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:

0902T and 0932T — Electrocardiogram analysis

0877T– 0880T — Chest imaging

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 behavioral 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 tumor or cyst addressed by the provider.

Additions:

• 49186–49190 — New codes to report the excision or destruction of the total size of intra-abdominal tumors/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 counseling services is the introduction of CPT code 96041, which replaces the previous code 96040. The new code allows genetic counselors 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.

How to Effectively Adapt to the New CPT Changes?

Change often presents challenges, but strategic planning makes all the difference. A proactive approach can help you transition seamlessly. Here’s how to smoothly integrate the 2025 CPT updates into your practice and overcome potential obstacles.

• Leverage Resources — Utilize the comprehensive tools and resources offered by the AMA, such as the CPT 2025 Professional Edition codebook, the CPT 2025 Standard Data File, and informative online webinars.
• Update Your EHR — Work with your IT team to ensure your EHR systems and billing software are ready for the changes. Integrate new codes, remove outdated ones, and update templates and workflows to match the revisions. Don’t forget to run thorough system tests to catch any issues before the updates go live — smooth transitions start with proper preparation. Glenwood's efficient GlaceEMR updates make it simple for practices to stay ahead and compliant with the latest CPT changes.
• Verify with Payers — Payers may implement coding changes differently, so it's imperative to communicate with them and confirm whether they cover services using the new and revised codes. Additionally, verify if specific codes, such as those for new telemedicine services, are included in your payer contracts. Be sure to update your billing protocols to reflect any payer-specific requirements.
• Train Staff — Training familiarizes your staff with the updates, empowering them to implement the CPT changes successfully. Real-world examples will help them become adept at applying the new codes, thereby preventing errors and denials. Consequently, it's necessary to provide ongoing support to address any questions or challenges during the transition.

CPT updates streamline the reporting and evaluation of medical services and procedures, improving coding accuracy while helping healthcare providers keep pace with emerging technologies and treatments. By taking a proactive approach, you can seamlessly integrate these changes into your practice, prevent denials, and optimize reimbursements.