As the medical field progresses through technological advancements and evolving clinical practices, the American Medical Association (AMA) releases annual updates to the Current Procedural Terminology (CPT®) codes8. These updates are essential for maintaining accurate and efficient billing practices, ensuring that healthcare organizations stay current with the latest medical coding developments8. The 2025 CPT codes set, which went into effect on January 1, 2025, introduces significant changes, including new codes, revisions, and deletions that reflect the dynamic nature of modern medicine87.

What are CPT Codes?

CPT codes are a standardized system used to report medical procedures and services6. These codes provide a uniform language that accurately describes medical, surgical, and diagnostic services, offering a streamlined way for physicians, coders, and payers to communicate6. CPT codes are crucial for billing and reimbursement, as they determine how healthcare providers are compensated for their services4. Staying informed about CPT code changes is vital for healthcare organizations to ensure proper coding, reduce claim denials, and optimize revenue8.

Overview of the 2025 CPT Code Updates

The 2025 CPT code set includes 420 overall updates, comprised of 270 new codes, 112 deletions, and 38 revisions37. These changes span various medical specialties, with significant updates in telemedicine, digital medicine, artificial intelligence (AI), and laboratory services17. The updates reflect the increasing role of technology and personalized medicine in patient care8.

Key Areas of Change in the 2025 CPT Codes

Several key areas have seen significant changes in the 2025 CPT code set1. These include telemedicine, AI, remote therapeutic monitoring, and evaluation and management (E/M) services915.TelemedicineThe rise of telemedicine has transformed healthcare delivery, necessitating new codes to accurately report these services9. The 2025 CPT code set introduces 17 new codes in the Evaluation and Management (E/M) section specifically for telemedicine services3. These codes differentiate between audio-visual and audio-only visits, streamlining the coding process and eliminating the need for modifiers1.

• New Codes: The new codes (98000-98016) cover synchronous audio-video E/M for new and established patients, as well as synchronous audio-only E/M for new and established patients11.
• Impact: These changes allow for more precise billing of telemedicine services, ensuring that healthcare providers are appropriately reimbursed for virtual care9. The new codes also support the continued expansion of telehealth by providing a clear framework for documentation and reimbursement.
• Internal Link: For more information on optimizing telemedicine billing, visit Telemedicine Billing Optimization on qzmedx.com.

Artificial Intelligence (AI)AI is increasingly integrated into healthcare, assisting in various tasks from data analysis to image interpretation9. The 2025 CPT code set includes seven new Category III codes for AI-driven augmentative data analysis9.

• New Codes: These codes (0902T, 0932T, 0877T-0880T, and 0898T) cover AI applications in electrocardiogram measurements, medical chest imaging, and image-guided prostate biopsy9.
• Impact: These codes recognize the growing role of AI in enhancing diagnostic accuracy and efficiency9. By providing specific codes for AI-driven services, the CPT update supports innovation and adoption of AI technologies in healthcare.
• Internal Link: Learn more about how AI is transforming medical coding at AI in Medical Coding on qzmedx.com.

Remote Therapeutic Monitoring (RTM)RTM involves monitoring data related to patients’ therapeutic responses5. The 2025 CPT code updates include revisions to RTM codes to accommodate digital therapeutic interventions5.

• Revised Codes: Codes 98975, 98976-98978, and 98980 have been updated to include digital therapeutic interventions and device supply for data access5.
• Impact: These revisions enable healthcare providers to bill for remote monitoring services that incorporate digital therapeutics, promoting better patient outcomes through continuous monitoring and intervention.
• Internal Link: Discover the benefits of RTM for patient care at Remote Therapeutic Monitoring on qzmedx.com.

Evaluation and Management (E/M) ServicesE/M codes are used to report office visits and other outpatient services1. The 2025 CPT code set eliminates codes 99441-99443 and introduces new codes for telemedicine services within the E/M section1.

• Deleted Codes: Codes 99441-99443 are no longer available1.
• New Codes: New codes (98000-98016) have been added to document audio/video services for new and established patients9.
• Impact: These changes streamline the coding process for telemedicine services, ensuring accurate and efficient billing1. The updates also provide clarity on how to code for different types of telemedicine visits based on medical decision-making or total time.
• Internal Link: Optimize your E/M coding practices with insights from E/M Coding Optimization on qzmedx.com.

Detailed Breakdown of Specific CPT Code Changes

To provide a more comprehensive understanding, here is a detailed breakdown of specific CPT code changes in the 2025 update.Telemedicine Codes (98000-98016)The new telemedicine codes in the E/M section (98000-98016) are designed to differentiate between audio-visual and audio-only services3. These codes are based on either medical decision-making or total time spent with the patient11.

