Medical Billing and Coding Industry Trends in 2026

Computer-assisted coding (CAC) has moved from pilot projects to production-scale deployment. According to the American Hospital Association, nearly 46% of hospitals and health systems now use AI in their revenue-cycle operations. These tools use natural language processing (NLP) to read physician documentation, suggest ICD-10-CM and CPT codes, and flag inconsistencies before claim submission.

Major CAC platforms — including Solventum's 3M 360 Encompass system and Optum's Enterprise CAC — are processing thousands of charts weekly at large health systems. UPMC Health System reported a 21% increase in the number of inpatient charts coded per hour after implementing Optum CAC, demonstrating measurable productivity gains. AI-assisted coding teams also report roughly 40% faster claim processing and 25% fewer initial rejections compared to fully manual workflows.

This does not mean coders are being replaced. Instead, the role is shifting. Coders increasingly function as auditors who review AI-generated code suggestions, catch errors the algorithms miss, and handle complex cases that require clinical judgment. Routine coding for straightforward encounters is where automation has the biggest footprint. Multi-comorbidity cases, surgical procedures with unusual complications, and specialty coding still depend heavily on human expertise. For a deeper look at this shift, see our analysis: Can AI Replace Medical Coders?

For current and aspiring coders, the takeaway is practical: learning to work alongside AI tools is becoming a baseline expectation. Employers increasingly list CAC experience or familiarity with AI-assisted workflows in job postings. The path into this career now includes understanding how these tools fit into the revenue cycle.

The World Health Organization's ICD-11 classification system officially went into effect for member states on January 1, 2022. As of mid-2024, the WHO reported that 50 countries were conducting or expanding ICD-11 implementation pilots, with 14 countries actively using the system. The United States is not among them — at least not yet.

The U.S. remains in an exploratory phase. In 2023, the National Committee on Vital and Health Statistics (NCVHS) created a dedicated ICD-11 Workgroup to study adoption requirements and develop recommendations for the Department of Health and Human Services. No official implementation date has been set. Industry projections generally place U.S. adoption somewhere between 2027 and 2030, with the understanding that a full transition will require a minimum of four to five years of planning, system upgrades, and workforce training.

ICD-11 introduces substantially more granular coding — roughly four times the number of codes compared to ICD-10. For coders, this means more specificity in documentation requirements and a longer learning curve during transition. The upside: greater clinical detail supports more accurate reimbursement and better population health data.

Beyond ICD-11, value-based care models continue to change how coding intersects with reimbursement. Under value-based payment, accurate risk-adjustment coding — particularly hierarchical condition category (HCC) coding — directly affects provider revenue. This has created strong demand for coders with risk-adjustment experience, a specialty that commands higher salaries than general outpatient coding. If you hold a CPC certification, adding an HCC credential is one of the clearest paths to higher earnings.

Remote work is no longer a perk in medical billing and coding — it is the default. AAPC's 2024 salary survey of more than 25,000 professionals found that 65.7% of medical records specialists work remotely full time, with another 14.1% in hybrid arrangements. That means roughly 80% of the workforce has at least some remote component, up from about 30–33% before 2020.

This shift held because the work itself is well-suited to remote delivery. Coders review electronic health records, assign codes, and submit claims through software — all tasks that require a secure workstation and internet connection, not physical presence in a facility. Employers have largely maintained remote arrangements because productivity metrics did not decline during the transition.

For those entering the field, one practical reality persists: most employers still require one to two years of on-site experience before approving remote work. Entry-level coders typically start in a facility-based role where they can receive direct mentorship and supervision, then transition to remote once they have demonstrated consistent accuracy and productivity. Our work-from-home guide covers the specific requirements and HIPAA compliance steps for setting up a home office.

On the employer side, major remote-coding employers include Optum, Datavant (formerly Ciox Health), Aviacode/GeBBS Healthcare Solutions, The Coding Network, and AGS Health. These companies collectively hire hundreds of remote coders annually across general outpatient, inpatient, HCC risk adjustment, and specialty coding roles. Learn more about remote medical coding jobs.

The combination of AI adoption, ICD-11 preparation, and value-based care expansion points toward a clear set of skills that will differentiate coders over the next several years. Professionals who build competence in these areas position themselves for higher salaries, more job security, and faster career advancement.

Coding auditing and compliance. As AI handles more routine code assignment, the human role tilts toward quality assurance. Coders who can audit AI-generated output, identify patterns in denial data, and ensure compliance with payer-specific guidelines are increasingly valuable. The AAPC's CPMA (Certified Professional Medical Auditor) credential directly targets this skill set.

Risk-adjustment and HCC coding. Value-based reimbursement models depend on accurate severity-of-illness documentation. HCC coders review charts to ensure all relevant chronic conditions are captured, directly affecting the revenue a provider receives from Medicare Advantage and similar programs. This specialty consistently commands salaries above the general coding average.

Specialty coding expertise. Surgical coding, interventional radiology, cardiology, and orthopedics are areas where AI accuracy lags behind general E/M coding. Coders with deep knowledge of a clinical specialty and the corresponding CPT code families remain in strong demand. AAPC offers more than 20 specialty credentials for professionals looking to formalize this expertise.

Denials management and revenue-cycle analytics. Understanding why claims get denied and how to prevent or appeal those denials combines coding knowledge with data analysis. Professionals who can pull denial reports, identify root causes, and implement process improvements bring measurable financial value to their employers — a skill set that often leads to management-track positions.

The BLS median salary for medical records specialists stands at $50,250 per year (SOC 29-2072), but certified professionals significantly outperform that figure. AAPC's 2025 salary report shows certified coders averaging $62,689, and those with three or more certifications reaching $81,227. Investing in credentials and specialized skills remains the most reliable path to earning above the median. For more on medical billing and coding salaries and how certification affects pay, see our salary guide.