AMA (American Medical Association) released the much-anticipated 2025 CPT code set on September 10, 2024. As with previous updates, this year too marks another significant step in ensuring that medical coding stays relevant to the dynamic needs of modern healthcare.

The 2025 CPT code set brings 420 updates, including 270 new codes, 112 deletions, and 38 revisions. The spotlight is on innovation, with 37% of the new codes covering proprietary lab analyses, primarily for novel genetic testing. Furthermore, 30% of the new codes fall under Category III — tracking emerging technologies, services, and procedures.

Here’s a breakdown of the key changes in the CPT code set, rolling out on January 1, 2025.

2025 CPT Code Updates:

Each year, the AMA updates the CPT code set to enhance the accuracy and efficiency of reporting healthcare services. For healthcare professionals and medical coders, staying current ensures compliance and helps secure timely and optimal reimbursements for services rendered. Let’s review the most significant updates to the CPT codes for 2025.

1. Augmented Intelligence (AI)

AI, or Augmented/Artificial Intelligence, is increasingly vital in healthcare, enhancing diagnostic accuracy and service delivery. Seven new Category III CPT codes have been introduced to capture augmentative data analysis by AI applications and better classify AI-driven services.

These new codes include:

1. 0902T and 0932T — Electrocardiogram analysis
2. 0877T– 0880T — Chest imaging
3. 0898T — Image-guided prostate biopsy

2. Remote Therapeutic Monitoring

2025 will see a few revisions to the CPT codes for reporting Remote Therapeutic Monitoring (RTM) services.

Here’s a breakdown of what’s revised:

• 98975 — Now includes digital therapeutic interventions
• 98976–98978 — Now cover the device supply required for data access or transmission to support RTM
• 98980 — Now applies to provider services lasting fewer than 20 minutes

Furthermore, effective January 2026, six new CPT codes will be added to RTM services, including:

• 99XX4 – Remote physiologic monitoring device supply
• 99XX5 – Remote physiologic monitoring treatment management services
• 98XX4, 98XX5, 98XX6 – Respiratory, musculoskeletal, and cognitive behavioural therapy codes
• 98XX7 – Remote therapeutic monitoring treatment management services

3. General Surgery

The general surgery section will see several critical updates to align with advancements in surgical techniques and improve reporting accuracy. The updates aim to streamline the coding process and capture the full scope of services provided by healthcare professionals. 

                Deletions:

• 49203–49205 — Codes to report the size of the single largest intra-abdominal tumour or cyst addressed by the provider.

                 Additions:

• 49186–49190 — New codes to report the excision or destruction of the total size of intra-abdominal tumour’s/ cysts addressed by the provider.
• 15011–15018 — Newly introduced codes to reflect innovative approaches in skin grafts that promote wound healing.

4. PLA and Vaccines

The 2025 CPT code updates include significant changes to Proprietary Laboratory Analyses (PLA) codes used to capture unique clinical laboratory tests. These adjustments aim to keep pace with advancements in diagnostic capabilities. The changes include:

• 2 Revised Codes — 0095U, 0365U
• 5 Deleted Codes — 0346U, 0380U, 0428U, 0448U, 0456U
• 10 New Codes — 0521U–0530U

In addition to PLA updates, the latest CPT code set introduces new vaccine codes that reflect progress in preventing life-threatening diseases. These include:

• 90593 — Chikungunya virus vaccine, effective Jan 1, 2025
• 90684 — Pneumococcal conjugate vaccine, effective June 17, 2024
• 90624 — Meningococcal pentavalent vaccine, effective October 1, 2024
• 90695 — Influenza virus vaccine (H5N8), effective upon FDA emergency use authorization or approval

5. Telemedicine

Telemedicine, which proved to be a lifeline during the COVID-19 pandemic, is entering a new phase of updates. Starting January 1, 2025, the following changes will take effect:

                  Deletions:

• 99441–99443 — Codes for audio-only telephone services will no longer be part of the CPT code set.

                 New Additions:

• 98000–98015 — A new range of codes covering audio-video and audio-only telemedicine services. However, note that Medicare will not recognize these codes.
• 98016 — A virtual check-in code, set to replace HCPCS code G2012, offering a streamlined option for brief telemedicine interactions.

6. Genetic Counseling

In 2025, a significant update for genetic counselling services is the introduction of CPT code 96041, which replaces the previous code 96040. The new code allows genetic counsellors’ to bill based on the total time spent providing services, eliminating the "face-to-face" criteria for reimbursement. The revised code offers more flexibility, improved reimbursement, and aligns with advanced healthcare delivery.

Why Should You Attend?

• Stay Current with the Latest CPT Updates
  Gain a comprehensive understanding of the 2025 CPT code changes, including the 270 new codes, 112 deletions, and 38 revisions. These updates are critical for accurate medical billing, coding, and ensuring compliance with AMA guidelines.
• Enhance Coding Accuracy and Efficiency
  Learn how to apply new codes for cutting-edge technologies like Augmented Intelligence (AI) applications, remote therapeutic monitoring, and telemedicine. These insights will help streamline your workflow and improve reporting accuracy.
• Optimize Reimbursement Strategies
  Understand the new and revised codes for general surgery, PLA, vaccines, and genetic counseling to maximize reimbursement potential and reduce claim denials.
• Adapt to Innovations in Healthcare
  Discover how new CPT codes reflect advancements in genetic testing, innovative surgical techniques, and vaccine development, enabling you to stay ahead in a rapidly evolving healthcare landscape.
• Prepare for Telemedicine Evolution
  Gain insights into the new telemedicine codes for 2025, ensuring your practice adapts to the latest trends and remains compliant with emerging standards.
• Improve Patient Care and Outcomes
  Explore how accurate coding for services like genetic counseling and PLA tests contributes to personalized patient care and supports cutting-edge diagnostic and therapeutic solutions.
• Expert Guidance from Industry Professionals
  Benefit from in-depth analysis and real-world applications shared by experienced professionals in medical coding, billing, and healthcare compliance.
• Tailored for Key Stakeholders
  This webinar is designed for medical coders, healthcare administrators, billing professionals, and clinicians who want to ensure their practices or organizations remain compliant while enhancing operational efficiency.

Who Should Attend?

• Medical Coders
• Billing Specialists
• Healthcare Compliance Officers
• Practice Managers
• Revenue Cycle Managers
• Genetic Counsellor’s
• Healthcare Administrators
• Physicians and Specialists
• Clinical Documentation Specialists
• Medical Auditors
• Insurance Claims Specialists
• Hospital Revenue Cycle Directors