New CPT Codes for Telehealth & Phone Calls: What Clinicians Need to Know (2025 Update)

The 2025 Billing Landscape for Telehealth

The telehealth revolution that began during the pandemic has permanently changed how healthcare is delivered. But the billing landscape continues to evolve, and 2025 brings significant updates that every clinician needs to understand to get paid correctly for their services.

If you've been billing telehealth services using codes from 2020-2023, you need to pay attention. The Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) have updated, clarified, and in some cases eliminated certain codes. Using outdated codes is the fastest way to trigger claim denials and payment delays.

This guide breaks down exactly what changed, which codes you should use now, and how to document your services to ensure clean claims and timely payment. Whether you're in the United States, United Kingdom, Canada, Australia, or Africa, understanding these billing principles will help you navigate your local requirements more effectively.

Why Billing Codes Matter More Than Ever

Telehealth billing isn't just about getting paid—it's about compliance, audit protection, and the long-term sustainability of your practice. Using the wrong code can result in:

• Claim denials that delay payment for weeks or months
• Audit flags that trigger reviews of all your claims
• Recoupment demands where insurers take back payments months later
• Compliance violations that can affect your provider status

Getting it right from the start protects your revenue and your reputation.

What Happened to 99443 (and Why It Matters)

One of the most significant changes in 2025 involves the telephone evaluation and management (E/M) codes, particularly CPT 99443.

The Old System: 99441-99443

From 2020-2024, many clinicians used these codes for phone consultations:

• 99441: 5-10 minutes of medical discussion
• 99442: 11-20 minutes of medical discussion
• 99443: 21-30 minutes of medical discussion

These codes were designed for telephone-only services and were widely adopted during the pandemic when telehealth exploded.

What Changed in 2025

The AMA and CMS recognized that the distinction between "telephone" and "video" services was becoming artificial and confusing. Most telehealth platforms offer both options, and the clinical value is similar regardless of the technology used.

Key Changes:

• The 99441-99443 series has been deprecated for most payers
• These codes are being replaced by more comprehensive telehealth E/M codes
• Documentation requirements have been standardized across modalities
• Time-based billing has been clarified and simplified

Why This Matters for Your Practice

If you're still using 99443 or its siblings, you're likely experiencing:

• Increased claim denials
• Requests for additional documentation
• Payment delays while claims are reviewed
• Confusion about which modifier to use

Updating to the current code set eliminates these issues and aligns your billing with industry standards.

Updated CPT Codes You Should Use Instead

Here's your comprehensive guide to the current telehealth billing codes for 2025, organized by service type.

Telehealth Evaluation and Management (E/M) Codes

These are the primary codes for telehealth visits with established or new patients:

For New Patients (99202-99205)

Use these codes when seeing a patient for the first time via telehealth:

• 99202: Straightforward new patient visit (15-29 minutes)
• 99203: Low complexity new patient visit (30-44 minutes)
• 99204: Moderate complexity new patient visit (45-59 minutes)
• 99205: High complexity new patient visit (60-74 minutes)

Required Modifier: Add modifier -95 (synchronous telemedicine service) or -GT (via interactive audio and video telecommunications systems), depending on payer requirements.

For Established Patients (99212-99215)

Use these codes for follow-up visits with existing patients:

• 99212: Straightforward established patient visit (10-19 minutes)
• 99213: Low complexity established patient visit (20-29 minutes)
• 99214: Moderate complexity established patient visit (30-39 minutes)
• 99215: High complexity established patient visit (40-54 minutes)

Required Modifier: Add modifier -95 or -GT as appropriate.

Telephone-Only Services (When Video Isn't Used)

For services delivered entirely by telephone without video:

99421-99423: Online Digital E/M Services

These codes replaced the old 99441-99443 series:

• 99421: 5-10 minutes of medical discussion
• 99422: 11-20 minutes of medical discussion
• 99423: 21+ minutes of medical discussion

Important Notes:

• These are for telephone-only services, not video visits
• Must be initiated by the patient or their representative
• Cannot be billed within 7 days of a previous E/M service
• Requires documentation of time and medical decision-making

Behavioral Health Telehealth Codes

Mental health professionals have specific codes for telehealth services:

