Each year, the AMA updates the CPT® code set, and every year those changes ripple straight into your revenue cycle. For 2025, there have been 270 new codes, 112 deleted codes, and 38 revisions. The revisions are significant, including new codes for telehealth, expanded remote monitoring, surgical coding refinements, and adjustments to the Medicare Physician Fee Schedule (PFS). If your billing and coding processes aren’t updated, you risk denials, lost revenue, or compliance headaches.

In this article, we’ll break down the major CPT 2025 updates, explain how they affect reimbursement, and walk through examples so you can see the changes in action.

 What’s Different in 2025

CPT 2025 touches almost every specialty. Some highlights:

Telehealth Expansion: New, modality-specific codes for audio/video and audio-only visits.

E/M Services: Clarifications around prolonged services and split/shared visits.

Specialty Revisions: Significant changes in surgery, oncology, pathology, and behavioral health.

Remote Therapeutic Monitoring (RTM): Expanded code sets for ongoing patient engagement.

Medicare PFS Adjustments: Lower conversion factor and revised practice expense calculations, which reduce baseline reimbursement rates.

1. Telehealth

 For the first time, CPT has created distinct codes for telehealth visits based on the modality used. Codes 98000–98007 describe audio/video visits, while 98008–98015 are for audio-only. There’s also 98016, replacing the “virtual check-in” HCPCS code G2012.

Until now, telehealth coding has been a patchwork of modifiers and place-of-service (POS) adjustments. The new structure offers more clarity, but reimbursement will vary. Medicare, for example, isn’t adopting all of these new codes in 2025, so you’ll need a payer-specific matrix.

For example, imagine a physician spends 30 minutes on an audio-only visit with a new patient. In the past, you might have billed 99203 with modifiers, hoping it would be accepted. Now, you can bill 98009 (new patient, audio-only, low complexity, 30 minutes). If the payer accepts it, reimbursement is more reliable, and documentation is easier to defend.

 2. The Medicare Conversion Factor Drop

CMS lowered the conversion factor from $33.2875 in 2024 to $32.3465 in 2025, representing a decrease of approximately 2.8%.

Even if your coding stays the same, each service reimburses less. Combined with updated practice expense RVUs, this squeeze can cut into margins, especially for high-overhead procedures.

If we take a wound care clinic that performs frequent surgical debridements, it may find margins tighter in 2025 because practice expense adjustments no longer cover as much of the supply cost. Unless the clinic offsets the loss with efficiency or better denial management, revenue will shrink.

 3. Remote Therapeutic Monitoring (RTM)

 RTM offers a way to generate recurring revenue between visits, particularly for specialties managing chronic conditions. Codes like 98977 and 98978 now cover monitoring for musculoskeletal conditions and behavioral health interventions. These allow billing for device use, patient adherence, and therapy response. But you need technology and documentation systems in place to qualify.

Let's take, for example, A behavioral health practice that uses a digital app to track patient anxiety symptoms. Each month, they submit 98978 for remote monitoring. With proper documentation, the practice adds steady income while improving patient engagement.

 4. Surgical Coding Refinements

General surgery saw sweeping changes. Codes 49203–49205 were deleted and replaced by 49186–49190, which more precisely describe intra-abdominal excision or destruction of tumors and cysts. Oncology also gained new Category I codes, including those for CAR-T cell therapy, which moves procedures out of the “experimental” category.

A surgical oncologist removing an abdominal tumour must now document the in situ size of the mass (not the excised specimen). Without that detail, the claim could default to a lower-valued code, resulting in a cost of hundreds per procedure to the practice.

 5. Behavioral Health Billing

CPT 2025 expands behavioral health coding, particularly in areas related to telehealth and collaborative care models. The permanent acceptance of telehealth for many behavioral services (at least through Medicare’s transitional policies) provides clarity. Behavioral health practices that expanded via telehealth during the pandemic can now sustain those services with clearer coding and reimbursement paths.

This is how the change looks in a real-world scenario. A psychiatric nurse practitioner conducts a 45-minute audio/video session. Instead of coding an office-based E/M with a modifier, they can now select the telehealth-specific code that matches the time and complexity, reducing the risk of denial.

 6. Add-On Codes & Prolonged Services

Prolonged service add-on codes (like +99417) have updated descriptors, and guidelines are clearer on what counts toward “prolonged.” Split/shared visit rules are also more precise. Accurately capturing prolonged services means more revenue for longer, complex encounters.

A new patient visit takes 75 minutes with high-complexity MDM. With updated guidance, you can confidently bill the base E/M plus the prolonged add-on, provided your notes reflect the total time spent. That could mean hundreds of dollars more per encounter.

 Other Specialties Impacted by CPT 2025 Updates

 Oncology & Hematology

CAR T-Cell Therapy: Four new Category I codes (38225–38228) now cover harvesting, preparation, receipt, and administration of CAR T procedures. This change gives oncologists more stable reimbursement and reduces the risk of denials tied to Category III “experimental” coding.

Prostate Ablation (TULSA): New codes (55881, 55882) describe transurethral ultrasound ablation, providing precise reporting for this newer prostate therapy.

General & Vascular Surgery

Intra-Abdominal Tumor/Cyst Excision: Old codes 49203–49205 were deleted, replaced with 49186–49190, which require in-situ tumour size documentation.

Peripheral Vascular Revisions: Forty-six new codes describe interventions across iliac, femoral, tibial, and inframalleolar territories, replacing broad revascularization codes like 37220–37235.

Thoracic Aorta Repairs: Endograft service codes updated, with revisions to 33880, 33881, 33883, and 33886.

Laboratory, Pathology & Digital Healt

Genetic & Molecular Tests: A large portion of new CPT codes are Proprietary Laboratory Analyses (PLAs) tied to genetic and precision medicine testing.

Remote Therapeutic Monitoring (RTM): Updates to 98975–98978 better define device supply, digital therapy interventions, and ongoing patient monitoring.

Conclusion

The 2025 CPT® updates represent more than just new code numbers they reshape how practices document, bill, and ultimately get paid. From telehealth and behavioral health to oncology, surgery, and emerging digital health tools, every specialty has something at stake.

If you stay proactive, align your billing with the latest codes, and develop payer-specific strategies, CPT 2025 can enhance both your compliance and cash flow.