Reimbursement & Coding, Explained: The 2026 Field Guide
What reimbursement & coding covers, why it matters in 2026, and the numbers decision-makers should know.
Behind many of this year's biggest health tech headlines sits reimbursement & coding. CPT codes, payment categories, and who gets paid for digital care. This explainer sets out what the category actually covers, why it has moved to the center of policy & regulation strategy, and the numbers every decision-maker should have at hand.
What it covers
CPT codes, payment categories, and who gets paid for digital care. In practice, that spans the vendors building the technology, the health systems and payers deploying it, and the regulators writing the rules around it. The category sits inside our broader Policy & Regulation coverage, and its daily developments stream into the live Reimbursement & Coding feed.
Why it matters in 2026
Consider the current numbers: the proposed CY2027 fee schedule would create Medicare's first payment category for clinical AI software (our coverage).
Meanwhile, eleven states have enacted twenty laws governing AI in mental health, from outright bans to crisis-routing mandates (our coverage).
Meanwhile, cMS launched a dedicated Office of Health Technology Products to steer AI and interoperability policy (our coverage).
What to watch next
Three signals will tell you where reimbursement & coding goes from here: the reimbursement decisions now moving through CMS and commercial payers, the consolidation pattern as larger platforms absorb point solutions, and the evidence base - peer-reviewed results increasingly separate durable categories from demo-ware.
The bottom line
Watch the regulatory calendar: the rules being written this year will shape this market for the rest of the decade. For the latest developments, follow our continuously updated Reimbursement & Coding topic page.