• 98000-98003: Synchronous audio-video E/M for new patients11.
• 98004-98007: Synchronous audio-video E/M for established patients11.
• 98008-90011: Synchronous audio-only E/M for new patients11.
• 90012-90015: Synchronous audio-only E/M for established patients11.
• 90016: Virtual check-in visits11.

Remote Therapeutic Monitoring (RTM) CodesThe revisions to RTM codes focus on incorporating digital therapeutic interventions and device supply5.

• 98975: Updated to include digital therapeutic intervention, such as initial set-up and patient education on the use of equipment5.
• 98976-98978: Revised to include device supply for data access or data transmissions to support remote therapeutic monitoring of patients5.
• 98980: Revised to apply to provider services that last fewer than 20 minutes5.

Category III Codes for AIThe new Category III codes for AI cover various applications in medical imaging and diagnostics9.

• 0902T and 0932T: AI augmentative data analysis in electrocardiogram measurements9.
• 0877T-0880T: AI in medical chest imaging9.
• 0898T: AI in image-guided prostate biopsy9.

Impact on Medical Billing and Coding Practices

The 2025 CPT code updates have significant implications for medical billing and coding practices4. Healthcare organizations must adapt to these changes to ensure accurate coding, reduce claim denials, and maintain compliance8.Accurate CodingProperly understanding and applying the new CPT codes is essential for accurate coding6. Coders need to be trained on the new codes and guidelines to ensure that services are correctly reported11.

• Training: Provide comprehensive training to coding staff on the 2025 CPT code updates11.
• Resources: Utilize resources such as the AMA’s CPT code book and coding software to stay informed3.

Reduced Claim DenialsAccurate coding helps reduce claim denials by ensuring that services are billed correctly8. By staying up-to-date with the latest CPT code changes, healthcare organizations can minimize errors and avoid denials4.

• Verification: Verify the accuracy of coding practices through regular audits3.
• Updates: Keep coding software updated with the latest CPT codes3.

ComplianceCompliance with CPT coding guidelines is crucial for avoiding penalties and maintaining ethical billing practices3. Healthcare organizations must adhere to the new guidelines to ensure they are in compliance with regulations8.

• Audits: Conduct regular internal audits to identify and correct any coding errors3.
• Policies: Develop and implement coding policies that align with the latest CPT guidelines3.

Preparing for the 2025 CPT Code Updates

To effectively prepare for the 2025 CPT code updates, healthcare organizations should take several proactive steps8.Education and TrainingProvide comprehensive education and training to coding and billing staff on the new CPT codes and guidelines11. This training should cover the specific changes in each area, such as telemedicine, AI, and remote therapeutic monitoring95.

• Workshops: Conduct workshops and seminars to educate staff on the new codes6.
• Online Resources: Utilize online resources and webinars to provide ongoing training3.

Update Coding SoftwareEnsure that coding software is updated with the latest CPT codes3. This will help prevent errors and ensure accurate coding8.

• Regular Updates: Schedule regular software updates to stay current with the latest changes3.
• Testing: Test the updated software to ensure that it is functioning correctly3.

Review and Revise PoliciesReview and revise coding policies to align with the new CPT guidelines3. This will help ensure compliance and reduce the risk of claim denials8.

• Policy Updates: Update coding policies to reflect the new CPT codes and guidelines3.
• Documentation: Ensure that all coding policies are well-documented and easily accessible to staff3.

Conduct AuditsConduct regular internal audits to identify and correct any coding errors3. This will help ensure accuracy and compliance8.

• Audit Schedule: Establish a regular audit schedule to monitor coding practices3.
• Feedback: Provide feedback to coding staff on audit findings and areas for improvement3.

Resources for Staying Informed

Staying informed about CPT code changes is an ongoing process8. Healthcare organizations can utilize various resources to stay up-to-date with the latest information3.

• American Medical Association (AMA): The AMA publishes the CPT code book annually and provides updates and resources on its website3.
• Coding Associations: Professional coding associations, such as the American Academy of Professional Coders (AAPC), offer training, certification, and resources for coders11.
• Coding Software Vendors: Coding software vendors provide updates and resources to help users stay informed about CPT code changes3.
• Webinars and Seminars: Attend webinars and seminars on CPT coding to learn about the latest changes and best practices3.

Conclusion

The 2025 CPT code updates represent a significant shift in medical coding, reflecting the evolving landscape of healthcare8. By understanding and adapting to these changes, healthcare organizations can ensure accurate coding, reduce claim denials, and maintain compliance4. Proactive education, updated coding software, and regular audits are essential for successfully navigating the 2025 CPT code updates and optimizing medical billing practices3. Staying informed and prepared will enable healthcare providers to deliver high-quality care while maintaining financial stability8.

For expert assistance with CPT coding and billing, visit Qzmedx Services on qzmedx.com.