We’re excited to share the latest updates to Telemedicine Evaluation and Management (E/M) Services for CPT 2025. These changes reflect the growing role of telemedicine in delivering equitable, efficient, and accessible care. Here’s what you need to know:

Why These Changes?

The pandemic underscored the importance of telemedicine but also revealed disparities in coding and reimbursement practices across various payers. The 2025 updates standardize services to align with modern care delivery methods, ensuring fair valuation for telemedicine visits.

Synchronous Audio-Video Codes (98000–98007)

These codes apply to real-time video encounters and cover both new and established patients. Service levels are determined by:

• Medical Decision-Making (MDM)
• Total Time Spent on the Date of the Encounter

 

New Patient	Established Patient
98000 Straightforward or 15-29 minutes	98004 Straightforward or 10-19 minutes
98001 Low or 30-44 minutes	98005 Low or 20-29 minutes
98002 Moderate or 45-59 minutes	98006 Moderate or 30-39 minutes
98003 High or 60+ minutes	98007 High or 40+ minutes

New codes have been introduced for patients who rely on audio-only services and cover both new and established patients. These code levels are also determined by:

• Medical decision making (MDM)
• Total time spent on the date of the encounter

However, these codes also require more than 10 minutes of medical discussion, regardless of the total time spent on the date of the encounter.
 

New Patient	Established Patient
98008 Straightforward or 15-29 minutes	98012 Straightforward or 10-19 minutes
98009 Low or 30-44 minutes	98013 Low or 20-29 minutes
98010 Moderate or 45-59 minutes	98014 Moderate or 30-39 minutes
98011 High or 60+ minutes	98015 High or 40+ minutes

CPT codes 99441, 99442, and 99443 for telephone E/M services have been deleted for 2025.

Virtual Check-Ins (98016)

For quick triage and follow-up, the brief communication technology-based service code is to be used for:

• Established patients initiating a check-in
• Determining if further evaluation or in-person visits are necessary
• This code applies to medical discussions lasting 5–10 minutes
• Cannot originate from a related E/M service provided within the previous 7 days
• Cannot lead to an E/M service within the next 24 hours or soonest available appointment

If the virtual check-in leads to an E/M service on the same calendar day, and if time is used to select that level of 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.
The Centers for Medicare and Medicaid (CMS) will delete HCPCS code G2012, which will be replaced by 98016. 

Updated Guidelines

These updates ensure telemedicine codes reflect current care practices:

• Codes describe real-time, interactive encounters (audio-video or audio-only)
• Excludes routine calls (e.g., sharing test results)
• Do not count time for establishing the connection or arranging the appointment, even when performed by the physician or other QHP
• If during the encounter audio-video connections are lost and only audio is restored, report the service that accounted for the majority of the time of the interactive portion of the service
• Do not count the time performing telemedicine service toward time performing chronic care management (CCM 99437, 99491) or principal care management services (PCM 99424, 99425)
• The same time is not counted twice

New Codes Not Adopted by CMS

While developing new, standardized codes for telemedicine services created opportunities for consistency and parity across payers, CMS did not adopt these codes for the calendar year 2025. They will continue to require reporting offices or other outpatient E/M services using CPT codes 99202-99215 for synchronous telemedicine services. Additionally, the statutory limitations that were in place prior to the COVID-19 PHE will retake effect for most telemedicine services. This includes geographic and location restrictions on where the services are provided.

 

 

Published: 02/19/2025

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