Key Updates in New CPT Code Set for 2025

The healthcare industry faces another set of CPT code updates—270 new codes, 38 revisions, and 112 deletions. You might wonder, "Are we still catching up with 2024, or are we ready for the 2025 updates?". Understanding these CPT code changes is crucial for maintaining a streamlined, efficient billing system. 

This post will guide you through the most critical updates to help you stay compliant and avoid costly mistakes in your medical coding process.

Why the 2025 CPT Code Changes Matter

Every year, the American Medical Association (AMA) releases updates to the Current Procedural Terminology (CPT®) code set. These changes reflect the rapid advancements in medical technology, treatments, and healthcare delivery. For healthcare providers like you, staying on top of these updates is essential to ensure accurate documentation, proper billing, and timely reimbursement.

The 2025 CPT code updates are particularly significant because they provide better ways to document and bill for newer procedures, including telemedicine, advanced wound care treatments, and cutting-edge cancer therapies. 

For medical billing companies, ACOs, IPAs, and other healthcare organizations, these updates offer the opportunity to refine coding practices and optimize revenue cycles, making accurate billing more streamlined and less prone to denials.

Key Changes in the 2025 CPT Code Set

The 2025 updates show advancements in various specialties such as telemedicine, oncology, and surgery. Two hundred seventy new codes, 38 revisions, and 112 deletions affect various healthcare procedures and services. According to the American Medical Association (AMA), “The latest updates to the CPT code set reflect advancements in contemporary clinical practice and ensure the code set fulfills its vital role as the trusted universal language of medicine.”

Major CPT Code Updates by Section

1. Evaluation & Management (E&M) Updates: Telemedicine continues to play an essential role in modern healthcare delivery. In the 2025 CPT updates, 17 new telemedicine codes have been introduced within the Evaluation and Management (E/M) services section to better capture the nuances of virtual care. Key updates include:

• 98000–98007: These codes apply to audio-video services provided in real-time.
• 98008–98015: These codes cover audio-only services, replacing the previously used telephone call codes 99441–99443.
• 98016: This code is for brief telemedicine consultations with established patients, such as virtual check-ins.

Along with the introduction of these new codes, it's important to note that traditional in-person E/M service codes 99202–99205 and 99212–99215 are no longer reported for telehealth encounters. Furthermore, Medicare will only reimburse for 98016, while the remaining 16 codes do not currently receive separate reimbursement.

These changes not only expand the range of telehealth services but also reflect the ongoing evolution of telemedicine in response to patient access disparities, helping integrate telehealth into more aspects of patient care.

2. Surgery Section Updates: The surgery section saw a major revision, with 33 new codes added, including ones for Skin Cell Suspension Autograft (SCSA), a significant advancement in wound care and burn treatment. This procedure uses the patient’s own cells to enhance healing, marking a new era in managing complex skin defects.
   
   
3. Musculoskeletal System: A major update here is the new consolidated code (25448) for carpometacarpal (CMC) joint arthroplasty suspension, a surgery used to treat thumb arthritis. This simplification eliminates confusion caused by redundant codes, making documentation and billing more straightforward.
   
   
4. Hemic and Lymphatic System: The introduction of four new codes (38225-38228) for Chimeric Antigen Receptor T-cell (CAR-T) therapy is a significant advancement for cancer treatment. CAR-T therapy is an innovative treatment that uses the patient’s own T cells to fight certain types of cancer, like leukemia and lymphoma.
   
   
5. Digestive and Urinary System: Several updates to the digestive and urinary system include new codes for tumor resection (49186-49190), reflecting more modern surgical techniques, and new codes for the minimally invasive TULSA procedure for treating prostate cancer.
   
   

Emerging/Temporary Procedure Codes: What’s New in Category III

Category III CPT codes are designed to track new, experimental, and emerging medical technologies, services, and procedures that are not yet universally adopted but show significant potential in clinical practice. The 2025 updates to these codes include a substantial expansion of 81 new codes, which reflect cutting-edge advancements across various healthcare fields. 

Key Updates

1. Cardiac Contractility Modulation-Defibrillation (CCM-D) Systems
   New Category III codes (0915T–0918T), effective January 1, 2025, have been introduced for the insertion, programming, and use of CCM-defibrillation systems in patients with chronic heart failure (NYHA Class III/IV) who are ineligible for cardiac resynchronization therapy. These codes are essential for documenting and billing the emerging technology of CCM-D systems.
   
