On September 9, 2026 the American Medical Association (AMA) announced the release of the Current Procedural Terminology (CPT®) 2027 code set which will go into effect on January 1, 2028.
Here is a breakdown of everything you need to know:
One of the most notable structural changes is the language used around service modifications:
- The term “protocol modification” has officially been replaced with “analysis”.
- All face-to-face services must be strictly face-to-face and requires active engagement. All face-to-face requirements emphasize that providers must be actively engaged with the patient.
- New T-Codes Introduced for Harmful Behavior:
- Base Codes: 97148 and 97159
- Add-on Codes: 97149 and 97160
- Non-Face-to-Face Services :97180
- QHP Treatment (97173): Dedicated to QHP 1:1 treatment with analysis
- Group Codes: The previous cap on group codes has officially been removed.
- Assessments & Family Treatment:
- Assessment codes (such as 97151) can now be utilized to create formal discharge plans.
- Family treatment codes have been updated to include “discussing protocols and treatment targets,” and these sessions can occur without the patient present.
While HIPAA mandates that covered health plans accept the standard CPT code set, HIPAA does not govern coverage or reimbursement rates. Providers must secure written confirmation from each individual payer regarding their implementation timelines, policies, and rates.
Preparation is key to a smooth transition into the new year. Make sure to utilize these official resources:
- Review the 2027 Code Conversion Chart.
- Reference the official Code Book.
- Reference the Supplemental Guidance Article
- Reference this Preparation Guide
- Check the ABA Coding Coalition Website frequently for updates.