Question: I hear there are new codes for telemedicine and phone calls, but I cannot find them. Do you have any information you can share?
You are indeed correct: there are 17 new codes for telemedicine. There are separate codes for live audio-video communication between patient and provider, and a revised and new set for phone calls. These updated codes were introduced in the 2025 CPT update.
Although the pandemic promulgated use of telemedicine, it remains viable and though not common, it is not unreasonable in a chiropractic setting when appropriate. Note these codes represent an evaluation and management (E&M) visit and closely mirror standard E&M coding.
New Patient (Audio-Video)
The first new section describes audio-video telemedicine visits for new patients:
98000 – Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision-making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.
98001 – Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision-making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
98002 – Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision-making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.
98003 – Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision-making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.
Established Patient (Audio-Video)
The second new telemedicine section describes audio-video services for established patients:
98004 – Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision-making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.
98005 – Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision-making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.
98006 – Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision-making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
98007 – Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision-making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.
New Patient (Audio Only)
Phone calls will no longer use the code set 9441-99443 and have been replaced with new audio-only telemedicine visit codes:
98008 – Synchronous audio-only visit for evaluation and management of a new patient, including medically appropriate history and straightforward medical decision-making, with more than 10 minutes of medical discussion. If using time, at least 15 minutes of total time on the encounter date must be met or exceeded.
98009 – Synchronous audio-only visit for evaluation and management of a new patient, including medically appropriate history and low medical decision-making, with more than 10 minutes of medical discussion. If using time, at least 30 minutes of total time on the encounter date must be met or exceeded.
98010 – Synchronous audio-only visit for evaluation and management of a new patient, including medically appropriate history and moderate medical decision-making, with more than 10 minutes of medical discussion. If using time, at least 45 minutes of total time on the encounter date must be met or exceeded.
98011 – Synchronous audio-only visit for evaluation and management of a new patient, including medically appropriate history and high medical decision-making, with more than 10 minutes of medical discussion. If using time, at least 60 minutes of total time on the encounter date must be met or exceeded.
Established Patient (Audio Only)
98012 – Synchronous audio-only visit for evaluation and management of an established patient, including medically appropriate history and straightforward medical decision-making, with more than 10 minutes of medical discussion. If using time, at least 10 minutes of total time on the encounter date must be met.
98013 – Synchronous audio-only visit for evaluation and management of an established patient, including medically appropriate history and low medical decision-making, with more than 10 minutes of medical discussion. If using time, at least 20 minutes of total time on the encounter date must be met.
98014 – Synchronous audio-only visit for evaluation and management of an established patient, including medically appropriate history and moderate medical decision-making, with more than 10 minutes of medical discussion. If using time, at least 30 minutes of total time on the encounter date must be met or exceeded.
98015 – Synchronous audio-only visit for evaluation and management of an established patient, including medically appropriate history and high medical decision-making, with more than 10 minutes of medical discussion. If using time, at least 40 minutes of total time on the encounter date must be met or exceeded.
Virtual Check-In
98016 – Brief communication technology-based service (e.g., virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the previous seven days or leading to an evaluation and management service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.
Other Codes/ Discussion
As with any new coding, verify with the patient’s insurance plan that the specific services are covered. Due to equality provisions under federal law mandating coverage, there could be contract provisions that may not allow coverage.
For billing purposes, place of service (POS) codes will continue to have two telehealth designations:
- 02 Patient not in their home when telehealth services are rendered.
- 10 Patient in their home when telehealth services are rendered. POS 10 will continue to be paid at the non-facility rate.
CMS will continue to allow providers to list their practice address, rather than their home address, when performing Medicare services via telehealth from their home. While not common, these services may be coded and payable when necessary.
Editor’s Note: Have a billing question? Submit it via email to Sam at sam@hjrossnetwork.com. Your question may be the subject of a future column. Note that submission of a question is acknowledgment that it may be referenced (anonymously) in his column.
