Current Procedural Terminology® 2025 Updates Alter the Medical Coding Landscape 

The New Year means new updates to the Current Procedural Terminology (CPT®) code set—substantial changes that reflect the rapid advancement of medical technology, procedures, and care delivery models and reshape the medical coding landscape. The CPT 2025 updates, which took effect on January 1, 2025, introduced 270 new codes, 112 deletions, and 38 revisions that offer healthcare providers the tools to document and bill for a broader range of services accurately.  

These latest updates from the American Medical Association (AMA), which seek to streamline reporting processes while ensuring coding accuracy for reimbursement, have broad implications for coding teams and their healthcare organizations. Physicians and other key clinical staff must also understand the changes and whether they require updates to clinical documentation to ensure coders can accurately code to the highest level of specificity. This, in turn, ensures that facilities, physicians, and organizations have appropriate data to support high-quality patient care and timely and proper reimbursement. 

Staying abreast of CPT 2025 code changes also ensures applicable systems and processes are updated, including encoder software, computer-assisted coding (CAC) and professional coding (CAPC) tools, physician queries, and superbills. Finally, proper education and planning on the CPT code updates will lead to quicker claim submission, reduce the likelihood of claim denials, and help prevent regulatory audits from outside agencies. 

The key changes in CTP 2025 are detailed in 2025 Current Procedural Terminology (CPT) Code Set Overview and summarized here. 

Evaluation & Management (E&M) 

One of the most significant changes in CPT 2025 is the introduction of 17 new telemedicine codes. These codes are categorized as real-time audio and video or audio-only encounters, aligning with existing E&M coding methodologies. 

Under CPT 2025, the telehealth service must be performed by a physician or qualified health care professional (QHP), and codes are selected based on whether the patient is new or established and whether medical decision-making (MDM) or time is used to select the level for the service. However, time spent establishing the connection or arranging the appointment cannot be counted even when performed by the physician or other QHP, nor can services of under five minutes be reported.  

Further, if the audio-video connection is lost during an encounter and only audio is restored, the format (audio-video or audio only) that accounted for most of the interactive portion of the service is reported—and only if 10 minutes or longer of medical discussion or patient observation took place. Audio-only codes (98008, 98009, 98010, 98011, 98012, 98013, 98014, and 98015) require more than 10 minutes of medical discussion. 

Other key changes in E&M coding include: 

• For 98000-98015, the level of service is selected based on MDM or total time on the date of the encounter.  
• Codes 98000, 98001, 98002, 98003, 98004, 98005, 98006, and 98007 may be reported for new or established patients and require synchronous audio and video telecommunication is required.  
• Code 98016 describes services for established patients with 5 to 10 minutes of medical discussion and is based only on the time of medical discussion, not MDM. 
• For audio-only codes 98008, 98009, 98010, 98011, 98012, 98013, 98014, and 98015, medical discussion is synchronous (real-time) interactive verbal communication. It does not include online digital communication (except when via a telecommunication technology device for the deaf).  
• Code 98016 is reported for established patients only, is patient-initiated, describes a service of shorter duration than audio-only services, is intended to evaluate whether a more extensive visit type is required, and does not require video technology.  

Surgery 

Surgery is another section that was significantly altered for 2025, with 33 new codes and 5 revised codes. One new category one CPT code (66683) has been added to Eye and Ocular Adnexa to capture implantation of an iris prosthesis, which addresses significant vision and light regulation issues caused by trauma or congenital conditions. 

Other key changes by system include: 

