As the healthcare industry continues to evolve, staying informed about 2025 CPT Code Updates is essential for providers, billing professionals, payers, and healthcare administrators. Each year, the American Medical Association (AMA) releases an updated CPT code set to reflect advances in medical knowledge, technology, and clinical practice. The 2025 CPT Code Updates are crucial to ensure accurate reporting, reimbursement, and statistical tracking of healthcare services.
The 2025 CPT code updates, effective January 1, 2025, bring substantial changes across several specialties, including evaluation and management (E/M), digital health, surgery, pathology, radiology, and emerging technologies. This newsletter breaks down the key changes, additions, deletions, and revisions you need to know—and how they may impact your practice.
Why CPT Code Changes Matter:
Before diving into specifics, it’s important to understand why CPT code updates are more than administrative tasks. They:
- Reflect clinical advances and new procedures or diagnostic tests.
- Ensure appropriate reimbursement from payers, including Medicare and private insurers.
- Improve documentation and compliance, reducing audit risk.
- Facilitate data collection and analytics in population health and healthcare quality initiatives.
Now, let’s look at the highlights of the 2025 CPT changes.
Overview of 2025 CPT Code Changes:
According to the AMA, the 2025 CPT update includes:
- 265 new codes
- 82 deleted codes
- 134 revised codes
These changes affect numerous specialties, with significant updates in:
- Evaluation & Management (E/M)
- Telehealth and Digital Medicine
- Surgical procedures
- Pathology & Laboratory
- Radiology
- Category III (emerging technologies)
Let’s explore each of these in more detail.
1. Evaluation & Management (E/M) Code Changes
Evaluation and Management codes are central to billing and documentation for office visits, hospital care, and more. In 2025, the CPT Editorial Panel has made clarifications and refinements to better align code descriptions with real-world practice.
Key Updates:
- Clarification on split/shared services: Updates to the guidelines around split/shared E/M visits (typically in hospital or facility settings) emphasize clearer definitions of substantive portion and documentation requirements.
- Refined prolonged service codes: Time thresholds for prolonged E/M services have been updated. Codes like +99417 and +99418 are adjusted to better match documentation standards in facility vs. non-facility settings.
- Home and residence services revisions: Definitions for codes 99341–99350 have been updated to better delineate services performed in assisted living facilities, private homes, and group homes.
These changes aim to reduce ambiguity and improve consistency across providers and payers.
2. Expansion of Telehealth and Digital Health Codes
One of the most transformative areas in the CPT 2025 update involves telemedicine and digital health services. Following the widespread adoption of remote care during and after the COVID-19 pandemic, the AMA has made significant strides to formalize and expand codes related to virtual services.
New Codes for Digital Health:
- Remote therapeutic monitoring (RTM) services continue to evolve. Several new codes have been introduced to reflect different use cases, including mental health, musculoskeletal therapy, and respiratory care.
- A new family of codes under Remote Treatment Management (e.g., cognitive behavioral therapy via app) has been introduced, giving providers the ability to report digital therapeutics more precisely.
- Expanded definitions of “interactive communication” now allow asynchronous modalities in certain cases, reflecting the diversity of digital care delivery platforms.
- Additional updates include clarified documentation guidelines for virtual check-ins and inter professional consultations.
These changes represent a major step toward legitimizing digital-first care delivery as part of mainstream healthcare.
3. Surgical Code Revisions and Additions
Surgical procedures, particularly in the orthopedic, cardiovascular, and gastroenterological realms, have seen notable updates. These changes reflect both new surgical techniques and refined categorizations of existing ones.
Key Surgical Updates:
- Minimally Invasive Spine Surgery (MISS): New codes for endoscopic lumbar decompression and spinal fusions using biportal techniques have been added.
- Transcatheter Valve Replacement: Updates in the cardiovascular section include new codes for transcatheter tricuspid valve repair/replacement, an increasingly common procedure in structural heart disease.
- Robotic-Assisted Procedures: A new modifier (Modifier 86) is introduced to denote robotic-assistance during certain laparoscopic or endoscopic procedures.