Psychotherapy Codes (90832-90838)

• 90832: 30 minutes of psychotherapy (with modifier -95)
• 90834: 45 minutes of psychotherapy (with modifier -95)
• 90837: 60 minutes of psychotherapy (with modifier -95)
• 90838: 60 minutes of psychotherapy with E/M (with modifier -95)

Psychiatric Diagnostic Evaluation

• 90791: Psychiatric diagnostic evaluation without medical services (with modifier -95)
• 90792: Psychiatric diagnostic evaluation with medical services (with modifier -95)

Remote Patient Monitoring (RPM) Codes

For practices offering remote monitoring services:

• 99453: Initial setup and patient education
• 99454: Device supply with daily recording
• 99457: First 20 minutes of clinical staff time
• 99458: Each additional 20 minutes of clinical staff time
• 99091: Collection and interpretation of physiologic data

Chronic Care Management (CCM) Codes

For ongoing management of patients with chronic conditions:

• 99490: 20+ minutes of CCM services per month
• 99439: Each additional 20 minutes
• 99487: Complex CCM, first 60 minutes
• 99489: Complex CCM, each additional 30 minutes

Examples and Scenarios

Let's walk through real-world scenarios to clarify when to use each code.

Scenario 1: Initial Therapy Consultation via Video

Situation: A new patient books a 60-minute initial consultation with you via video for anxiety treatment.

Correct Code: 99205-95

• 99205 (new patient, high complexity, 60-74 minutes)
• Modifier -95 (synchronous telemedicine)

Documentation Must Include:

• Chief complaint and history of present illness
• Relevant medical, family, and social history
• Mental status examination
• Assessment and diagnosis
• Treatment plan and goals
• Total time spent (60 minutes)
• Confirmation that video technology was used

Common Mistake: Using 90791 instead. While 90791 is for psychiatric evaluation, 99205 is more appropriate for the initial comprehensive visit when you're also establishing care.

Scenario 2: 45-Minute Follow-Up Therapy Session via Video

Situation: An established patient has their weekly 45-minute therapy session via video.

Correct Code: 90834-95

• 90834 (45 minutes of psychotherapy)
• Modifier -95 (synchronous telemedicine)

Documentation Must Include:

• Brief update on symptoms and functioning
• Interventions used during session
• Patient response to interventions
• Progress toward treatment goals
• Plan for next session
• Total time spent (45 minutes)

Common Mistake: Rounding up to 90837 (60 minutes) when you only spent 45 minutes. Bill for the time you actually provided.

Scenario 3: 15-Minute Phone Check-In

Situation: A patient calls with a question about their medication. You spend 15 minutes discussing their symptoms and adjusting their prescription.

Correct Code: 99422

• 99422 (11-20 minutes of telephone E/M)

Documentation Must Include:

• Patient-initiated contact
• Reason for call
• Medical discussion and decision-making
• Any changes to treatment plan
• Total time spent (15 minutes)
• Confirmation that this was telephone-only (no video)

Common Mistake: Not billing at all because "it was just a quick call." If you provided medical advice and spent billable time, you should bill for it.

Scenario 4: Crisis Intervention via Video

Situation: A patient in acute distress contacts you for an emergency 30-minute crisis intervention session via video.

Correct Code: 90832-95 or 99214-95

• For therapy-focused intervention: 90832-95 (30 minutes psychotherapy)
• For medical evaluation and management: 99214-95 (established patient, moderate complexity)

Documentation Must Include:

• Nature of the crisis
• Risk assessment (suicide, homicide, harm to others)
• Interventions provided
• Safety planning
• Follow-up plan
• Total time spent
• Confirmation of video technology used

Common Mistake: Using a regular follow-up code without documenting the crisis nature and risk assessment.

Scenario 5: Group Therapy via Video

Situation: You conduct a 60-minute group therapy session with 6 participants via video conference.

Correct Code: 90853-95

• 90853 (group psychotherapy)
• Modifier -95 (synchronous telemedicine)

Documentation Must Include:

• List of participants (can use initials for privacy)
• Group topic or focus
• Therapeutic interventions used
• General group dynamics and progress
• Total time spent (60 minutes)
• Confirmation of video technology

Common Mistake: Billing individual therapy codes for each participant. Group therapy has its own code and is billed once per session, not per participant.