   Note: While CCM-D is categorized as an emerging technology, the use of CCM therapy is still considered investigational and not medically necessary according to specific insurer policies. This is important as many insurers do not cover this procedure for heart failure treatment.
   
   
2. Subcutaneous Ascites Pumps
   Category III codes 0870T–0875T have been created for the implantation, replacement, programming, and removal of peritoneal ascites pump systems. These devices are used to manage refractory ascites in patients with liver cirrhosis, offering an innovative approach to a challenging condition in patients with advanced liver disease.
   
   
3. Category III Code Volume
   The 2025 updates include 81 new Category III codes, marking a significant expansion in tracking emerging healthcare technologies and procedures.

AI Taxonomy and New AI-Related Codes

A significant part of the 2025 CPT code updates is the implementation of an AI taxonomy that categorizes AI-driven technologies into three main types:

• Assistive AI: Technologies that detect clinically relevant data but do not analyze it or generate conclusions. These technologies require physician or qualified healthcare professional (QHP) interpretation and reporting.
  
  
• Augmentative AI: Technologies that analyze and/or quantify data to yield clinically meaningful output, but still require physician or QHP interpretation and reporting.
  
  
• Autonomous AI: Technologies that automatically interpret data and independently generate clinically meaningful conclusions, with minimal or no physician or QHP involvement. This category includes three levels of autonomy based on the degree of independent action taken by the AI system.

The 2025 CPT code set introduces seven new Category III codes for AI-driven technologies, which aim to enhance the specificity of coding and better support the integration of AI in clinical practice. These new codes cover:

• Electrocardiogram (ECG) Measurements:
  
  • 0902T, 0932T: AI augmentative data analysis for ECG.
• Medical Chest Imaging:
  
  • 0877T–0880T: AI augmentative analysis for diagnostic support in chest CT imaging.
• Image-Guided Prostate Biopsy:
  
  • 0898T: AI-driven augmentative analysis for prostate cancer estimation maps.

Please note: 

• 0877T pertains to AI augmentative analysis of chest CT imaging and should not be confused with autonomous AI or real-time diagnostics.
• 0898T is specifically for AI-driven analysis for prostate biopsy and is unrelated to coding automation.

These AI-related codes reflect the growing role of AI in healthcare, particularly in augmenting the diagnostic and imaging workflows. They help clarify the role of AI in clinical decision-making and provide a framework for the appropriate recognition and reimbursement of AI-assisted services.

Key Takeaways from the 2025 CPT Code Updates

1. Impact on Providers and Coders: Staying updated with the new CPT codes is essential for healthcare providers to avoid coding errors and ensure proper reimbursement. Coders must familiarize themselves with these updates to maintain accuracy and efficiency.
   
   
2. Documentation Accuracy and Compliance: Accurate documentation is more critical than ever with the introduction of these new codes. Providers must ensure that their records fully support the use of these codes, as incomplete or incorrect documentation can lead to claim denials.
   
   
3. Technology and Integration: Advanced coding systems and software, such as RapidClaims, can streamline the adoption of these new codes. By automating coding workflows and ensuring compliance with up-to-date guidelines, RapidClaims helps reduce errors and improve the speed of claim processing.

How to Stay Prepared for the 2025 CPT Code Changes

1. Ongoing Training and Education: Coders and healthcare providers should invest in regular training to stay current with the latest CPT updates. Ensure that your team has access to the resources they need to understand the intricacies of the new codes and how to apply them.
   
   
2. Investing in Technology Solutions: Leveraging technology solutions like RapidClaims can significantly reduce the burden of manual coding and help ensure that the new codes are implemented correctly. Integrating AI-driven coding solutions can reduce errors, accelerate claim submission, and improve overall revenue cycle efficiency.
   
   
3. Strengthening Internal Processes: Ensure that your internal processes are aligned with the new code set. Updating your coding practices and documentation procedures is essential for a seamless transition. Implementing new workflows and systems can help your organization adapt quickly and accurately.