- Gastrointestinal procedures: Codes for advanced endoscopic submucosal dissection (ESD) have been added to differentiate it from standard mucosal resection techniques.
Practices using advanced surgical technology should review these updates to ensure billing accuracy and compliance.
4. Pathology and Laboratory Code Enhancements
Precision medicine and molecular diagnostics are rapidly growing areas in laboratory medicine. CPT 2025 reflects this with several new codes and updates to laboratory testing, especially in genomics and microbiology.
Highlights:
- New Tier 1 Molecular Pathology codes have been added for genetic markers involved in oncology and rare diseases.
- Additional codes for next-generation sequencing (NGS) panels reflect the growing use of comprehensive genomic profiling in cancer care.
- Codes related to COVID-19 testing have been deprecated or bundled, reflecting the shift toward more routine respiratory panels rather than standalone SARS-CoV-2 tests.
- Updates to pathology consultation services allow for better specificity in reporting intraoperative and frozen section pathology support.
These changes improve the granularity and accuracy of diagnostic reporting, critical for personalized medicine strategies.
5. Radiology and Imaging Modifications
Radiology saw a mix of new codes, revised descriptors, and clarified guidelines in 2025, especially in advanced imaging modalities.
Key Changes:
- Dual-energy CT (DECT) codes introduced to reflect increasing use of this technique in vascular imaging and kidney stone evaluation.
- Revised descriptors for MRI and PET scans to better reflect anatomical coverage and contrast usage.
- Additional guidance for reporting radiological supervision and interpretation to reduce confusion and duplication of billing efforts between technical and professional components.
These updates are crucial for radiologists, imaging centers, and multi-specialty groups relying on imaging for diagnosis and treatment planning.
6. Category III Codes: Tracking Emerging Technology
Category III CPT Codes are temporary codes used to track emerging technologies, procedures, and services. These codes are not yet assigned RVUs (Relative Value Units) but are crucial for documenting early adoption and collecting utilization data.
2025 Additions Include:
- Artificial Intelligence (AI)-assisted diagnostic tools: New codes allow providers to report use of AI in radiology, dermatology, and pathology—especially those using AI for triage or preliminary reads.
- VR/AR-assisted therapy codes: For example, immersive virtual reality therapy for pain management or PTSD.
- Advanced neuromodulation and neurostimulation procedures, particularly those targeting treatment-resistant depression and chronic pain.
- Wearable device monitoring: Codes for passive physiologic data collection using wearable sensors that integrate with clinical decision-making platforms.
These codes signal the ongoing shift toward technology-driven care models, and while they may not yet be reimbursable across all payers, documenting their use is key to long-term viability and policy inclusion.
7. Modifier and Guideline Changes
New Modifier 86 – Robotic Assistance
This newly introduced modifier is to be used in conjunction with existing laparoscopic and endoscopic procedure codes to indicate that the procedure was performed with robotic assistance. It allows payers and researchers to better track utilization of robotic technology.
Revised Guidelines and Parenthetical Notes
- Clarification around when to use add-on codes, particularly in complex E/M and surgical scenarios.
- Updated guidance for time-based coding across multiple specialties, especially for prolonged services.
- Expanded definitions and examples in the Appendix B (Summary of Additions, Revisions, and Deletions) and Appendix P (Telemedicine Services).
Preparing Your Practice for the 2025 CPT Changes
With over 400 total changes, the 2025 CPT update is substantial. Here are key steps you should take now to stay ahead:
Review and Train Early:
Ensure coding teams, billing staff, and clinical documentation specialists are trained well ahead of the January 1, 2025 implementation date.
Update Billing and EHR Systems:
Work with your EHR and practice management vendors to ensure code sets and templates are updated.
Conduct Internal Audits:
Focus on high-risk areas like E/M coding, digital health, and surgical documentation to identify areas for improvement.
Coordinate with Payers:
Clarify with private insurers and CMS how new codes will be handled in their policies, especially for Category III or emerging technology codes.
Leverage Coding Resources:
Use AMA’s CPT Assistant, coding webinars, and specialty society updates to stay informed. Joining local or national coding associations can provide additional support.