Coding Brief: Reporting Instructions for Modifier 95 (March 2025)

March 2025 pages 9-15 Coding Brief: Reporting Instructions for Modifier 95 For the CPT 2025 code set, codes 98000-98016 were established to report telemedicine services (synchronous audio-video visit, synchronous audio-only visit, and brief communication technology-based service). Therefore, the telemedicine symbol (★) was removed from codes 99202-99205 and 99212-99215. This article provides an overview of the intent and use of modifier 95, Synchronous Telemedicine Service Rendered Via a Real-Time Interactive Audio and Video Telecommunications System. Coding Tip The Centers for Medicare & Medicaid Services (CMS) Final Rule states that codes 99202-99205 and 99212-99215 may continue to be reported for telemedicine...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This premium coding brief reviews how modifier 95 is addressed in the March 2025 CPT environment and how that compares with CMS and payer reporting guidance. It is aimed at coders, billers, and compliance staff who need a high-level understanding of telemedicine reporting changes, the purpose of the new telemedicine code range, and the role of Appendix P in selecting office and outpatient codes for synchronous telemedicine services.

Why This Topic Matters

Telemedicine reporting has changed across code sets and payer policies, so readers need to know where CPT guidance, CMS guidance, and payer-specific requirements may differ. The article helps coding professionals understand the scope of those changes without relying on outdated telemedicine reporting practices.

Article Sections

  1. March 2025 pages 9-15

    Introduces the topic and places the brief in the March 2025 CPT Assistant issue.

What You Will Learn

  • The purpose and scope of modifier 95 in telemedicine reporting
  • How the March 2025 CPT environment addresses telemedicine-related code changes
  • Why payer-specific reporting requirements may differ from general CPT guidance
  • The role of Appendix P in telemedicine-related reporting context
  • How telemedicine guidance is presented for office and outpatient services

Who Should Read This

  • Medical coders
  • Medical billing staff
  • Compliance professionals
  • Practice managers
  • Healthcare revenue cycle teams

Codes Discussed

Code Ranges Discussed

Modifiers Discussed


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