Complete Updated List of Urgent Care CPT Codes 2026

As 2026 has started, many urgent care CPT codes, HCPCS codes, and modifiers have been updated. These updates directly affect visit leveling, procedures, injections, diagnostic testing, and same-day billing rules. Many of these changes are already active, yet a large number of urgent care providers are still billing with outdated code sets.

One of the biggest problems providers are facing right now is access to a complete and accurate list of urgent care billing codes. Updates are scattered across payer bulletins, CPT revisions, CMS releases, and AMA guidance. Most practices are missing codes, using discontinued ones, or applying new codes incorrectly, leading to denials, underpayments, and compliance risks.

This blog provides that complete list and explains how to apply the 2026 code updates correctly in your urgent care billing workflows.

Key Changes to Urgent Care Billing Codes for 2026

The 2026 updates to Urgent Care CPT Codes bring one of the most extensive changes in recent years.

• 2026 CPT Code Set Update: The American Medical Association (AMA) released the 2026 CPT code set effective January 1, 2026, with a significant update that includes hundreds of additions, revisions, and deletions to the code set.
• New Code Additions for Emerging Technologies: CPT 2026 adds nearly 288 new codes, many tied to digital health, remote monitoring, and artificial intelligence (AI) applications in clinical practice.
• Digital Health & Remote Monitoring: Expanded remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) options now include shorter-duration code options (e.g., services lasting 2 to 15 days within a 30-day cycle), plus treatment management codes starting at lower cumulative minutes.
• AI-Assisted Services Recognition: Updates include new codes that recognize AI and algorithm-assisted diagnostics (e.g., imaging analyses), reflecting broader integration of AI tools into clinical workflows.
• Telehealth and Virtual Care Code Updates: CPT updated and expanded codes for telehealth and virtual care, including audio-video and audio-only services, improving reporting flexibility beyond traditional in-office E/M codes.
• Revisions to Bundling and Guidelines: Several revisions to descriptors and bundling rules impact how Urgent Care CPT Codes should be applied and interpreted in practice, requiring careful review to avoid denials.

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The Complete 2026 Urgent Care Billing Codes List

How to Implement These Code Updates in Your Practice

Update Your EHR and Practice Management System

Input all 2026 urgent care CPT codes into your system before January 31, 2026. Configure the new telemedicine codes (98000–98016) with automatic modifiers, update AI-assisted procedure codes (0877T–0880T, 0902T, 0932T), and revise fee schedules. For urgent care billing and coding accuracy, ensure your charge capture templates separate new patient codes (99202–99205, 98000–98003) from established patient codes (99212–99215, 98004–98007). Most urgent care procedure codes remain unchanged, but verify your superbills include the complete wound repair series (12001–12018) and injection codes (96372, 96374).

Train Staff on Critical Code Distinctions

Your billing team must understand key differences in urgent care codes:

99202 CPT code requires straightforward medical decision-making (MDM) with minimal data review and low risk. The 99202 CPT code description specifies a new patient visit with 15-29 minutes of total time OR straightforward MDM.

99203 CPT code requires low MDM with limited data review and low to moderate risk. Document the number of problems addressed, data reviewed (labs, imaging, outside records), and risk level to support this code selection.

99212 CPT code is for established patients with straightforward MDM. The 99212 CPT code description requires 10-19 minutes of total time OR straightforward MDM, bill based on whichever supports the code.

CPT 99283 is an emergency department code. Critical: most freestanding urgent care centers cannot bill 99283 or any ED codes. Only hospital-based urgent care facilities with a dedicated ED status can use this code. Use 99205 or 99215 instead for high-complexity urgent care visits.

When billing urgent care procedure codes (wound repair, I&D, injections) on the same day as an E/M visit, add modifier 25 to the E/M code (99202, 99203, 99212, etc.) only if the visit is significant and separately identifiable from the procedure.

Implement Documentation Requirements

For 99202–99205 and 99212–99215, providers must document: (1) number and complexity of problems, (2) amount and complexity of data reviewed, (3) risk of complications, and (4) total face-to-face time if using time-based billing. For telemedicine codes 98000–98016, document platform used, patient consent, provider/patient locations, and audio-video quality confirmation. For AI-assisted codes, document the AI software name, physician interpretation separate from AI output, and patient consent. These documentation standards are essential for compliant urgent care billing and coding practices.

Conduct Weekly Coding Audits

Review 10 charts weekly for the first 90 days. Verify MDM elements support the billed code level (99202 vs 99203, 99212 vs 99213), check that time is documented if used for code selection, confirm modifier 25 usage when E/M codes are billed with urgent care procedure codes, and validate that telemedicine consent is documented for codes 98000–98016. Monitor claim acceptance rates by code, target 95% or higher. Address denials immediately, as most early rejections are due to payer fee schedule delays, not coding errors.

Final Words

If all of this seems overwhelming, Medcare MSO can handle it for you. We specialize in urgent care billing and coding with the complete 2026 code updates already implemented in our system. Our team ensures your claims are coded correctly, documented properly, and reimbursed faster, so you can focus on patient care instead of billing complexities. Contact Medcare MSO today to simplify your urgent care revenue cycle management.