Conclusion

The 2025 CPT code updates introduce significant changes that reflect the ongoing evolution of medical practices, from new telemedicine codes to advanced surgical procedures and cancer treatments. These updates present healthcare providers with an opportunity to refine their coding practices, improve accuracy, and ensure compliance.

To navigate these changes successfully, it’s crucial to stay informed and proactive. Regular training for coding teams, accurate documentation, and the integration of advanced coding solutions are key strategies for adapting to these updates. 

By embracing these changes, healthcare providers can enhance their billing processes, ensure timely reimbursement, and streamline their revenue cycle for greater efficiency.

Why Choose RapidClaims for 2025 CPT Code Integration?

With the 2025 CPT code updates now in effect, integrating an AI-driven solution like RapidClaims can ensure your medical coding remains accurate, efficient, and compliant. Here's how RapidClaims can help you stay ahead of the curve:

• AI-Powered Automation: RapidClaims leverages artificial intelligence to automate the coding process, reducing the risk of human error and ensuring the accurate application of the 2025 CPT codes.
• Real-Time Compliance: Our platform is constantly updated with the latest coding standards, so you never have to worry about missing regulatory changes like the 2025 CPT code updates. RapidClaims ensures your coding practices stay in line with industry guidelines.
• Seamless Integration: RapidClaims integrates seamlessly with your existing Electronic Health Records (EHR) systems and billing platforms, enabling quick adoption of the new codes without disrupting your workflow.
• Speed & Accuracy: Our system processes over 100 charts per minute, ensuring faster reimbursement cycles and fewer claim denials due to coding errors.
• Actionable Insights: With built-in real-time insights, RapidClaims detects potential coding errors or missing documentation before claim submission, enhancing your claim acceptance rates and reducing the time to payment.
• Tailored Rule Sets: Whether you're in radiology, surgery, or primary care, RapidClaims customizes its coding logic to fit the unique requirements of your specialty, making sure you get the most out of the new 2025 CPT codes.

Ready to simplify your coding process and boost your revenue cycle efficiency? Contact us today for a demo of RapidClaims and see how our AI-driven platform can seamlessly integrate the 2025 CPT updates into your practice.

Frequently Asked Questions (FAQ)

1. What are the 2025 CPT code updates, and why are they important?

The 2025 CPT code updates involve the addition of 270 new codes, 38 revisions, and 112 deletions. These changes aim to keep up with advancements in medical technology, treatments, and healthcare delivery models. For healthcare providers, staying current with these updates ensures accurate billing, compliance with industry standards, and proper reimbursement for services rendered.

2. How do the new telemedicine codes in the 2025 CPT set affect billing for virtual visits?

The 2025 updates introduce 17 new telemedicine codes, which allow healthcare providers to report services delivered through real-time audio-video and audio-only encounters. These new codes differentiate between patient types (new vs. established) and allow for more precise billing based on medical decision-making or time spent during the consultation.

3. What impact do the updates to the surgery section of the 2025 CPT codes have?

The surgery section has undergone significant changes with the addition of 33 new codes, particularly for advanced treatments such as autologous skin cell suspension (ASCS) for wound care. These new codes ensure that providers can accurately report and receive reimbursement for cutting-edge surgical procedures, especially those related to skin grafts and burn treatments.

4. How do the 2025 CPT code updates affect cancer treatment billing?

The 2025 CPT updates introduce new codes (38225-38228) for Chimeric Antigen Receptor T-cell (CAR-T) therapy, a groundbreaking treatment for blood cancers like leukemia and lymphoma. These new codes enable healthcare providers to more accurately bill for cellular and gene therapies, ensuring they are properly reimbursed for these advanced treatments.

5. What is the significance of the changes to musculoskeletal system codes, such as the one for thumb arthritis surgery?

In the musculoskeletal section, the 2025 CPT updates include a new consolidated code (25448) for carpometacarpal (CMC) joint arthroplasty suspension, a procedure used to treat thumb arthritis. This simplification removes redundant codes, improving the clarity of documentation and billing processes for this common hand surgery.

6. How should providers prepare for these CPT code changes?

Healthcare providers should invest in ongoing training and education so that their coding teams stay updated on the new codes and revisions. Ensuring that patient documentation is accurate and aligns with the new CPT codes is also essential. Providers may also consider integrating advanced coding software to automate the adoption of the updated codes and reduce the risk of errors.