2026 Compliance Updates for Foot Surgery Billing Services

Last year’s updates recorded several changes, including various adjustments in CPT and ICD-10 codes as well as changes in Medicare coverage policies. Following the tradition, 2026’s annual updates will introduce a new set of alterations, having a brief mention of foot surgery billing services as well. Medical practitioners are always motivated to ensure compliance to prevent any claim denials and stay updated with podiatric practices.

This blog provides a detailed walkthrough for orthopedic procedure coding specialists and medical providers around the United States to adapt new CPT and ICD codes seamlessly. 

Major Regulatory Changes Impacting Foot Surgery Billing

Medicare Physician Fee Schedule Adjustments for 2026

Medicare’s changes for foot surgery billing in 2026 will impact how clinics get paid. The fees for foot and ankle surgeries will change a bit as some will increase while others go down based on Medicare’s new math. Basic procedures like fixing bunions, hammertoes, and scoping ankles might pay differently than before.

Medicare changed how they pay when doctors do multiple surgeries at once. They’re paying less for extra procedures done in the same surgery. Billers need to check surgery notes carefully and list procedures in the right order to get the most money back.

Medicare also updated its rules about which surgery codes can go together. Billers can’t just split up services to get paid more. They need to know when to use special codes to show why some procedures should be billed separately when it makes medical sense.

Since Medicare has to keep its total spending the same, the payment for some things falls inversely proportional to the others. Billing offices should look at what surgeries they usually do and figure out how these changes will affect their money in 2026. 

ICD-11 Transition Timeline and Preparation

The switch from ICD-10 to ICD-11 is a big change for medical billing. While other countries started using ICD-11 in 2019, the US is taking its time. We’ll probably start using it bit by bit in late 2025 or early 2026, but we’re still waiting for the government to determine the exact date.

ICD-11 works differently from what we use now and has more detailed codes for foot and ankle problems. Moving from the old codes to new ones isn’t as simple as sometimes one old code matches several new ones, and some new codes are for things we’ve never coded before. Billing offices should start making lists matching their common ICD-10 codes with the right ICD-11 ones.

For a while, we’ll probably need to use both old and new codes on claims. This means more paperwork and more complicated billing that offices need to plan for ahead of time.

Prior Authorization Policy Expansions

More insurance companies want approval before foot surgeries in 2026, making extra work for billing staff. Medicare added new rules for some outpatient surgeries, especially ones done in surgery centers. Billing offices need to know which surgeries need approval first and make sure they get it before scheduling anything.

Private insurance companies are getting stricter too. They want approval for things like bunion surgery, removing nerve growths, and foot reconstruction. Each insurance company has their own rules and ways of doing things, so billing offices have to keep track of what each one wants.

Some new computer programs might help. They can connect to the office system to find which surgeries need approval, send the requests online, and watch for answers. This saves time and helps avoid doing surgeries without getting approval first.

All this affects when offices get paid. When approvals get delayed, surgeries get pushed back, and the office waits longer for money. If insurance says no, filing appeals takes even more time. Billing offices need to plan for these delays and keep enough money saved up while they wait to get paid.

Telehealth Billing Compliance Post-Pandemic

The world still tries to cope up with the online doctor visit criteria after 2025. Congress made some pandemic rules permanent but left others temporary. Billing offices need to keep track of which online services they can still bill for next year.

Insurance companies are looking closer at online visits before and after surgery. Doctors need to write down why they chose an online visit instead of seeing the patient in person, get the patient’s okay, note what video system they used, and write their notes just like they would for office visits. Phone calls without video usually pay less and have more rules.

The rules about where patients can be during online visits might change. During COVID, patients could have online visits from home, but some rules might go back to requiring patients to be at medical offices. Whether someone lives in a city or rural area might also change what’s covered.

Different insurance companies pay different amounts for online visits. Some states say online visits must pay the same as office visits, but others don’t. Medicare kept some equal payment rules, but not all of them. Billing offices need to know both Medicare’s rules and their state’s rules to bill correctly and know what they’ll get paid.

Strategic Implementation for Compliance

Actionable Implementation Timeline

Early 2026

January to March needs close attention when the new rules start. Check claims every day to catch problems fast. Look at every claim that gets denied to see if it’s because of wrong codes, missing approvals, or insurance company system issues. Have specific people ready to fix problems within a day. Keep talking with your claim processing companies and insurance contacts to fix any big problems. Help your staff through daily meetings, solving problems as they happen, and having easy-to-find guides. Write down all problems and solutions to help everyone learn.

From April to June, work on making things better. Look at the first three months to find what’s still causing trouble with coding, approvals, or getting claims paid. Give extra training to staff who need help with specific parts. Adjust your office routines based on what you’ve learned about the new diagnosis codes, billing rules, and approval timelines. Update your price lists based on what Medicare’s actually paying.

All year long, be ready to change things as insurance companies give new directions and Medicare explains unclear rules.

Conclusion

Proactive preparation for 2026 compliance changes is essential for foot surgery billing services to maintain revenue integrity and avoid costly claim denials. By implementing a structured timeline beginning in early 2025, billing providers can navigate Medicare fee schedule adjustments, ICD-11 transition requirements, expanded prior authorization policies, and evolving telehealth regulations with confidence and minimize operational disruptions.

It’s time to modernize denial management, prepare for upcoming mandates, and leverage compliance as a competitive edge. Contact Virginia Medical Billing, a preferred partner of medical practitioners, for actionable insights and ready-to-execute plans.

FAQs

What are the key changes in foot surgery billing for 2026?

Major changes include adjustments in CPT and ICD-10 codes, modifications to the Medicare fee schedule, and new prior authorization requirements.

How will the transition to ICD-11 impact billing?
The ICD-11 transition will require medical offices to adapt to new, detailed codes for foot and ankle problems, complicating billing processes.

What do the new prior authorization policies entail?
More insurance companies now require approval for outpatient foot surgeries. It’s essential for billing offices to track these requirements to avoid delays in payment.

How has telehealth billing changed post-pandemic?
Updated rules dictate which online services can be billed, and proper documentation is critical for compliance with coverage requirements.