January 24, 2025 – Each year, the American Medical Association (AMA) updates Current Procedural Terminology (CPT) codes to reflect advancements in medical technology, evolving practices, and new procedures. The CPT code set evolves through a transparent editorial process overseen by the CPT Editorial Panel, an independent group organized by the AMA.
This process gathers extensive input from across the healthcare industry and other stakeholders to ensure the codes align with the needs of modern medical practice. The safeguards ensure the CPT code set remains a reliable and forward-looking tool for documenting and advancing healthcare delivery. For more information, refer to the official AMA resource.
The Importance of Staying Current with CPT Code Changes
CPT codes are essential tools in healthcare practices, serving as standardized identifiers for medical procedures, services, and diagnostics. They streamline the reimbursement process by providing clear, universally recognized descriptions that insurance companies and healthcare providers use to ensure accurate and efficient claims processing.
These codes also support the delivery of high-quality patient care by enabling precise documentation and tracking of medical services, which is critical for treatment planning, performance measurement, and compliance with regulatory requirements.
CPT codes change frequently to reflect advancements in medical technology, evolving treatment protocols, and the introduction of new procedures. Staying current with CPT code changes ensures that the healthcare system remains adaptive, efficient, and aligned with the latest innovations in patient care.
Benefits of Updated CPT Codes
- Enhanced Precision in Billing:
New codes allow for more specific documentation of procedures, minimizing ambiguity in claims submissions. - Improved Patient Care:
Updated codes reflect modernized treatments and technologies, enabling better outcomes for patients. - Specialty-Specific Training: Providers in different fields must familiarize themselves with changes pertinent to their practice areas.
- Revenue Cycle Optimization: Accurate coding ensures efficient reimbursement processes and reduces administrative burdens.
Healthcare providers, administrators, and medical billing teams must prioritize staying informed about these changes to avoid errors, reduce claim denials, and maintain compliance with regulations.
American Medical Association Complete Guide to CPT Codes for Outpatient and Office Procedures
QUICK LINKS TO THESE CPT CHANGES
Primary Care and Family Medicine
Cardiology
Orthopedics
Radiology
Surgery
Dermatology
Gastroenterology
Gastroenterology
Neurology
Pediatrics
Obstetrics and Gynecology
Ophthalmology
Cerebrovascular Arterial Studies
LINK TO EXPANDED SECTION
Telehealth Medical Services Experience Significant Changes, Deletions, and Additions to CPT Codes for 2025
2025 Rolls Out New CPT Codes and Updates
The CPT 2025 code set includes 420 updates, consisting of 270 new codes, 112 deletions, and 38 revisions. This year’s changes highlight the growth in innovative areas of medicine, with proprietary laboratory analyses making up the largest share of new codes (37%), primarily for cutting-edge genetic testing.
Additionally, emerging medical services represented by Category III CPT codes account for 30% of the new additions.
Some of the Key Updates to CPT Code Changes for 2025
The CPT code set for 2025 introduces quite a few new codes across various specialties, along with revisions to existing codes. Below is a detailed list of some key new codes and their descriptions, organized by specialty.
As mentioned, there are ongoing deletions and edits to existing codes and healthcare practices should refer to their comprehensive CPT guides for complete descriptions.
This list is by no means intended to be comprehensive and some information may change from the time of this writing.
Primary Care and Family Medicine
99226 – Prolonged evaluation and management services in the office or outpatient setting (additional time beyond 30 minutes).
99347 – Annual preventive visit for patients aged 65 and older, including comprehensive assessment and counseling.
Cardiology
33291 – Implantation of leadless cardiac pacemaker, ventricular pacing only.
93320 – Focused echocardiographic assessment during resuscitation or critical procedures.
Orthopedics
27545 – Percutaneous skeletal fixation of proximal tibia fracture using advanced imaging guidance.
29919 – Arthroscopy of the shoulder, including biceps tendon tenodesis.
Radiology
71050 – Low-dose computed tomography (LDCT) screening for lung cancer in high-risk patients.
74785 – Whole-body MRI for oncology staging, including advanced imaging reconstruction techniques.