• Integumentary System: Eight new CPT codes (15011-15018) were generated to capture Autologous Skin Cell Suspension (ASCS), which marks a leap forward in wound care and burn treatment by using the patient’s own cells to enhance healing. This provides a cutting-edge approach to managing complex skin defects. New guidelines were also put in place to address how to apply the new codes. 
• Musculoskeletal System: A new consolidated code (25448) simplifies reporting for carpometacarpal (CMC) suspension arthroplasty, a common hand surgery that treats thumb arthritis by removing diseased joint tissue and suspending the first metacarpal bone. This change eliminates the confusion caused by redundant codes, improving documentation clarity.  
• Hemic and Lymphatic System: Four new codes (38225-38228) have been introduced for Chimeric Antigen Receptor T-cell (CAR-T) therapy, an innovative treatment for certain cancers that uses the patient’s own T cells. These codes provide greater granularity in documenting cellular and gene therapy procedures, which are becoming standard in cancer care.  
• Digestive System: Outdated tumor resection codes have been replaced with five new ones (49186-49190), reflecting modern surgical techniques used to treat intra-abdominal tumors. These updates improve coding specificity and align with current clinical practices. These codes include cytoreduction, debulking, or other methods of removal of tumor(s) or cysts(s) via open approach.  
• Urinary System: The updates introduce three new codes (51721, 55881, and 55882) for TULSA (transurethral ultrasound ablation), a minimally invasive MRI-guided procedure used to treat prostate cancer and enlargement that represents a shift toward less invasive, more precise treatment options in urology.  
• Nervous System: Anesthesiologists will have six new plane blocks they can report on, and the Centers for Medicare & Medicaid Services (CMS) is covering the codes. These codes enhance coding accuracy for procedures targeting fascial planes and are applicable across various specialties. 

Medicine  

The introduction of 18 new Medicine Section codes demonstrates the evolving nature of medicine and emerging technologies. 

For example, a new section was created for Medical Genetics and Genetic Counseling that contains one new code and instructional guidelines that reflect the increasing demand for personalized care based on genetic insights. Code 96041 is used to report the total duration of time spent by the genetic counselor to provide genetic counseling services.  

Two new codes (96380-96381) under Therapeutic, Prophylactic, and Diagnostic Injections and Infusion were created for the administration of a respiratory syncytial virus (RSV) antibody. The revised RSV antibody administration codes address the growing need for preventive measures against respiratory syncytial virus. 

Category III 

Some of the most significant updates in the 2025 CPT code set were made to Category III, with 81 new codes, two revisions, and 13 deletions. Category III codes are a set of temporary codes to capture emerging procedures, services, technology, and service paradigms. Among the most notable changes are: 

• Six new category III codes (0870T-0875T) enable reporting of subcutaneous insertion, revision, removal, programming, or replacement of a percutaneous peritoneal ascites pump.  
• One new category III code (0867T) for transperineal laser ablation for a prostate of larger volume (> 50 mL).  
• Seventeen new codes (0915T-0931T), a new subsection “Cardiac Contractility Modulation-Defibrillation (CCM-D),” and new guidelines to were created to report CCD-D services.   
• Four new codes (0827T to 0940T) were created to report continuous external ECG monitoring for greater than 15 days up to 30 days continuously. The new codes, which may only be reported once during a 30-day period, fill a gap in medical coding because existing codes could only be reported for external ECG device recordings that last up to 15 days or less. 

Practical Takeaways for RCM 

The CPT 2025 updates are not just about new codes; they represent an opportunity for healthcare providers to refine their practices, align with modern clinical standards, and improve patient care. There are several actionable steps healthcare organizations and coders can take to ensure compliance and optimize the impact of CPT 2025:  

• Stay Educated. With 270 new codes and numerous revisions, ongoing education is crucial for providers and coders. Regular training sessions and reviews of official CPT guidelines will ensure that staff remain compliant and up to date. 
• Invest in Technology. Advanced coding software and EHR systems can help automate the implementation of the new codes, reducing errors and improving efficiency. Providers should evaluate their current systems to ensure they support the latest updates. 
• Focus on Documentation. Accurate and detailed documentation is key to effectively leveraging the new codes. Providers must ensure that patient records include the necessary details to support using specific codes. 

The Path Forward 

CPT 2025 updates represent a significant step forward in aligning medical coding with modern clinical practices. Healthcare providers that embrace these changes and take a proactive approach to education, technology, and documentation can enhance efficiency, improve patient care, and ensure appropriate reimbursement for advanced treatments.  

By prioritizing these efforts, providers can navigate the complexities of the CPT 2025 updates and position their organizations for success in a rapidly evolving healthcare landscape.