Each year, the AMA updates the existing CPT codes used for submitting claims. These changes can include deletions of existing codes, additions of new codes, and modifications to existing code descriptions. For 2025, the AMA has introduced new CPT codes that significantly alter the billing process for telehealth claims.
The new code sets differ according to:
- A patient’s status – New versus Established
- The type of telehealth utilized – Phone versus Audio/Video
- The code level determination – Which can be selected based on time or documentation.
In addition to the new telehealth codes, the AMA has introduced new pain service CPT codes to more accurately document the performance of fascial plane injections.
Check out our overview of the most important CPT code updates of which you should be aware.
Telemedicine codes
- Audio/Video – New Codes – will replace the current use of E/M office visit cpt codes (99202-99215)
- 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
- 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
- 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
- 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
- 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.
- 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
- 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
- 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. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded
- 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
- Telephone – New Codes – will replace the code 99441-99443 which will be deleted
- 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
- 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
- 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. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded
- 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, 45 minutes must be met or exceeded. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded
- 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, 45 minutes must be met or exceeded. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded
- 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, 45 minutes must be met or exceeded. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded
- 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, 45 minutes must be met or exceeded. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded
- 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, 45 minutes must be met or exceeded. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded
- 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 Fascial Plane Block CPT Codes
The codes below will replace some instances for which we previously coded 64999.
- 64466 – Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed
- 64467 – Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed
- 64468 – Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed
- 64469 – Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed
- 64473 – Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed
- 64474 – Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed
How Ventra Can Help
Ventra coders have received comprehensive training and education on the new CPT codes. We are committed to partnering with our providers to ensure they fully understand these new codes and how they apply to the services they perform.
Contact our Provider Education team to learn more.
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