Cracking the Code: Essential CPT Changes for 2025 You Can’t Afford to Miss

The American Medical Association (AMA) has updated the Current Procedural Terminology code set for the year 2025. The recent release featuring 420 changes is updated on the AMA website and must be included in the fee schedule and patient claims. AMA, which acts as the governing body for code changes, rolls out a new edition of CPT codes in the fourth quarter of every year to be implemented on January 1. It oversees the changes in the code set via the CPT Editorial Panel, an independent body convened by the AMA, based on the healthcare community’s and other stakeholders’ feedback to ensure the changes align with the modern healthcare system.

CPT Code Changes at A Glance

Most of the annual changes can be attributed to technological advancements, innovative procedures, and medical inventions. The release of CPT code set updates 2025 serve as a uniform data set required for medical procedures and services published by the AMA. The annual release of 2025 sees 420 updates in the CPT 2025 code set. There are 270 additions, 112 deletions, and 38 revisions.

CPT Code Changes for 2025

Change Type	No. of codes
New Codes	270
Deletions	112
Revisions	38

With many additions this year, it’s easy to understand that the CPT codes are continuously expanding. For instance, medicine with proprietary laboratory analyses makes up the most significant proportion of new codes, i.e., 37%, mostly for novel genetic testing. While Category III CPT codes representing emerging medical services comprise 30%. Before diving deep into the CPT 2025 updates, let’s tell you a bit about CPT codes and their significance.

What Is A CPT Code?

CPT stands for Current Procedural Terminology. This terminology is in the form of codes used by doctors and healthcare professionals. They use it as a uniform language for coding diagnosis, treatment, and procedures for seamless reporting to increase efficiency and accuracy. Apart from that, CPT codes are the basis for administrative management processes like insurance claims and guidelines for medical care. It is the most widely used medical terminology accepted all across the US to report medical, surgical, radiology, laboratory, anesthesiology, sequencing, evaluation, and management services under public and private health insurance programs.

The Significance of CPT Codes

CPT codes combined with ICD codes are undeniably one of the most significant sets of codes used for administrative purposes. These are used to generate revenue for a doctor or a practice through careful coding and claim submission. So, it is imperative for medical coders to familiarize themselves with these codes. Simply put, CPT code is a coded language used in the healthcare industry to describe treatments, surgeries, evaluations, and other procedures conducted by a healthcare professional on a patient. This specialized language is quite broad and has codes for thousands of medical procedures.

Importance of CPT Codes In Billing

When it comes to billing and reimbursement for services rendered, CPT nomenclature plays a pivotal role. This code set clearly conveys to the payor the procedures and provided treatments for which the healthcare practice wants reimbursement. Even the symptoms are in the coded form. One similarity between ICD and CPT codes is that both are essential in tracking crucial health data and measuring efficiency and performance. Authorities use CPT codes to monitor the frequency and value of specific procedures. While hospitals and healthcare facilities assess the abilities of professionals or divisions within their facility.

Types of CPT

Used nationally by physicians and healthcare providers, CPT codes are known to include a complete range of healthcare services. These are five-digit codes and can be numeric or alphanumeric based on the category. Below are the types of CPT codes.

Category I

CPT codes falling under Category I come with descriptors that relate to a procedure or service. Category I CPT codes range from 00100–99499. Usually, these are ordered into sub-categories depending on the service type, chosen procedure, anatomy, etc.

Category II

These codes are a combination of alphabets and numeric. Used to measure performance, these are also known as supplemental codes. So, these are optional and aren’t essential for correct coding.

Category III

CPT codes falling under Category III are temporary alphanumeric codes that describe new and developing procedures, services, and technology. These codes were specially developed for the collection of data, assessment, and payment against those procedures and services that don’t fulfill the requirements for Category I.

Proprietary Laboratory Analyses (PLA) Codes

These codes are the latest addition to the CPT code set and are used to describe proprietary clinical laboratory analyses. A single laboratory can provide it, or multiple laboratories approved by the FDA can license or market it. This new Category includes, but is not limited to, Advanced Diagnostic Laboratory Tests (ADLTs) and Clinical Diagnostic Laboratory Tests (CDLTs), as defined in the Protecting Access to Medicare Act of 2014 (PAMA).

Notable Updates in The CPT 2025 Code Set

This year, we see some critical changes in Digital Medicine, Augmented/Artificial Intelligence (AI) and General Surgery. Let’s go through these changes briefly.

Digital Medicine

The editorial panel revised remote therapeutic monitoring (RTM) in this year’s updates. AMA updated the code 98975 to include digital therapeutic intervention. Whereas they revised codes 98976-98978 to include device supply for access to data and transmission to support RTM.

Augmented/Artificial Intelligence (AI)

American Medical Association implemented AI Taxonomy in category III CPT codes for the classification of AI medical services and procedures as assistive, augmentative, or autonomous. The new CPT code set to be implemented in 2025 has seven Category III codes for AI augmentative data analysis involved in electrocardiogram measurements (0902T and 0932T), medical chest imagining (0877T-0880T), and image-guided prostate biopsy (0898T).

General Surgery

The new code set also includes a general surgery section based on novel approaches in skin grafts for wound care and recovery with codes (15011-15018). There are also modifications for advancements in surgical techniques for tumor elimination within the abdomen (49186-49190).

Are You Ready to Embrace the Changes?

With 2025 around the corner and the new CPT code set to be implemented from January 1st, healthcare providers, practices, and billing departments are doing their best to get acquainted with the modifications. Preparing to implement these changes is the first step toward efficiency and accuracy. The healthcare and RCM industries are stepping up and taking concrete steps towards role-based training. Going through training means your record is correct, which not only helps authorities but also helps ensure no claim is denied based on a coding error and that you maintain compliance. If you want more information regarding CPT code changes for 2025, visit the AMA website for helpful information.

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