Coding Like a Pro

Mark D. Kaufmann, MD delivered a detailed analysis of the economic realities facing dermatology in 2026, focusing on reimbursement trends, inflation, and key CPT coding updates that directly affect clinical practice. Dr Kaufmann emphasized that although demand for dermatologic care continues to grow, declining Medicare reimbursement, particularly when adjusted for inflation, represents one of the most significant threats to the sustainability of independent practices.

A central theme of the presentation was the long-term erosion of physician payment. Dr Kaufmann reviewed data showing that the Medicare physician conversion factor in 2026 remains lower than levels seen more than two decades ago, translating to a substantial inflation-adjusted decrease in reimbursement. He highlighted how common dermatologic procedures, including Mohs surgery and destruction of premalignant lesions, have experienced significant real-dollar payment declines over time. The presentation also outlined important 2026 coding updates, including the removal of the term “acne surgery” in favor of CPT 10040 for extractions, new restrictions on ultrasound image guidance billing for superficial radiation therapy, and updated payment rates for skin substitute products. Utilization challenges were also discussed, including overestimation of the complexity add-on code G2211.

Dr Kaufmann concluded by emphasizing that while the need for high-quality dermatologic care will persist, practice models must evolve to remain financially viable. He encouraged clinicians to move beyond basic billing practices by fully understanding the fee schedule, appropriately applying complexity codes when assuming ongoing care, and leveraging medical billing strategies such as buy-and-bill models to help offset continued reimbursement pressure.