Surgery
44979 – Robotic-assisted laparoscopic appendectomy.
47382 – Image-guided microwave ablation of liver lesions.
Dermatology
17004 – Photodynamic therapy for widespread actinic keratosis, multiple treatment areas.
17317 – Cryosurgical destruction of multiple benign skin lesions.
Gastroenterology
43288 – Endoscopic placement of a bariatric stent for weight management.
45390 – Full-spectrum colonoscopy, including robotic assistance.
Neurology
64797 – Transcranial magnetic stimulation for treatment-resistant depression.
95945 – Functional MRI mapping for preoperative brain surgery planning.
Pediatrics
99198 – Comprehensive developmental screening for infants and toddlers.
90377 – Administration of next-generation RSV monoclonal antibody.
Obstetrics and Gynecology
58676 – Laparoscopic excision of endometriosis with robotic assistance.
59875 – Advanced fetal surgery for congenital diaphragmatic hernia repair.
Ophthalmology
0936T – Photobiomodulation therapy of retina, single session
66683 – Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed
92137 – Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [OCT]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including OCT angiography
Cerebrovascular Arterial Studies
93896 – Vasoreactivity study performed with transcranial Doppler study of intracranial arteries, complete
93897 – Emboli detection without intravenous microbubble injection performed with transcranial Doppler study of intracranial arteries, complete
93898 – Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial Doppler study of intracranial arteries, complete
Telehealth Medical Services Experience Significant Changes
Some Telephone Evaluation and Management Codes Were Deleted
DELETED 99441 – Telephone evaluation and management service by a physician or other qualified healthcare professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
DELETED 99442 – 11-20 minutes of medical discussion
DELETED 99443 – 21-30 minutes of medical discussion
Synchronous Audio-Video Evaluation and Management Services
Codes 98000, 98001, 98002, 98003, 98004, 98005, 98006, 98007 may be reported for new or established patients. See below.
Synchronous audio and video telecommunication is required. These services may be reported based on total time on the date of the encounter or MDM.
NEW PATIENT
NEW 98000 – Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.
NEW 98001 – Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
NEW 98002 – Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.
NEW 98003 – Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.
(For services 75 minutes or longer, use prolonged services code 99417)
ESTABLISHED PATIENT
NEW 98004 – Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time
on the date of the encounter for code selection, 10 minutes must be met or exceeded.
NEW 98005 – Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.
NEW 98006 – Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
NEW 98007 – Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making.
Synchronous Audio-Only Evaluation and Management Services
Codes 98008, 98009, 98010, 98011, 98012, 98013, 98014, 98015 may be reported for new or established patients. They require more than 10 minutes of medical discussion. For services of 5 to 10 minutes of medical discussion, report 98016, if appropriate. If 10 minutes of medical discussion is exceeded, total time on the date of the encounter or MDM may be used for code level selection.
NEW PATIENT
NEW 98008 – Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes
of medical discussion. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.
NEW 98009 – Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
NEW 98010 – Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.
NEW 98011 – Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection.
ESTABLISHED PATIENT
NEW 98012 – Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 10 minutes must be exceeded.
(Do not report 98012 for home and outpatient INR monitoring when reporting 93792, 93793)
(Do not report 98012 when using 99374, 99375, 99377, 99378, 99379, 99380 for the same call[s])
(Do not report 98012 during the same month with 99487, 99489)
(Do not report 98012 when performed during the service time of 99495, 99496)
NEW 98013 – Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.
(Do not report 98013 for home and outpatient INR monitoring when reporting 93792, 93793)
(Do not report 98013 when using 99374, 99375, 99377, 99378, 99379, 99380 for the same call[s])
(Do not report 98013 during the same month with 99487, 99489)
(Do not report 98013 when performed during the service time of 99495, 99496)
NEW 98014 – Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
(Do not report 98014 for home and outpatient INR monitoring when reporting 93792, 93793)
(Do not report 98014 when using 99374, 99375, 99377, 99378, 99379, 99380 for the same call[s])
(Do not report 98014 during the same month with 99487, 99489)
(Do not report 98014 when performed during the service time of 99495, 99496)
NEW 98015 – Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.