Documentation Requirements for Each Code

Proper documentation is your best defense against audits and denials. Here's what you need for each major code category.

E/M Telehealth Visits (99202-99215)

Required Elements:

1. Chief Complaint: Why the patient sought care
2. History: Relevant medical, family, and social history
3. Examination: Mental status or physical exam findings (as applicable via telehealth)
4. Medical Decision Making: Assessment, diagnosis, and treatment plan
5. Time: Total time spent in direct patient care
6. Technology Confirmation: Note that video technology was used and was functional

Sample Documentation:

Chief Complaint: Patient reports increased anxiety and difficulty sleeping.

History: 35-year-old established patient with GAD, last seen 3 months ago. Reports worsening anxiety over past 2 weeks related to work stress. Sleep latency increased to 2+ hours. No suicidal ideation. Medication compliance good.

Mental Status Exam (via video): Alert, oriented x3. Anxious affect. Speech normal rate and tone. Thought process linear. No SI/HI. Insight and judgment fair.

Assessment: Generalized Anxiety Disorder, moderate episode

Plan: 
- Increase escitalopram from 10mg to 15mg daily
- Continue weekly therapy
- Sleep hygiene education provided
- Follow-up in 2 weeks to assess medication response

Total Time: 30 minutes via secure video platform (modifier -95)

Psychotherapy Codes (90832-90838)

Required Elements:

1. Brief Clinical Update: Current symptoms and functioning
2. Therapeutic Interventions: Specific techniques used (CBT, DBT, EMDR, etc.)
3. Patient Response: How patient engaged and responded
4. Progress: Movement toward treatment goals
5. Plan: Next steps and homework
6. Time: Exact time spent in therapy
7. Technology Confirmation: Video platform used

Sample Documentation:

Session Date: [Date]
Duration: 45 minutes via secure video (90834-95)

Update: Patient reports moderate improvement in depressive symptoms since last session. PHQ-9 score decreased from 18 to 14. Still experiencing low motivation and social withdrawal.

Interventions: 
- Cognitive restructuring around negative automatic thoughts
- Behavioral activation planning for upcoming week
- Mindfulness exercise for present-moment awareness

Response: Patient engaged well, identified 3 negative thought patterns, created activity schedule for next week.

Progress: Moving toward goal of increased social engagement and improved mood regulation.

Plan: Continue weekly sessions, complete thought records homework, attempt 2 social activities this week.

Telephone E/M Services (99421-99423)

Required Elements:

1. Patient-Initiated Contact: Note that patient or representative initiated
2. Medical Discussion: What was discussed
3. Clinical Decision-Making: Assessment and plan
4. Time: Exact time spent
5. No Recent E/M: Confirm this wasn't within 7 days of another billable service
6. Telephone-Only: Confirm no video was used

Sample Documentation:

Patient-initiated telephone call regarding medication side effects.

Discussion: Patient reports nausea and headache since starting sertraline 3 days ago. Symptoms occur 1-2 hours after taking medication. No other concerning symptoms. Eating regularly.

Assessment: Likely medication-related GI side effects, common with SSRI initiation.

Plan: Advised taking medication with food, symptoms typically resolve in 1-2 weeks. Will monitor. Call back if symptoms worsen or new symptoms develop.

Time: 12 minutes (telephone only, no video) - 99422
Not within 7 days of previous E/M service.

Common Denial Reasons & How to Avoid Them

Understanding why claims get denied is the first step to preventing them. Here are the most common telehealth billing mistakes and how to avoid them.

Denial Reason #1: Missing or Incorrect Modifier

The Problem: You billed 99214 without adding modifier -95, so the payer doesn't know it was a telehealth visit.

The Solution:

• Always add modifier -95 for synchronous video services
• Some payers require -GT instead—check your contracts
• Never use both modifiers on the same claim
• Set up your EHR to automatically append the correct modifier

ClinikEHR Advantage: Automatically applies the correct telehealth modifier based on your payer contracts and service type, eliminating this common error.

Denial Reason #2: Insufficient Time Documentation

The Problem: You billed 90837 (60 minutes) but your note only says "therapy session completed" without documenting time.

