The experts at Radiation Business Solutions have put together a summary of the 2025 E&M Changes for your convenience. Radiation Business Solutions is committed to supporting practices through these changes.
Key Changes:
- CMS Telehealth Rules: CMS will not adopt the new AMA codes and will continue using existing in-person E&M codes with modifiers:
- Use the appropriate E&M code with a 95 modifier for audio/video visits.
- Use the appropriate E&M code with a 93 modifier for audio-only visits if the provider has video capability but the patient cannot or refuses to use it.
- Virtual Check-In Update: CPT code 98016 has replaced HCPCS code G2012 for 5-10 minute virtual check-ins. The G2252 code for 11-20 minute check-ins remains unchanged.
- Complexity Code Update: CMS now allows an extra payment for complex office or outpatient visits (G2211) when these occur on the same day as an annual wellness visit, vaccine administration, or other Medicare Part B preventive service.
- Telehealth Restrictions: Starting January 1, 2025, unless Congress intervenes, pre-COVID restrictions on Medicare telehealth services may be reinstated, affecting access based on geographic and location limitations, as well as restrictions on eligible practitioners.
- CPT 77427 Status: CPT 77427 (physician OTV) remains on the list of approved telehealth services with provisional status for 2025, requiring video with a 95 modifier.
Radiation Business Solutions is committed to supporting practices through these changes. Contact us with any questions.
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