When CPT 2025 debuted several new audiovisual E/M codes (98000-98007) on Jan. 1, 2025, coders across the U.S. were eager to have new options for reporting telemedicine services. After all, it’s been confusing to select the right telehealth CPT codes for the past several years.

Check out a few pointers that will help you choose the right telehealth CPT codes the next time your provider performs an E/M visit via telemedicine.

Don’t Submit 98000 Series to Medicare

The most important fact to know about the new telehealth CPT codes (98000-98007) is that Medicare doesn’t accept them. As part of the 2025 Medicare Physician Fee Schedule, CMS chose not to reimburse these codes.

Instead, if a patient is covered by Medicare payers, you’ll submit one of the CMS-covered telehealth codes. For instance, you can report an established patient E/M visit performed over telehealth with a code from the 99211-99215 series, depending on the documentation of the amount of time spent or the level of medical decision making (MDM).

Know the Time Thresholds

Much like the traditional E/M codes, the new telehealth CPT codes are selected based on either the time spent or the MDM level.

For example, if you perform an audio-video E/M visit for an established patient and spend 20 minutes, you’d report 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). In the non-facility setting, you’d collect about $67 for this service.

If you spend 20 minutes performing an E/M service for an established patient over telehealth and your payer doesn’t accept 98005 (for instance, such as Medicare), you’d instead report 99213 (Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded). For this service in a non-facility setting, you’d collect about $89.

Check With Payers

While you may be thinking you have the option of choosing between the E/M codes and the new telehealth CPT codes based on your own preferences, that’s not always the case. Many insurers have their own preferences on when to report each code set.

For instance, Blue Cross Blue Shield of North Dakota announced that they would accept the E/M telehealth codes in the 98000 series, as long as you report place of service 02 or 10 with them. Get your payers’ policies in writing to find out whether they have preferences similar to these.