RCM Pulse Weekly

Hospital Price Transparency Enforcement Live • PA Reform: UHC, Cigna, Aetna Deliver • Agentic AI Goes Mainstream in RCM • April 1 ICD-10-CM Update • Autonomous Revenue Cycle Operations

CY2027 MA Final Rule: 0.09% Rate Increase • PA Transparency Era Begins: Payers Publish Denial Data • AI Becomes the RCM Operating System • April 1 ICD-10 Excludes1→Excludes2 Revenue Opportunities • Front-End RCM Market Grows $1.65B by 2030

CMS Finalizes Electronic Claims Attachments Rule: $782M in Savings • March 31 PA Metrics Deadline • HIMSS26 Agentic AI Arms Race • 36 New HCPCS Codes April 1 • Denial Rates Hit 11.8%, $262B Unpaid • CodaMetrix Wins Inaugural KLAS Autonomous Coding Title

CMS PFS 3.26% Rate Increase Confirmed • AHIP Voluntary PA Reforms Live for 270M Members • 74% of Hospitals Running RCM Automation • 418 CPT 2026 Code Changes • April 1 Price Transparency Enforcement Deadline

Medicare Advantage Plans Cut Benefits and Geographic Coverage for 2026 • Prior Authorization Real-Time Decision Mandate: 80% by 2027 • Healthcare Eligibility Verification Automation: 60-90% of Verifications Now Autonomous • FY 2026 ICD-10-CM Guidelines: Major HIV Coding Revisions Take Effect • RPA Adoption in Revenue Cycle Management Reaches 50-75% of U.S. Hospitals

CMS Physician Fee Schedule 2026: 3.26% Rate Increase and Key Payment Updates • Prior Authorization Reform Takes Effect: Industry-Led 72-Hour Response Commitment • AI-Powered RCM Reaches Critical Mass: 63% of Providers Already Using AI • CPT 2026 Recognizes AI-Augmented Services for the First Time • Denial Rates Surge to 15%: AI Denial Prevention Becomes Standard Practice

Medicare Advantage Market Disruption: 10% of Enrollees Forced to Switch Plans • RADV Audits Accelerate: Payment Year 2020 Reviews Now Underway • The Autonomous Coding Revolution: AI Medical Coding Market Update • ICD-10 and CPT 2026: Critical Guideline Changes You May Have Missed • Denial Management in 2026: Upstream Prevention Replaces Downstream Recovery

CMS 2026 Payment Updates: What Your Practice Needs to Know • Prior Authorization Reform: 50+ Payers Commit to Major Changes • AI and Automation: The Agentic Revolution in RCM • CPT and ICD-10 Code Updates for 2026 • Revenue Velocity: 7 KPIs Every Practice Should Track