Heads up: this issue is from October 30, 2025. Because it covers time-sensitive coding and regulatory topics, some details may have changed since. See the latest issues for current guidance.
The CPT update involves 418 total changes, which include 288 new codes “designating the latest advances in medical, surgical and diagnostic services available to patients,” 84 deletions and 46 revisions, an AMA press release said. For once, there are no E/M changes, except for Remote Physiological Monitoring. There are also no drug administration changes.
The changes, effective January 1, 2026, include six new codes created to report remote monitoring services over 2-to-15-day periods (instead of ≥ 16 days) within a 30-day period and two new codes that report remote monitoring of treatment management after 10 minutes of service per calendar month, down from the previous 20-minute threshold. The new codes include the following:
- 99445: Remote Physiological Monitoring, device supply with daily recording(s) or programmed alerts transmission, 2-15 days in a 30-day period.
- 99470: Remote Physiological Monitoring, treatment management services, clinical staff/physician/other qualified health professional time in a calendar month, requiring 1 real-time communication with the patient during the calendar month, first 10 minutes.
- 98984: Remote Therapeutic Monitoring, device supply for data access to support monitoring of the respiratory system, 2-15 days in a 30-day period.
- 98985: Remote Therapeutic Monitoring, device supply for data access to support monitoring of the musculoskeletal system, 2-15 days in a 30-day period.
- 98986: Remote Therapeutic Monitoring, device supply for data access to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period.
- 98979: Remote therapeutic monitoring, treatment management services, physician or other qualified health professional time in a calendar month, requiring 1 real-time communication with the patient during the calendar month, first 10 minutes.
The organization noted that these codes are in response to new technologies that allow health care providers to collect and monitor patients’ health data and use that data to manage patients’ conditions outside a clinical setting. These are services you can offer if telehealth goes away forever (which we hope does not happen).
Meanwhile, several new codes will affect augmentative and AI services that assist physicians by detecting clinically relevant data that might otherwise go undetected, or supplementing physician work by analyzing and quantifying data to produce insights that enhance clinical judgment.
These high-tech codes include:
- coronary atherosclerotic plaque assessment derived from augmentative software analysis to evaluate the severity of coronary disease;
- multispectral imaging for burn wounds through an assistive algorithmic classification of burn healing;
- detection of cardiac dysfunction via assistive algorithmic analysis of acoustic and electrocardiogram recording; and
- perivascular fat analysis for cardiac risk through two codes for noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with or without concurrent CT scan of the heart.
- AMA’s update also includes 12 new patient-centered codes for hearing aid services, including assessment of visual, dexterity, and psychosocial factors, validation of device performance and sound quality, and training and support for patients using personal devices that are connected to their hearing devices.
Other changes you might want to review include:
- Radiation Therapy Revisions: 77014 and 77401 have been deleted. 77402, 77407, and 77412 have been revised. 77385-77386 for IMRT have been deleted as the revisions include IMRT.
- Ice Caps: 97007-97009 are new codes for scalp cooling. Codes are for initiation, placement, and an add-on for after chemo. These are used once per chemo treatment period, or per chemo session. We shall see if and how Medicare will pay for these.
- Hearing Device Services: Twelve new codes have been introduced to replace older codes (92590-92595) and to better reflect the complexity of modern hearing device services, including candidacy evaluation, fitting, verification, and follow-up.
- Lower Extremity Revascularization: The section for this procedure has been comprehensively updated with 46 new codes to replace existing ones, modernizing the coding to reflect technological advancements.
- Bone lengthening codes: Yes, with modern science, you can lengthen your bones and play in the NBA. Here are the codes:
- 27458: Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device
- 27713: Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment
- Behavioral Health: Updates were made to existing codes for behavioral health services, adding them to CPT appendices P and T to recognize services delivered via audio-video or audio-only technology as corresponding to in-person services.
- New codes for services like high-intensity-focused ultrasound (HIFU) for prostate tissue ablation, totally implantable active middle ear hearing implants, and partial craniectomies.
- New codes for specialized services selective enzymatic debridement.
- Three new codes for immunization counseling “when an immunization is not administered to the patient on the same date.” Unfortunately, CMS has proposed not to pay for them under Medicare. It is questionable whether other payers will pay for these as well.
This is a summary and overview — please check the sections relevant to you.
BREAKING: Senator Cassidy said this week that he wants CPT in the public domain!!! If Congress is ever in session again, I hope this becomes law!!!!
