The American Medical Association (AMA) has released the 2027 Current Procedural Terminology (CPT) code updates, which include 299 new codes, 80 deletions, and 74 revisions. These changes affect various specialties and will be implemented on January 1, 2027.
Among the significant changes are updates to maternity care codes, as well as new codes for speech therapy, sleep medicine, behavior analysis, and proprietary lab analyses (PLA). The PLA codes account for nearly a third of the new codes and include services such as DNA methylation analysis and next-generation sequencing.
Some of the new PLA codes include 0625U for endocrinology, 0629U for infectious disease, and 0635U for autoimmune services. If a practice is performing a test covered by these codes, it is essential to check with the payer before submitting a claim, as some services may not be approved for use.
Practices should always get information from the insurer in writing to understand the payment criteria. This will help ensure that claims are processed accurately and reduce the risk of denied payments.
New Adaptive Behavior Codes
The 2027 CPT code updates also include new codes for adaptive behavior services, which were previously considered experimental. The new codes, such as 97148 and 97149, provide more options for billing adaptive behavior visits and allow for non-face-to-face services.
These changes reflect the evolution of adaptive behavior services and provide more flexibility for clinicians to bill for their services. However, practices should still check with payers to determine the coverage guidelines and payment rates for these new codes.
The new codes also include significant revisions to the descriptors of existing codes, such as 97152, which no longer requires a technician to be under the direction of a physician or qualified healthcare professional.
As the implementation deadline approaches, practices should review the new codes and updates to ensure a smooth transition. This may involve updating billing software, changing superbills, and providing training to staff on the new codes and coverage guidelines.
Sleep Medicine Updates
The American Academy of Sleep Medicine has introduced new codes for sleep studies, which will replace the existing codes 95800, 95801, and 95806. The new codes, such as 95843 and 95844, reflect advances in sleep technology and provide more options for billing sleep studies.
Additionally, the 2027 CPT code updates include new codes for flu shots, such as 90616 and 90639, and changes to speech therapy codes, including the deletion of 92507 and the introduction of new codes such as 92654 and 92656.
The American Speech-Language-Hearing Association notes that the changes in speech therapy codes reflect the evolution of clinical practice, research, and technology in the field. The new codes provide more specificity and accuracy in billing for speech therapy services.
Preparing for Implementation
With the implementation of CPT 2027, practices should review the entire list of changes to ensure accurate medical claims. This includes updating systems, training staff, and understanding the coverage guidelines for new codes, such as the 10 new codes describing artificial intelligence systems that may aid clinicians in medical analyses.
The American Medical Association and other organizations will likely provide more guidance on the new codes and updates as the implementation deadline approaches. In the meantime, practices should prepare for the changes by reviewing the new codes and updates and making necessary adjustments to their systems and processes.
One key aspect of the new codes is the increased focus on artificial intelligence and its role in medical analyses. The new codes describing artificial intelligence systems will likely have a significant impact on how clinicians bill for their services and interact with payers.