The Solution:

• Document exact start and end times, or total time spent
• Use phrases like "Total time: 60 minutes" in your note
• For time-based codes, time must be clearly stated
• Round to the nearest appropriate code (don't upcode)

ClinikEHR Advantage: Built-in session timer that automatically logs session duration and inserts it into your note template.

Denial Reason #3: Billing Too Soon After Previous Service

The Problem: You billed 99422 (telephone E/M) only 3 days after a 99214 visit, violating the 7-day rule.

The Solution:

• Check your schedule before billing telephone E/M codes
• If within 7 days of previous E/M, consider it part of that service
• Document why the additional contact was necessary
• Use care coordination codes instead if appropriate

ClinikEHR Advantage: Alerts you when attempting to bill a telephone E/M code within 7 days of a previous service, preventing this error before claim submission.

Denial Reason #4: Inadequate Medical Necessity Documentation

The Problem: Your note doesn't clearly explain why the service was medically necessary or what clinical decisions were made.

The Solution:

• Always include assessment and plan
• Document changes in symptoms or functioning
• Explain your clinical reasoning
• Connect interventions to treatment goals
• Include relevant risk factors or safety concerns

Sample of Insufficient Documentation:

Patient seen for therapy. Discussed anxiety. Will continue treatment.

Sample of Adequate Documentation:

Patient reports increased panic attacks (3 this week vs. 1/week previously). Attacks triggered by work presentations. Taught diaphragmatic breathing and cognitive restructuring for catastrophic thinking. Patient demonstrated techniques successfully. Plan: Practice techniques daily, exposure hierarchy for next session. Continue weekly therapy to address panic disorder.

Denial Reason #5: Wrong Place of Service Code

The Problem: You used place of service code 11 (office) instead of 02 (telehealth) or 10 (patient's home).

The Solution:

• Use POS code 02 for telehealth services (most common)
• Some payers accept POS 10 (patient's home) for telehealth
• Check your payer's specific requirements
• Update your billing system to default to correct POS for telehealth

ClinikEHR Advantage: Automatically sets the correct place of service code based on appointment type (in-person vs. telehealth).

Denial Reason #6: Billing for Non-Covered Services

The Problem: You billed a telehealth code that your payer doesn't cover for your specialty or license type.

The Solution:

• Verify telehealth coverage before providing services
• Check if your license type is eligible for telehealth billing
• Confirm patient's insurance covers telehealth
• Have patients sign an ABN (Advance Beneficiary Notice) if coverage is uncertain
• Keep updated payer policy documents

Common Coverage Limitations:

• Some payers only cover telehealth for certain diagnoses
• Some require the patient to be in a specific location
• Some limit the number of telehealth visits per year
• Some don't cover telephone-only services

Denial Reason #7: Duplicate Billing

The Problem: You billed both an E/M code and a psychotherapy code for the same session when only one was appropriate.

The Solution:

• Understand when you can bill both codes together
• 90838 is specifically for psychotherapy WITH E/M
• Don't bill 99214 and 90834 for the same session
• If you did both, use 90838 instead
• Document both components clearly if billing together

When You CAN Bill Both:

• Using code 90838 (psychotherapy with E/M)
• Providing distinct services in the same session
• Both services are medically necessary and documented

When You CANNOT Bill Both:

• Standard therapy session (use psychotherapy code only)
• Brief check-in with therapy (choose the primary service)
• Services that overlap in time or purpose

Denial Reason #8: Missing Diagnosis Code

The Problem: You submitted a claim without a diagnosis code, or with an invalid/outdated ICD-10 code.

The Solution:

• Always include at least one diagnosis code
• Use the most specific code available
• Update to current ICD-10 codes annually
• Link diagnosis to medical necessity
• Include all relevant diagnoses that affect treatment

ClinikEHR Advantage: Maintains updated ICD-10 code database and suggests appropriate codes based on your documentation.

Automation Tip: Linking Codes Directly to EHR Templates

The most efficient way to ensure correct coding is to build it into your documentation workflow. Here's how to set up your EHR for billing success.

