Telehealth Cpt Codes For 2025: Updated List With Modifiers

By Author: 247 medical billing
Total Articles: 2
Comment this article

Telehealth has significantly transformed healthcare delivery by allowing patients to consult doctors from home through video calls, phone conversations, and online messaging. With its growing use, correct billing practices have become essential.
To support these advancements, the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) have updated telehealth CPT codes and modifiers for 2025. These updates help accurately represent the care provided, whether via full video consultation, a phone call, or a digital message.
New CPT Codes have replaced many of the temporary ones introduced during the pandemic. However, payers have varying policies - while Medicare continues using traditional Evaluation & Management (E/M) codes, many Medicaid programs and private insurers have started adopting the new 98000-series telehealth codes.
This guide walks you through the 2025 telehealth codes and modifiers to help prevent billing errors and enhance patient care delivery.
2025 Telehealth CPT Codes & Modifiers Overview
A fresh set of telehealth-specific codes ...
... and modifiers have been introduced for 2025, structured under the E/M framework but tailored for virtual care delivery.
1. Audio-Video Consultations (Two-Way Live Interaction)
These codes apply when a provider and patient interact via real-time audio and video. They can be billed for both new and established patients, following time or Medical Decision Making (MDM) guidelines like in-person visits.
For New Patients:
98000: Mirrors 99202 (Straightforward MDM or 15 mins)
98001: Mirrors 99203 (Low MDM or 30 mins)
98002: Mirrors 99204 (Moderate MDM or 45 mins)
98003: Mirrors 99205 (High MDM or 60 mins)

For Established Patients:
98004 to 98007: Equivalent to 99212 to 99215

Note: Modifier 95 is not needed as these codes inherently indicate telehealth.
2. Audio-Only (Phone-Based Consultations)
These codes are specific to phone-only services, designed for patients unable or unwilling to use video platforms. A minimum of 10 minutes of clinical discussion is required.
For New Patients:
98008 to 98011: Equivalent to 99202 to 99205

For Established Patients:
98012 to 98015: Equivalent to 99212 to 99215

Important: Medicare requires Modifier 93 for audio-only services. Documentation should clarify that video was an option but not used.
3. Brief Communication Technology-Based Service
CPT 98016 replaces the earlier Medicare code G2012. It covers short check-ins via audio or video (5–10 mins) with established patients.
Conditions:
Cannot be billed if related to an E/M visit from the prior 7 days.
Not billable if it results in an E/M service within the next 24 hours.

4. Medicare Guidelines
Medicare continues with its established policies:
Use 99202–99215 for telehealth.
POS 10: Telehealth from patient's home (non-facility rate).
POS 02: Telehealth elsewhere (facility rate).
Modifier 93: Required for audio-only.
GT modifier: May apply in legacy systems.

Medicare has not yet adopted the 98000-series codes.
5. Medicaid & Commercial Insurer Policies
Medicaid and private insurers vary in their acceptance of the 98000-series. While some have embraced them, others still require traditional in-person E/M codes. Providers must verify payer-specific policies, especially regarding audio-only versus video-enabled telehealth services.
6. Digital Health Services
6.1 E-Visits (Patient-Initiated Online Services)
For secure portal or email communication over 7 days:
99421: 5–10 mins
99422: 11–20 mins
99423: 21+ mins

Not billable if linked to another E/M service within 7 days or results in an immediate visit.
6.2 Virtual Check-Ins
Quick consultations to determine if further care is needed:
98016: Brief 5–10 min check-in
G2252: Extended 11–20 min communication
G2010: Review of patient-submitted images/videos (response within 24 hours)

7. Telehealth Modifiers
Modifier 95: Denotes real-time audio-video services (mostly for commercial payers).
Modifier 93: Identifies audio-only services; necessary for Medicare.
Modifier GT: Legacy use; still requested by some payers.
Modifier FQ: Applied by Federally Qualified Health Centers and Rural Health Clinics for audio-only visits.

Provider Action Plan for 2025
Providers should:
Continue using 99202–99215 for Medicare patients, with Modifier 93 for phone-only visits.
Adopt 98000–98015 codes for Medicaid/private payers supporting them.
Use 98016 and G2252 for brief interactions and virtual check-ins.
Keep billing staff well-informed of changing payer-specific telehealth rules.

Given the complexity and frequent updates in telehealth coding and reimbursement policies, it is often beneficial to outsource telehealth billing and coding to specialized professionals. By doing so, healthcare providers can minimize claim denials, ensure compliance with the latest coding standards, and maximize revenue. Partnering with expert services like 24/7 Medical Billing Services allows your practice to focus more on patient care while leaving the complexities of telehealth billing in expert hands.
FAQs
Q1: Can telehealth be billed across state lines?
 A: Subject to licensing laws and payer policies.
Q2: Are Remote Patient Monitoring services part of this update?
 A: No, they have separate CPT codes.
Q3: Is patient consent necessary for telehealth?
 A: Yes, and it must be documented.
Q4: Is real-time documentation during telehealth required?
 A: Yes, for compliance and accuracy.
Q5: Can both telehealth and in-person visits be billed on the same day?
 A: Generally, no; both cannot be billed for the same issue on the same day.
Read detailed: https://www.247medicalbillingservices.com/blog/telehealth-cpt-codes-for-2025-updated-list-with-modifiers
For More Information:
Call us at 888–502–0537 or info@247medicalbillingservices.com
Visit at https://www.247medicalbillingservices...
Our Office Locations:
Ohio: 28405 Osborn Road, Cleveland, OH, 44140
Texas: 2028 E Ben White Blvd, #240–1030 Austin TX, 78741
Subscribe @247medicalbillingservices
Follow us on social media channels-
Facebook: https://www.facebook.com/247MBS
Twitter: https://x.com/247MBServices
Instagram: https://www.instagram.com/247mbs/
LinkedIn: https://www.linkedin.com/company/24-7-medical-billing-services/