What You Need to Know About New CPT Codes for 2025

American Medical Association (AMA) has introduced the new CPT codes for 2025. If you are in the healthcare sector, familiarizing yourself with such changes is very important for you and other stakeholders such as patients and payers.  CPT 2025 updates will affect day-to-day medical operations for healthcare providers, medical coders, billers, and insurance providers.

This blog post covers the basics of CPT codes, what changes are made, and how this will impact healthcare providers and payers. What you need to do and all the important information you need to stay updated after the AMA CPT 2025 release

CPT code set is expanding in new areas such as medicine with proprietary laboratory analyses assigned to the largest proportion of new codes (37%), mostly for novel genetic testing. Two-thirds of the new codes were assigned to emerging medical services.

Overview of CPT Codes and Their Importance

What Are CPT Codes?

CPT is the abbreviation for Current Procedural Terminology. CPT codes are standardized numeric codes used in healthcare sectors to describe medical procedures and services provided by medical professionals. These codes are important for documenting medical, surgical, and diagnostic services. The American Medical Association (AMA) maintains and updates them annually.

The code set is vast and includes codes for thousands of different medical procedures, diagnostics, and surgeries.

The CPT codes are divided into three categories. Below is a brief description of each category.

Categories:

●             Category I: Common procedures and services (e.g., office visits, surgeries, lab tests).

●             Category II: Performance measurement and quality improvement tracking (optional, not for billing)

●             Category III: Emerging technologies, services, and procedures.

Importance OF CPT Codes

●        Standardization of Medical Procedures Communication:

It helps keep uniformity in describing the medical procedures across the United States. It bridges the communication gap between healthcare providers, patients, and payers.

●        Facilitates Accurate Billing:

CPT simplifies the billing process by assigning codes. Prevents errors in the insurance claims and helps avoid disputes of reimbursements.

●        Supports Insurance Reimbursement:

It is needed by the payers (insurance companies) to determine the coverage and approve reimbursements. Accurate coding ensures providers are compensated fairly and promptly

New CPT codes 2025 have been introduced via AMA CPT 2025 release. The below section discusses the key changes in the CPT 2025 code set and its impact on all stakeholders in detail.

 Key CPT Changes In 2025

Overall, there are 420 updates in CPT 2025 updates including 270 new codes, 112 deletions, and 38 revisions. The CPT code set is evolving to cover more areas of medicine, with proprietary laboratory tests accounting for the majority of new codes (37%), mainly focused on innovative genetic testing.

We will be exploring the CPT 2025 changes by specialty. The key changes were made in codes for Remote Therapeutic Services, Artificial Intelligence applications in the medical field, and General surgery procedures.

Digital Medicine

The editorial changes were made to Remote Therapeutic Services. Code 98975 was revised to include digital therapeutic intervention, and codes 98976-98978 were updated to include device supply for data access or data transmissions to support the RTM of patients.

Augmented / Artificial Intelligence

AI Category III CPT codes have been implemented to classify AI medical services and procedures as assistive, augmentative, or autonomous based on the work performed by the AI application on behalf of the physician or other qualified health care professional (QHP) with the introduction of AI taxonomy in 2023.

Seven Category III codes have been established for AI data analysis involved in electrocardiogram measurements (0902T and 0932T), medical chest imagining (0877T-0880T), and image-guided prostate biopsy (0898T).

General Surgery

Key changes in general surgery were announced in the AMA CPT 2025 release. New approaches such as skin grafts for wound care and recovery (15011-15018). Progress in surgical methods for removing tumors located in the abdominal region (49186-49190)

 How Will This Impact Medical Billing

 Evolution and Management of Codes:

Due to the latest changes, medical billers, and coders have to learn and adopt this quickly, as it will change the billing process.

Changes in Surgical Codes:

To explain the changes in billing we will discuss the change in surgical codes as this will include the new techniques and advancements and billers and coders have to keep them in account also.

