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Date: February 18,2026
NCCI Edits Version 31.2 in Effect July 1, 2025
The National Correct Coding Initiative (NCCI) Edits Version 31.2 are in effect for dates of service July 1, 2025 – September 30, 2025. NCCI edits are used in all outpatient therapy settings for original Medicare and Medicaid beneficiaries. In addition, some Medicare Advantage plans, commercial insurers, and workers compensation programs also utilize the NCCI edits.
Gawenda Seminars & Consulting has created a NCCI Edit therapy specific reference sheet for both Medicare and Medicaid. These reference sheets will inform providers when modifier 59 is required on a CPT code on the claim form. In addition, the reference sheet will inform providers what combination of codes will not reimbursed by Medicare and Medicaid if provided on the same date of service.
Click HERE to access the current version of NCCI edits for Medicare.
Click HERE to access the current version of NCCI edits for Medicaid.
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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.
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Which column Left or Right gets the modifier 59 when needed ?
Column 2