Rule Change Feed

Track payer rule changes, CMS updates, coding changes, and NCCI edits — get notified before they affect your claims

Healthcare billing rules change constantly. Know before your claims get denied.

The Rule Change Feed tracks every change that affects how you bill, code, and get paid. Subscribe to the rules that matter to your practice and get notified before changes take effect.

Browse recent changes at rcintell.com/tools

Why this matters

A payer quietly shortens its timely filing limit from 180 to 90 days. A new prior auth requirement takes effect for imaging. CMS updates the conversion factor. An NCCI edit bundles a procedure pair you bill separately.

Without tracking these changes, you find out when claims start getting denied.

What the feed tracks

CMS / Medicare Changes

Change type	Frequency	Example
Conversion factor update	Annual (+interim)	$32.35 → new rate
RVU changes	Annual (Jan 1)	99213 Work RVU 1.30 → 1.32
GPCI updates	Annual	Manhattan PE GPCI 1.281 → 1.295
New CPT/HCPCS codes	Annual (Jan 1) + Quarterly	New Category III codes
Deleted codes	Annual	Code retired, use replacement
NCCI edit updates	Quarterly	New code pair bundles
MUE updates	Quarterly	Units per day changes
NCD/LCD changes	Ongoing	New coverage determination
MAC jurisdiction changes	Rare	Jurisdiction reassignment

Commercial Payer Changes

Change type	Tracking method	Example
Timely filing changes	Policy monitoring	180 → 90 day limit
Prior auth requirement changes	Policy monitoring	Imaging now requires PA
Fee schedule updates	Contracted rate changes	Rate adjustment for code group
Network changes	Provider directory	New requirements for participation
Appeal process changes	Policy monitoring	New appeal level or form
COB rule changes	Policy monitoring	Updated coordination rules

State Medicaid Changes

Change type	Example
Rate updates	FY2027 rate increase for E/M
Program changes	Expanded telehealth coverage
Prior auth changes	New PA requirement for DME
Enrollment changes	Provider type requirements

Coding System Changes

System	Update cycle	Tracked changes
CPT	Annual + interim	New/deleted/revised codes
HCPCS Level II	Quarterly	New/deleted/revised codes
ICD-10-CM/PCS	Annual (Oct 1)	New/deleted/revised codes
CDT (dental)	Annual	New/deleted/revised codes

Example feed entries

[
  {
    "id": "chg_2026_cf_update",
    "type": "cms.conversion_factor",
    "severity": "high",
    "effective_date": "2026-01-01",
    "published_date": "2025-11-15",
    "title": "2026 Medicare Conversion Factor: $32.35",
    "summary": "CMS finalized the 2026 MPFS with a conversion factor of $32.35, a 2.9% decrease from the 2025 rate of $33.29.",
    "impact": "All Medicare MPFS payments decrease. Verify contracted payer rates that reference MPFS.",
    "source": "CMS-1784-F",
    "affects": ["all_facilities", "mpfs"]
  },
  {
    "id": "chg_cigna_tf_2026q1",
    "type": "payer.timely_filing",
    "severity": "critical",
    "effective_date": "2026-03-01",
    "published_date": "2026-01-15",
    "title": "Cigna shortens timely filing to 90 days (select plans)",
    "summary": "Cigna commercial plans in TX, FL, CA will enforce 90-day timely filing limit, reduced from 180 days, effective March 1, 2026.",
    "impact": "Claims for Cigna commercial plans in affected states must be submitted within 90 days of date of service.",
    "affects": ["cigna", "TX", "FL", "CA"]
  },
  {
    "id": "chg_ncci_2026q1",
    "type": "coding.ncci_edit",
    "severity": "medium",
    "effective_date": "2026-01-01",
    "published_date": "2025-12-20",
    "title": "Q1 2026 NCCI edit updates — 47 new code pairs",
    "summary": "CMS released Q1 2026 NCCI PTP edits with 47 new code pair bundles. Radiology and surgical sections most affected.",
    "impact": "Review affected code pairs. Some previously separately billable services are now bundled.",
    "source": "CMS NCCI",
    "affects": ["radiology", "surgery", "ncci"]
  }
]

Subscribe to changes

Pull (supported)

curl "https://api-dev.rcintell.com/v1/data/changes?since=2026-01-01" \
  -H "X-API-Key: kp_test_..."

curl "https://api-dev.rcintell.com/v1/340b/changes?since=2026-01-01" \
  -H "X-API-Key: kp_test_..."

curl "https://api-dev.rcintell.com/v1/policies/changes?since=2026-01-01" \
  -H "X-API-Key: kp_test_..."

There is no POST /v1/webhooks feed. Agent jobs can still POST to your URL via callback_url — see Agent callbacks.

RSS / Email

Subscribe to the public RSS feed at https://rcintell.com/tools/feed.xml or sign up for email digests (daily or weekly).

Severity levels

Level	Meaning	Example
Critical	Will cause claim denials if not addressed	Timely filing shortened
High	Payment amount will change	Conversion factor update
Medium	May affect some claims	New NCCI edit pair
Low	Informational	Minor code description change

Free to browse

The Rule Change Feed is publicly browsable at rcintell.com/tools. Filtered API access requires an API key.