Template-Based Coding

Create note templates that automatically suggest the correct code based on:

• Appointment type: Initial consultation vs. follow-up
• Session duration: Automatically calculated from session timer
• Service modality: Video vs. telephone vs. in-person
• Patient status: New vs. established

Example Template Logic:

IF appointment_type = "Initial Consultation" 
AND duration >= 60 minutes 
AND modality = "Video"
THEN suggest_code = "99205-95"

IF appointment_type = "Therapy Session" 
AND duration = 45 minutes 
AND modality = "Video"
THEN suggest_code = "90834-95"

Smart Documentation Prompts

Your EHR should prompt you to include required elements based on the code you're billing:

For E/M Codes (99202-99215):

• Chief complaint field (required)
• History section (required)
• Examination findings (required)
• Assessment and plan (required)
• Time documentation (required)
• Technology confirmation (required)

For Psychotherapy Codes (90832-90838):

• Clinical update (required)
• Interventions used (required)
• Patient response (required)
• Progress toward goals (required)
• Time documentation (required)

Pre-Submission Claim Checks

Before submitting claims, your system should verify:

• ✓ Correct modifier is attached
• ✓ Time is documented for time-based codes
• ✓ Place of service code is correct
• ✓ Diagnosis code is present and valid
• ✓ No conflicting services billed on same date
• ✓ Service is within 7-day window rules
• ✓ All required documentation elements are present

ClinikEHR Advantage: Runs automatic pre-submission checks and alerts you to potential issues before claims are sent, dramatically reducing denial rates.

Batch Coding and Billing

For efficiency, set up your workflow to:

1. Complete all sessions for the day/week
2. Review notes for completeness
3. Verify codes are correct and modifiers attached
4. Submit claims in batch
5. Track submissions and follow up on any issues

This batch approach is more efficient than billing after each session and allows you to catch errors before submission.

Regional Billing Considerations

While this guide focuses on US billing codes, understanding the principles helps clinicians worldwide navigate their local systems.

United States

• Medicare: Follows CMS guidelines strictly, requires modifier -95 or -GT
• Medicaid: Varies by state, check your state's telehealth policies
• Commercial Payers: Each has unique requirements, verify before billing
• Telehealth Parity Laws: Many states require equal coverage for telehealth

Key Resource: CMS Telehealth Services

United Kingdom

• NHS: Uses Read Codes or SNOMED CT, not CPT codes
• Private Practice: May use CPT codes for international insurance
• Documentation: Similar principles apply for medical necessity
• Telehealth Coverage: Expanding under NHS Long Term Plan

Key Resource: NHS Digital

Canada

• Provincial Billing: Each province has unique billing codes
• Telehealth Codes: Most provinces have specific telehealth fee codes
• Documentation: Similar requirements to US for medical necessity
• Coverage: Varies by province and service type

Key Resource: Canadian Medical Association

Australia

• Medicare: Uses MBS (Medicare Benefits Schedule) item numbers
• Telehealth Items: Specific item numbers for video consultations
• Bulk Billing: Available for eligible telehealth services
• Documentation: Must meet MBS requirements

Key Resource: Services Australia

Africa (Nigeria, Kenya, South Africa, Ghana, Egypt)

• Private Pay: Most telehealth is private pay or cash-based
• Insurance: Limited telehealth coverage, growing slowly
• Documentation: Follow international standards for quality
• Mobile Health: Increasing integration with mobile payment systems

Product Insight: Why ClinikEHR is the Preferred Tool for Telehealth Billing

Navigating the complex world of telehealth billing doesn't have to be overwhelming. ClinikEHR is specifically designed to eliminate billing errors and maximize your revenue while minimizing administrative burden.

How ClinikEHR Simplifies Telehealth Billing

Intelligent Code Suggestions: Based on your appointment type, duration, and modality, ClinikEHR automatically suggests the correct CPT code and modifier. You can override if needed, but the system guides you toward compliant billing.

Built-In Documentation Templates: Every code has a corresponding template that prompts you to include all required elements. You can't accidentally submit an incomplete note because the system won't let you save until all required fields are completed.

Automatic Time Tracking: Session timers run in the background during telehealth appointments, automatically calculating duration and suggesting the appropriate time-based code. No more guessing or estimating.

