AMA Releases CPT 2025 Code Set
The CPT 2025 update introduces key changes across specialties, including remote patient monitoring, telemedicine, AI-driven analysis, and surgical advancements.
Medical Billing Newsletter
The 2025 release of the Current Procedural Terminology (CPT®), developed by the American Medical Association (AMA), showcases updates largely driven by advancements in medical innovation, technologies, and procedures. This standardized code set is essential for documenting medical procedures and services across the United States.
Role and Importance of CPT Codes in Modern Healthcare
The CPT code set underpins efficient data exchange in a health system driven by information. Its role facilitates critical activities such as reporting, analyzing, measuring, researching, and benchmarking medical procedures, all aimed at enhancing patient care, improving outcomes, and reducing costs. The updates ensure the CPT code set continues as the universal medical language reflecting modern clinical practice.
Key Changes in the CPT 2025 Code Set: New Additions and Revisions
The CPT 2025 code set features 420 changes: 270 new codes, 112 deletions, and 38 revisions. A significant portion of the new codes (37%) pertains to proprietary laboratory analyses, primarily for innovative genetic testing, while emerging medical services represented by Category III CPT codes make up 30% of the new additions.
The CPT Editorial Panel, an independent group assembled by the AMA, oversees the open editorial process. This ensures that updates are informed by diverse input from across the healthcare landscape, maintaining the relevance of the CPT code set to contemporary medical science and its applicability to future healthcare challenges.
Key Highlights Of The CPT 2025 Code
Key highlights of the CPT 2025 code updates include:
Digital Medicine Updates in CPT 2025
The CPT 2025 code set includes key revisions to Remote Therapeutic Monitoring (RTM) services to better align with current digital health practices. These revisions are as follows:
- Code 98975 has been updated to include digital therapeutic interventions, expanding its scope to cover the growing role of digital tools in patient care.
- Codes 98976-98978 have been revised to now include device supplies necessary for data access or data transmission, supporting the effective implementation of RTM for patient monitoring.
These updates reflect the increasing use of digital technology in healthcare, enhancing remote patient management and ensuring that RTM services are well-supported by the necessary tools and interventions.
Augmented/Artificial Intelligence (AI) Updates in CPT 2025
The AI Taxonomy, introduced in 2023, has been integrated into Category III CPT codes to classify AI medical services and procedures. This taxonomy categorizes AI applications based on their role and the work they perform in collaboration with healthcare professionals. The three categories are:
- Assistive: AI tools that aid healthcare providers in their tasks.
- Augmentative: AI applications that enhance the physician's ability to analyze data and make decisions.
- Autonomous: AI systems that independently perform tasks without the need for human intervention.
In addition, seven new Category III codes have been established for AI augmentative data analysis. These codes cover AI applications in the following medical areas:
- Electrocardiogram measurements (Codes 0902T and 0932T)
- Medical chest imaging (Codes 0877T-0880T)
- Image-guided prostate biopsy (Code 0898T)
These updates ensure that AI applications in healthcare are appropriately categorized and supported by specific CPT codes, reflecting their growing role in clinical practice.
General Surgery Updates in CPT 2025
The CPT 2025 code set introduces updates in the General Surgery section to reflect recent advancements in surgical practices. These updates include:
- Skin Grafts for Wound Care and Recovery: New codes (15011-15018) address innovative approaches to skin grafting, improving the treatment and healing process for wound patients.
- Surgical Techniques for Tumor Elimination in the Abdomen: Codes 49186-49190 have been revised to include advancements in surgical procedures for removing tumors in the abdominal region.
Additionally, the American Medical Association (AMA) is inviting the healthcare community to participate in the CPT & RBRVS 2025 Annual Symposium. This event, held virtually in November, offers valuable guidance on the updates to the CPT 2025 code set, providing insight from the authority on medical coding.
Key Changes in CPT 2025: High-Impact Updates Across Specialties
The CPT 2025 update introduces several crucial changes that will affect healthcare providers across various specialties. Here's a breakdown of the key updates:
1. Remote Patient Monitoring (RPM):
- Starting January 1, 2026, CPT code 98975 will include digital therapeutic interventions, expanding its scope to cover more comprehensive remote care.
- Codes 98976-98978 will now incorporate devices for data access or data transmission, supporting the effectiveness of RPM.
- The CPT code 98980 for RPM treatment management has been updated to reflect a shorter duration requirement: it now only requires 11-20 minutes of provider time, down from the previous 20 minutes or more.
- New RPM codes: Six new codes (99XX4-99XX5, 98XX4-98XX7) will cover RPM services for shorter durations (2 to 15 days).
- As the hospital-at-home movement grows, these updates will provide more opportunities for reimbursement for RPM services, especially for varying time durations.
2. Telemedicine:
- Effective January 1, 2025, 17 new telemedicine codes
will
be introduced,
including:
- Audio-video visits for new patients (98000-98003)
- Audio-video visits for established patients (98004-98007)
- The CPT 2025 update deletes previous
telephone-only codes
(99441-99443) and replaces them with:
- Audio-only telemedicine visits for new patients (98008-98011)
- Audio-only telemedicine visits for established patients (98012-98015)
- A new CPT code 98016 for virtual check-ins replaces the HCPCS code G2012, reflecting the growing demand for telemedicine services in post-pandemic healthcare.
3. Augmented/Artificial Intelligence (AI):
- CPT 2025 introduces 7 new Category III codes for
AI-driven
data analysis,
including:
- AI-powered analysis for medical chest imaging (0877T-0880T)
- AI-augmented electrocardiogram data analysis (0902T-0932T)
- AI-augmented image-guided prostate biopsies (0898T)
- These new codes reflect the increasing use of AI in medicine, enhancing diagnostic accuracy and the ability to process complex medical data.
BillingFreedom: Staying Updated For 2025 Code Set to Minimize Denials and Maximize Reimbursement
At BillingFreedom, we stay updated with the latest changes in the CPT 2025 code set to ensure our clients' billing processes remain accurate and compliant. By incorporating new codes for Remote Patient Monitoring (RPM), telemedicine, and AI-driven data analysis, we help providers adapt to evolving healthcare standards.
Staying ahead of these updates allows us to optimize billing, reduce errors, and minimize the chances of denials. With our expertise, we ensure that all services, including telemedicine visits and AI-assisted procedures, are properly coded, leading to faster claims processing and improved reimbursement outcomes for our clients.
For more details about our exceptional medical billing services, please don't hesitate to email us at info@billingfreedom.com or call us at +1 (855) 415-3472.
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