this manually until our automated restriction is live in early 2026.
Product Enhancements
- 8-Minute Rule: SOAP 2.0 now correctly accepts 0 units for timed charges of 0–7 minutes when billed with evaluative codes.
- Claims Feed: The Claims Feed Report now automatically updates to “Claim Resubmitted” upon resubmission.
To view the full CPT code tables and details on all the updates, check out this page on the Discover site.