E/M CPT 2025 Coding Changes and Guidelines

The 2025 Current Procedural Terminology (CPT) code set introduces significant updates to Evaluation and Management (E/M) services, effective January 1, 2025. These changes include new codes, deletions, and revisions aimed at enhancing the accuracy and specificity of medical reporting. New Telemedicine E/M Codes: A new subsection for telemedicine services has been added, featuring 17 codes for synchronous audio-video and audio-only E/M office visits. These codes are structured similarly to existing office and outpatient E/M codes, with separate designations for new and established patients. Synchronous Audio-Video Visits: New Patients: 98000: Requires a medically appropriate history and/or examination and straightforward medical decision making; minimum 15 minutes. 98001: Low medical decision making; minimum 30 minutes. 98002: Moderate medical decision making; minimum 45 minutes. 98003: High medical decision making; minimum 60 minutes. Established Patients: 98004: Requires a medically appropriate history and/or examination and straightforward medical decision making; minimum 10 minutes. 98005: Low medical decision making; minimum 20 minutes. 98006: Moderate medical decision making; minimum 30 minutes. 98007: High medical decision making; minimum 40 minutes. Synchronous Audio-Only Visits: New Patients: 98008: Requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion; minimum 15 minutes. 98009: Low medical decision making, more than 10 minutes of medical discussion; minimum 30 minutes. 98010: Moderate medical decision making, more than 10 minutes of medical discussion; minimum 45 minutes. 98011: High medical decision making, more than 10 minutes of medical discussion; minimum 60 minutes. Established Patients: 98012: Requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion; minimum 10 minutes. 98013: Low medical decision making, more than 10 minutes of medical discussion; minimum 20 minutes. 98014: Moderate medical decision making, more than 10 minutes of medical discussion; minimum 30 minutes. 98015: High medical decision making, more than 10 minutes of medical discussion; minimum 40 minutes. Additionally, 98016 has been introduced for brief communication technology-based services (e.g., virtual check-ins) by a physician or other qualified healthcare professional for established patients, lasting 5-10 minutes. AAPC Deleted Codes: The following codes have been deleted and should no longer be used: 99441: Telephone E/M service by a physician or other qualified healthcare professional for an established patient; 5-10 minutes of medical discussion. 99442: 11-20 minutes of medical discussion. 99443: 21-30 minutes of medical discussion.