Announcing the New CPT Code Set for 2025

By Randy Goodman, Ph.D., MHA, FACHE, PMP, BCMAS

The American Medical Association (AMA) has officially released the updated Current Procedural Terminology (CPT) codes for 2025. This release marks a significant update reflecting the rapid advancements in medical technology and innovative healthcare practices.

Why the 2025 CPT Code Set Matters to Your Business

The CPT code set serves as the backbone for the uniform exchange of medical information across the United States. These codes are vital for healthcare providers, medical device companies, and technology firms, as they facilitate accurate reporting, measurement, and benchmarking of medical services and procedures. The overarching goal of these codes is to enhance patient care, improve outcomes, and drive cost-efficiency in our healthcare system.

Significant Changes to Current CPT Codes and Their Implications

Overview of the 2025 CPT Code Updates

The latest update includes an extensive overhaul with 420 changes: 270 new codes have been introduced, 112 codes have been removed from the 2024 set, and 38 codes have seen revisions. Notably, the largest proportion of new codes (37%) has been assigned to proprietary laboratory analyses, primarily for cutting-edge genetic testing. This focus underscores the growing importance of personalized medicine in contemporary healthcare.

Expanded Codes for Digital and AI-Enhanced Medicine

Remote Therapeutic Monitoring (RTM)

The RTM services have seen significant revisions. Code 98975 has been updated to encompass digital therapeutic interventions. Additionally, codes 98976-98978 were amended to include device supplies necessary for the data access or transmission that supports RTM, enhancing patient monitoring capabilities.

Augmented and Artificial Intelligence (AI) Applications

In a pioneering move, the 2023-introduced AI Taxonomy has been integrated into Category III CPT codes. These codes now classify AI-driven medical services as assistive, augmentative, or autonomous. This classification aids in streamlining the deployment of AI technologies in clinical settings. Seven new codes cover AI-augmented tasks such as electrocardiogram analysis, medical chest imaging, and image-guided prostate biopsies.

Updates in General Surgery

The general surgery section of the CPT code set has been updated to reflect novel surgical techniques and approaches, particularly in the areas of skin grafting and tumor removal within the abdomen. These changes are indicative of the continuous improvements in surgical practices that benefit patient recovery and outcomes.

Broader Implications for Diagnosis and Treatment

Alongside the CPT code updates, the AMA has also introduced numerous new diagnosis codes within the ICD-10-CM system, covering a range of conditions from mental health issues to physical ailments like alopecia and hypoglycemia. These additions are crucial for healthcare providers in diagnosing and treating emerging health challenges.

The Role of New Codes in Healthcare Economics

While the introduction of new codes does not directly equate to insurance reimbursement, it does open avenues for healthcare innovators to argue for payer reimbursement based on clear clinical and economic benefits. These codes also play a crucial role in shaping pricing and healthcare reimbursement strategies for new medical technologies and services.

How Facet Life Sciences Can Help

Facet Life Sciences stands at the forefront of assisting medical device and healthcare technology companies in navigating these new CPT codes. Our expertise ensures that companies not only understand these changes but also leverage them to optimize reimbursement strategies and market positioning. Contact our team of experts today to learn more.