The new year brings new opportunities—and new pressures. As reimbursement rules tighten, documentation expectations increase, and payer oversight becomes more automated, the practices that thrive in 2026 will be the ones that operate with clarity, discipline, and intentionality. After working with O&P clinics across the country, one thing is overwhelmingly clear: Success is not about doing one thing exceptionally well. It’s about doing many small things consistently and correctly.
Here are the five strategies every O&P practice needs to prioritize as we move into the new year.
- Strengthen Your Documentation Foundation
Documentation remains the cornerstone of every claim, every device, and every audit response. In 2026, providers are expected to do more, especially delivering more detailed documentation to connect the dots between patient evaluations and code selection, providing greater clarity about medical necessity. The most common denials we see today originate from small gaps—vague functional assessments (even something as simple as documenting ambulation is often too vague or just implied), unclear justification for custom fabrication, or incomplete notes supporting addition codes.
The practices that succeed this year will adopt standardized documentation guidelines, conduct regular internal audits, and ensure clinicians understand exactly what payers look for. A strong documentation foundation doesn’t just protect revenue, it accelerates it.
- Recommit to Coding Accuracy
Coding in O&P isn’t static. Every year brings new interpretations, new policy changes, and new patterns of scrutiny. In 2026, payers are especially focused on:
- Custom versus off-the-shelf distinctions
- Add-on coding justification
- Frequency limitations
- Code combinations that appear inconsistent
- PDAC rules and device-specific listings
Practices must avoid relying on “the way we’ve always done it.” Coding accuracy requires continuous education, coordinated communication between clinicians and billers, and a willingness to audit your own claims before the payers do. The strongest practices have quarterly coding checkups and maintain shared accountability between clinical and billing teams.
- Build a Culture of Compliance—Not a Reaction to Audits
Compliance cannot be something a practice turns on only when an audit arrives. In 2025, we saw an increase in AI-initiated payer reviews, retrospective claim audits, and recoupment demands. These trends will only accelerate. The most financially stable practices treat compliance as a routine business function, not an emergency response.
This means maintaining updated policies and procedures, ensuring LCD regulations are always met, reviewing aging accounts receivable monthly, and embedding compliance conversations into team meetings. When compliance becomes part of your culture, audits become far less intimidating—and far less disruptive.
- Invest in Training Across Every Level of the Practice?
In 2026, education is no longer optional. It is a competitive advantage. The most successful practices are the ones that invest in their teams. For example, teach clinicians what payers require and help billing staff understand functional terminology like multiaxial components and variable cadence, for example.
Cross-training is particularly powerful. When clinicians understand billing, and billing understands clinical reasoning, documentation and claims improve dramatically. What I see is that the practices committed to structured, ongoing education have fewer denials, faster payment timelines, and higher staff confidence.
- Use Data to Drive Better Decisions
In the past, many O&P practices made decisions based on instinct. In 2026, instinct is not enough. Today’s highest-performing clinics review key metrics weekly or monthly—including days to first payment, percentage of clean claims, denial categories, and accounts receivable aging buckets. Data exposes bottlenecks, highlights training needs, and allows owners to intervene before small problems become costly ones.
The goal here is toward progress not perfection. When owners understand their numbers, they gain control of their financial health.
The Blueprint Is Simple—But Powerful
Success in 2026 won’t come from any single strategy. It will come from consistency: documenting well, coding accurately, staying compliant, educating your team, and making data-driven decisions.
The new year offers a fresh start. With the right foundation, this can be the year O&P practices build stronger systems, stronger teams, and stronger financial stability—one intentional step at a time.
Erin Cammarata is president and owner of CBS Medical Billing and Consulting. She can be contacted at erin@cbsmedicalbilling.com.
Image: Fauzi/stock.adobe.com
