• You're one step from joining Medical Billing & Coding Forum – Insurance Claims & CPT Codes.
    Create a free account to post, follow threads, and never miss an update.  Sign up free →

Updated telehealth codes

ROCKY5

New member
Joined
Jul 20, 2025
Messages
3
Good day! I recently attended an AAPC meeting and learned about the new Telehealth CPT E/M codes for audio/video. But thenn when I checked, it said CMS doesnt recognize codes 98000-98016. Can someone clarify this for me? Im located in California.
 
Yeah that part confused me too. CMS tends to be behind on newer codes, especially if they haven't gone through full approval yet.
 
Yeah that part confused me too. CMS tends to be behind on newer codes, especially if they haven't gone through full approval yet.
I was wondering if thats why the code still doesn't show up in the latest CMS lookup. Do you know if there's a typical timeline for when CMS adopts newer telehealth codes , or does it just vary case by case?
 
This is a very common question right now. The new CPT codes (98000-98016) were created by the AMA for 2025. However, CMS decided not to adopt most of them for Medicare in their final rule, assigning them an "I" status indicator for invalid.

For Medicare patients, you must continue to use the standard E/M codes (99202-99215) with the appropriate modifier (95 for audio-video or 93 for audio-only), but they did adopt 98016 for virtual check-ins.

CMS makes these decisions on an annual basis through their rulemaking process, so there's no set timeline for when they might adopt other new codes.. Always check the specific payer's policy, as many private insurers are recognizing the new codes.
 
Back
Top