Healthcare just got a major update! The American Medical Association dropped 270 new CPT codes for 2025, and we're here to break down what this means for your practice. These changes aren't just numbers on paper, they're game-changers that could impact your revenue, workflow, and patient care delivery.
Ready to ensure your practice stays compliant and profitable with these coding updates? Contact our team today to learn how our virtual healthcare services can help you navigate these critical changes seamlessly.
What's Actually New in CPT 2025?
Let's cut straight to the facts. The 2025 CPT update brings us 420 total changes:
- 270 brand new codes
- 112 deleted codes
- 38 revised codes
Revolutionary Telehealth Codes Transform Virtual Care
Gone are the days of using regular office visit codes with modifiers for telehealth. The new system creates distinct pathways:
Audio-Video Services for New Patients:
- 98000 (Straightforward MDM, 15+ minutes)
- 98001 (Low complexity MDM, 30+ minutes)
- 98002 (Moderate complexity MDM, 45+ minutes)
- 98003 (High complexity MDM, 60+ minutes)
Audio-Only Services for Established Patients:
- 98012 (Straightforward MDM, 10+ minutes)
- 98013 (Low complexity MDM, 20+ minutes)
- 98014 (Moderate complexity MDM, 30+ minutes)
- 98015 (High complexity MDM, 40+ minutes)
The catch? Medicare won't accept these new telehealth codes. They're sticking with the old system using office visit codes plus modifiers. Commercial payers are split, some love the new codes, others don't. You'll need to check with each payer individually.
AI Gets Its Own CPT Category
Artificial intelligence isn't science fiction anymore. Seven new Category III codes now specifically describe AI services:
- 0877T-0880T: AI analysis of chest CT imaging for lung disease classification
- 0898T: AI-powered prostate cancer mapping from biopsy data
- 0902T & 0932T: AI electrocardiogram analysis
These codes classify AI services as assistive, augmentative, or autonomous based on how much work the AI performs versus the healthcare provider.
Remote Monitoring Gets Digital Medicine Boost
Digital therapeutics are no longer optional. Updated codes 98975-98978 now include "digital therapeutic intervention" language, reflecting how remote patient monitoring has evolved beyond simple data collection.
Key updates:
- 98975: Now includes digital therapeutic intervention setup
- 98976-98978: Device supply codes expanded for data transmission support
These changes recognize that modern remote monitoring actively intervenes in patient care, not just passively collects information.
Laboratory and Pathology Expand Testing Options
New lab codes address emerging medical needs:
Neurological Testing:
- 82233-82234: Beta-amyloid testing for Alzheimer's evaluation
- 83884: Neurofilament light chain testing
- 84393 & 84395: Tau protein testing (phosphorylated and total)
Infectious Disease Detection:
- 87513: Helicobacter detection
- 87564: Mycobacterium tuberculosis detection
- 87594: Pneumocystis jirovecii detection
Plus dozens of new Proprietary Laboratory Analyses (PLA) codes for genetic testing and specialized diagnostics.
Radiology Safety Takes Priority
MRI safety concerns prompted six new codes (76014-76019) for managing patients with implanted devices. These address the growing need for specialized protocols when imaging patients with pacemakers, cochlear implants, and other electronic devices.
The codes cover:
- Safety assessments by clinical staff
- Physician safety determinations
- Custom safety planning by medical physicists
- Device programming and positioning
Category III Codes Signal Future Trends
Category III codes represent emerging technology worth watching:
- Subcutaneous Peritoneal Pumps (0870T-0875T): New approach to managing ascites
- Intracoronary Drug Delivery (0913T-0914T): Targeted cardiac medication delivery
- Advanced Imaging Analysis: Multiple codes for AI-enhanced diagnostic imaging
These codes allow data collection while technology proves its value before moving to permanent Category I status.
Implementation Strategy for Your Practice
Step 1: Audit Your Current Processes
Review how you currently code telehealth, tumor excisions, and remote monitoring services. Identify which new codes apply to your specialty.
Step 2: Update Payer Policies
Contact each payer to determine:
- Which telehealth codes they accept
- Required modifiers and place of service codes
- Documentation requirements for new procedures
Step 3: Train Your Team
Schedule training sessions covering:
- New code descriptions and requirements
- Documentation standards (especially for tumor measurements)
- Payer-specific billing rules
Step 4: Update Systems
Ensure your practice management and EHR systems include all new codes with correct descriptors and billing rules.
Revenue Impact Considerations
The new telehealth codes carry different RVU values than traditional office visits. Audio-only services typically reimburse less than audio-video services, which reimburse less than in-person visits.
Example RVU Comparison:
- 99213 (office visit): 2.73 total RVUs
- 98005 (audio-video equivalent): 2.23 total RVUs
- 98013 (audio-only equivalent): 1.90 total RVUs
Plan your service mix accordingly to maintain revenue targets while providing appropriate care modalities.
Need expert guidance on maximizing revenue while staying compliant with new coding requirements? Connect with our team to discover how our virtual healthcare billing specialists can optimize your revenue cycle with the latest CPT 2025 updates.
Looking Ahead: Your Next Steps
The new CPT codes for 2025 represent more than administrative updates, they reflect healthcare's digital transformation and evolving patient care models. Success requires proactive preparation, not reactive scrambling.
Start now by identifying which codes impact your practice most. Focus your training and system updates on high-volume services first. Remember, these changes took effect January 1, 2025, there's no grace period for compliance.
Healthcare continues evolving rapidly. Stay ahead by partnering with experts who understand both the technical requirements and practical implications of coding changes. Your patients deserve seamless care delivery, and your practice deserves optimized revenue, the right preparation makes both possible.