Diagnostic Changes:

When billing and coding after the CPT code change in 2025, healthcare providers, coders, and billers must consider the changes made in diagnostic codes.

How CPT 2025 Code Will Impact Billing and Reimbursement

Streamlining Billing Process

New and revised codes provide more accurate descriptions of services, reducing errors in claims submission. Updated language in revised codes minimizes ambiguities, helping billing staff and payers interpret services correctly.

Facilitating Reimbursement

The new codes help insurers identify and process claims for emerging technologies, ensuring providers are reimbursed for modern services. Precise coding supports clear communication with payers about the value and necessity of advanced procedures, leading to smoother approvals.

Reducing Claim Denials

 Updated Codes for Current Practices: By addressing outdated or vague codes, the updates reduce the risk of denied claims due to coding discrepancies. Proactive Adoption: Providers who implement the new codes early can avoid disruptions in claims processing.

How Healthcare Providers Can Adjust After 2025 CPT Changes

 Stay Informed: Health Care providers need to keep updated and stay informed with the changes in the sector.

Coding Training: Ensure clinical staff is adequately trained on new CPT codes and billing guidelines to avoid errors. 

Impact on Healthcare Providers and Medical Coders

 Healthcare Providers

● Accurate Documentation: Providers must document services accurately to align with updated codes. This ensures proper billing and reimbursement.

● Collaboration with Coders: Providers work closely with medical coders to clarify treatment details and ensure correct code assignment.

● Compliance Responsibility: Staying compliant with the updated codes is essential to avoid audits and claims Medical Coders

Medical Coders

●             Code Selection: Coders translate medical services into appropriate CPT codes, ensuring accuracy based on the 2025 updates.

●             Claim Preparation: Coders play a crucial role in creating error-free claims that comply with the latest regulations.

●             Training Advocates: Coders often lead or support training initiatives to familiarize healthcare teams with the updates

Training Programs

●             Workshops and Webinars: Organizations can host AMA-certified training sessions to guide staff on new, revised, and deleted codes.

●             Hands-On Practice: Practical coding exercises help coders apply the changes in real-world scenarios.

Challenges Faced by Health Care Providers

1.            Learning Curve:

Both providers and coders may struggle initially to familiarize themselves with the changes, especially for new procedures and technologies.

2.            System Updates:

Delays in updating EHRs or billing software can cause temporary disruptions in claim processing.

3.            Financial Investment:

Training programs and software updates may require significant resources, impacting smaller practices.

Resources for Staying Current with CPT 2025 Updates

1. Leverage Trusted Resources

●             American Medical Association (AMA):

○             Visit the AMA website for official updates, webinars, and the latest CPT codebook.

○             Subscribe to the AMA newsletter for real-time notifications on updates and training opportunities.

●             Coding Software and Tools: Use CPT coding software integrated into Electronic Health Records (EHR) systems that are updated with the latest codes.

○             Utilize apps like Codify or Find-A-Code to search, compare, and understand CPT codes efficiently.

● Professional Organizations: Join organizations like the American Academy of Professional Coders (AAPC) or the Health Information Management Association (AHIMA) for resources, training, and certification.

2. Implement Regular Training Programs

● Workshops and Webinars:

○ Attend AMA-hosted webinars or conferences that focus on the 2025 updates.

○ Participate in online workshops organized by professional coding associations.

● In-House Training:

○ Healthcare institutions can organize team sessions led by certified trainers to ensure all staff understand the updates.

● Self-Paced Learning:

○ Coders and providers can access online modules or eBooks that detail CPT changes at their convenience.

Conclusion:

New 2025 CPT code changes will make an impact on medical billing, coding, and other relevant day-to-day operations. Some of the major changes were made to the CPT codes for general surgery procedures, and the use of artificial intelligence in medicine. These new 2025 CPT updates require adjustments in coding and billing. Once it is done it will streamline the processes. Healthcare providers should stay up to date on the latest developments. Utilize the available tools for better understanding. Relevant training programs should be conducted for staff to make them familiar 2025 CPT code set.