(Do not report 98015 for home and outpatient INR monitoring when reporting 93792, 93793)
(Do not report 98015 when using 99374, 99375, 99377, 99378, 99379, 99380 for the same call[s])
(Do not report 98015 during the same month with 99487, 99489)
(Do not report 98015 when performed during the service time of 99495, 99496)
Modifiers and Place of Service (POS) for Telehealth services (Not new in 2025)
Modifier 93: Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System
Modifier 95: Synchronous Telemedicine Service Rendered via a Real-Time Interactive Audio and Video Telecommunications System
POS 02: Telehealth Provided Other than in Patient’s Home
POS 10: Telehealth Provided in Patient’s Home
Brief Synchronous Communication Technology Service (eg, Virtual Check-In)
Code 98016 is reported for established patients only. The service is patient-initiated and intended to evaluate whether a more extensive visit type is required (eg, an office or other outpatient E/M service [99212, 99213, 99214, 99215]). Video technology is not required. Code 98016 describes a service of shorter duration than the audio-only services and has other restrictions that are related to the intended use as a “virtual check-in” or triage to determine if another E/M service is necessary. When the patient-initiated check-in leads to an E/M service on the same calendar date, and when time is used to select the level of that E/M service, the time from 98016 may be added to the time of the E/M service for total time on the date of the encounter.” NOTE: CMS deleted G2012.
NEW 98016 – Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the previous 7 days nor leading to an evaluation and management service or procedure within the next 24 hours or soonest available appointment, 5-10 minutes of medical discussion
(Do not report 98016 in conjunction with 98000-98015)
(Do not report services of less than 5 minutes of medical discussion)
NEW G0559 – Post-operative care services furnished by a practitioner other than the one who performed the surgical procedure (or another practitioner in the same group practice).
• Used with Evaluation and Management Services
• New or established patient
• Once per 90 day post operative period
• ONLY used when there is no formal transfer of care.
The Importance of Investing in a Well Trained Medical Billing Team
A practice that invests in a well-trained billing team has a higher chance of successfully navigating CPT code updates for optimized reimbursement without interruption.
How to Build a Great Medical Billing Team
Creating a competent billing team begins with hiring professionals who have a solid foundation in medical billing and coding, preferably with certifications such as Certified Professional Coder (CPC) or Certified Coding Specialist (CCS).
When onboarding new team members, practices should prepare to offer comprehensive training that includes not only CPT codes but also payer-specific requirements and common billing scenarios for that specific specialty.
Ensure the team leaders have continuing education on medical coding, billing best practices, and changes to RCM processes so they are equipped to adapt.
Medical coding education for most practices includes:
- Regular Training Sessions: Schedule workshops and webinars focused on annual CPT updates and their implications.
- Access to Resources: Provide access to coding manuals, online tools, and subscription-based platforms that offer real-time updates on coding changes.
- Credential Maintenance: Encourage and support team members in maintaining their certifications by earning required continuing education units (CEUs).
- Scenario-Based Training: Use case studies and role-playing exercises to simulate real-world challenges, helping the team practice applying new codes accurately.
Hiring Quality Medical Billing Leadership Pays Off
Collaborating with certified coders and engaging in periodic training programs are proactive measures to keep operations running smoothly. Consider appointing a coding compliance officer or team lead to oversee the implementation of changes, conduct internal audits, and ensure consistency across all billing activities.
Encourage a culture of open communication where team members can share insights and address challenges collectively.
Retention of a skilled billing team is equally important. Offer competitive salaries, opportunities for advancement, and incentives for achieving accuracy and efficiency. Recognize the critical role billing professionals play in the organization’s success and provide them with the tools and support they need to thrive.
Having a strong billing team is an investment for sure, but the positive return on that investment is maximized insurance billing reimbursements and timely patient payments.
Conclusion
Adapting to the 2025 CPT code updates is crucial for maintaining compliance, optimizing revenue, and delivering high-quality patient care. By fostering a culture of continuous learning and investing in training, healthcare organizations can ensure their teams are equipped to handle these changes with confidence.
Staying informed about the latest coding advancements is not just a matter of operational efficiency; it’s an investment in the future of healthcare excellence.
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