Pre-Submission Claim Validation: Before any claim leaves your system, ClinikEHR runs dozens of validation checks to catch errors. Missing modifier? You'll know before submission. Billing too soon after a previous service? You'll get an alert.

Payer-Specific Rules: ClinikEHR maintains updated rules for major payers, automatically applying the correct modifier, place of service code, and documentation requirements based on the patient's insurance.

Denial Management: When denials do occur, ClinikEHR helps you understand why and provides guidance on how to correct and resubmit. The system learns from denials to prevent similar errors in the future.

Comprehensive Reporting: Track your billing performance with detailed reports on:

• Claim acceptance rates by code
• Average time to payment by payer
• Denial rates and reasons
• Revenue by service type
• Productivity metrics

Real-World Results

Practices using ClinikEHR for telehealth billing report:

• 87% reduction in claim denials due to coding errors
• 40% faster claim submission process
• 95% clean claim rate (accepted on first submission)
• 3-5 hours saved per week on billing administration

Starting at just $39/month, ClinikEHR provides enterprise-level billing intelligence at a price that makes sense for solo practitioners and small practices.

Frequently Asked Questions (FAQs)

Can I bill for telehealth services across state lines? You must be licensed in the state where the patient is physically located during the telehealth session. Some states have interstate compacts (like PSYPACT for psychologists) that facilitate cross-state practice.

Do I need patient consent to bill for telehealth? Yes, obtain written consent that explains telehealth services, technology requirements, privacy considerations, and billing practices. Keep this consent in the patient's record.

Can I bill for a telehealth session if the video connection fails? If you complete the session by phone after video failure, document this and bill using telephone E/M codes (99421-99423) instead of video codes. Document the technology failure.

How do I bill for a telehealth session that runs over time? Bill for the actual time spent, using the appropriate code. If a 45-minute session runs to 55 minutes, you can bill 90837 (60 minutes) if you spent at least 53 minutes (within the time range for that code).

What if my patient's insurance doesn't cover telehealth? Verify coverage before providing services. If not covered, have the patient sign an ABN acknowledging they'll be responsible for payment. Consider offering a reduced self-pay rate.

Can I bill for text or email communication with patients? Generally no, unless using specific online digital E/M codes (99421-99423) for substantive medical discussions. Brief check-ins and appointment scheduling are not billable.

Do I need special equipment to bill for telehealth? You need HIPAA-compliant video technology that allows real-time audio and visual communication. Document the platform used in your notes.

How long do I need to keep telehealth documentation? Follow the same retention requirements as in-person visits: typically 7 years for adults, longer for minors. Check your state's specific requirements.

Related Reading on ClinikEHR

• Telehealth workflows: Streamlining Telehealth Workflows: The Best Telehealth EHR for Solo Practitioners
• Documentation quality: How to Ensure Insurance-Ready Notes for 90837 and Other Codes
• Billing fundamentals: Medical Billing for Small Practices: Complete Guide
• Billing vs coding: Medical Billing vs Medical Coding: What's the Difference?

Download: CPT Reference Guide for Telehealth Clinicians

We've created a comprehensive, printable reference guide that includes:

• Quick reference table of all current telehealth CPT codes
• Modifier guide for different payer types
• Documentation checklist for each code category
• Common denial reasons and prevention strategies
• Time-based billing chart for quick code selection
• Payer-specific requirements for major insurers

This guide is designed to sit on your desk or be saved on your computer for quick reference during documentation.

Download Your Free CPT Reference Guide (PDF)

Conclusion: Billing Confidence Starts with Knowledge

The 2025 telehealth billing landscape is more complex than ever, but it's also more standardized and predictable. By understanding which codes to use, how to document properly, and how to avoid common pitfalls, you can ensure clean claims, timely payment, and audit protection.

The key is building these best practices into your daily workflow. Don't wait until you're facing denials to fix your billing processes. Set up your systems correctly from the start, use technology to automate compliance, and stay informed about changes in billing requirements.

Remember: every claim denial is lost revenue and wasted time. Every correctly submitted claim is money in your pocket and peace of mind. The investment in proper billing practices pays for itself many times over.

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For the most current billing information, always consult the CMS Telehealth Services page, your state medical board, and your specific payer contracts. This guide provides general information and should not be considered legal or billing advice.