Telehealth continuously evolves, with Medicare extending coverage through September2025 and Centers for Medicare & Medicaid Services (CMS) actively working to establishpermanent telehealth policies. Important changes include new telehealth CPT codes(98000 series), the retirement of telephone only visit CPT codes (99441-99443), andlower reimbursement rates for virtual visits. This guide breaks down the updates,providing strict billing instructions to help your practice navigate the transitionseamlessly.
In this guide, we’ll break down the 2025 telehealth CPT code changes, provideactionable billing strategies, and highlight key resources to keep your practicecompliant.
When to Use: For video-based visits with new or established patients.
Key Changes:
| Patient Type | CPT Code | Minimum Time | Service Description | Medical Decision Making |
|---|---|---|---|---|
| New Patient | 98000 | 15 minutes | A/V Telehealth Visit | Straightforward MDM |
| New Patient | 98001 | 30 minutes | A/V Telehealth Visit | Low MDM |
| New Patient | 98002 | 45 minutes | A/V Telehealth Visit | Moderate MDM |
| New Patient | 98003 | 60 minutes | A/V Telehealth Visit | High MDM |
| Established Patient | 98004 | 10 minutes | A/V Telehealth Visit | Straightforward MDM |
| Established Patient | 98005 | 20 minutes | A/V Telehealth Visit | Low MDM |
| Established Patient | 98006 | 30 minutes | A/V Telehealth Visit | Moderate MDM |
| Established Patient | 98007 | 40 minutes | A/V Telehealth Visit | High MDM |
When to Use: For phone calls when video isn’t feasible (e.g., patient tech limitations).
| Patient Type | CPT Code | Minimum Time | Service Description | Medical Decision Making |
|---|---|---|---|---|
| New Patient | 98008 | 15 minutes | Telephone Assessment | Straightforward MDM |
| New Patient | 98009 | 30 minutes | Telephone Assessment | Low MDM |
| New Patient | 98010 | 45 minutes | Telephone Assessment | Moderate MDM |
| New Patient | 98011 | 60 minutes | Telephone Assessment | High MDM |
| Established Patient | 98012 | 10 minutes | Telephone Assessment | Straightforward MDM |
| Established Patient | 98013 | 20 minutes | Telephone Assessment | Low MDM |
| Established Patient | 98014 | 30 minutes | Telephone Assessment | Moderate MDM |
| Established Patient | 98015 | 40 minutes | Telephone Assessment | High MDM |
Payer-Specific Tips & Compliance Risks
Medicare vs. Commercial Payers:
| Payer | Accepts Old Codes? | Accepts Audio-Only? | Key Policy |
|---|---|---|---|
| Medicare | No | Yes (98008-98015) | New codes only |
| Priority Health | Yes (for now) | Yes | Transitioning |
| BCBS | Varies by state | Often case-by-case | Check portal |
Conclusion & Key Takeaways
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