2025 CPT Codes and Descriptions

These CPT Codes and Descriptions include Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Principal Care Management (PCM), and Remote Therapeutic Monitoring (RTM) and other Virtual Care Programs

At the end of each year, the Centers for Medicare and Medicaid Services (CMS) publishes its final Physician Fee Schedule, which updates reimbursement policies and rates for the upcoming year. This year, there were several significant updates regarding virtual care and chronic disease management: the introduction of Advanced Primary Care Management (APCM) Codes and the discontinuation of G0511 for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). Instead, these facilities will now adopt the CPT codes commonly used by other fee-for-service providers.  Starting January 1, 2025, rural providers will be able to bill for care management services using individual HCPCS/CPT codes along with add-on codes instead of the previous single code G0511.

  • CPT Code 99453  CMS Description
    Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment)

    CPT Code 99454  CMS Description
    Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days) [minimum 16 readings each 30 days]

    CPT Code 99457  CMS Description
    Remote physiologic monitoring treatment management services, clinical staff/ physician/ other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes.

    CPT Code 99458  CMS Description
    Remote physiologic monitoring treatment management services, clinical staff/ physician/ other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; each additional 20 minutes (list separately in addition to code for primary procedure)

    CPT Code 99091 CMS Description
    Collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) provided personally by a physician or other QHP, a minimum of 30 minutes of time during the month.

  • CPT Code 99490  CMS Description
    Chronic Care Management (CCM) services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, with the following required elements: Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient; Chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline; Comprehensive care plan established, implemented, revised, or monitored

    CPT Code 99439  CMS Description
    Chronic Care Management (CCM) services, each additional 20 minutes of clinical staff time directed by a physician or other qualified healthcare professional, per calendar month

    CPT Code 99491  CMS Description
    Chronic Care Management (CCM), provided personally by a physician or other qualified health care professional, at least 30 minutes of physician or other qualified health care professional time, per calendar month, with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient; chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline; comprehensive care plan established, implemented, revised, or monitored

    CPT Code 99437  CMS Description
    Chronic Care Management (CCM) services each additional 30 minutes by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

    CPT Code G0511 CMS Description
    Rural health clinic or federally qualified health center (RHC or FQHC) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an RHC or FQHC practitioner (physician, NP, PA, or CNM), per calendar month (Discontinued on 6/30/2025)

    Additional CCM Information
    Although patient cost sharing applies to the CCM service, some patients have supplemental insurance (Medigap) to help cover CCM cost sharing. Also, CCM may help avoid the need for more costly services in the future by proactively managing a patient’s health, rather than only treating severe or acute disease and illness.

  • CPT Code 99426  CMS Description
    Principal Care Management (PCM), for a single high-risk disease first 30 minutes of clinical staff time directed by physician or other qualified health care professional, per calendar month (replaces G2065)

    CPT Code 99427  CMS Description
    Principal Care Management (PCM) services, for a single high-risk disease each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

    CPT Code 99424  CMS Description
    Principal Care Management (PCM) services for a single high-risk disease first 30 minutes provided personally by a physician or other qualified health care professional, per calendar month (replaces G2064)

    CPT Code 99425  CMS Description
    Principal Care Management (PCM) services for a single high-risk disease each additional 30 minutes provided personally by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

  • By automatically receiving real-time discharge notifications, your practice can reach out to patients to ensure a smooth transition between care settings and eliminate gaps in care.

    CPT Code 99495  CMS Description
    Transitional Care Management (TCM) services with moderate medical decision complexity.

    • Communication (direct contact, telephone, electronic) with the patient and/or caregiver within two business days of discharge

    • At least moderate level of medical decision making during the service period

    • Face-to-face visit withing 14 calendar days of discharge

    CPT Code 99496  CMS Description
    Transitional Care Management (TCM) services with high medical decision complexity.

    • Communication (direct contact, telephone, electronic) with the patient and/or caregiver within two business days of discharge

    • High level of medical decision making during the service period

    • Face-to-face visit withing seven calendar days of discharge

  • CPT Code 99487  CMS Description
    Complex chronic care management (CCCM) services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline, comprehensive care plan stablished, implemented, revised, or monitored, moderate or high complexity medical decision making; first 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month

    CPT Code 99489  CMS Description
    Complex chronic care management (CCCM) services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored, moderate or high complexity medical decision making; each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

  • CPT Code 98975  CMS Description
    Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment

    CPT Code 98976  CMS Description
    Remote therapeutic monitoring (e.g., respiratory system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s), manual reporting by patient, and/or programmed alert(s) transmission to monitor respiratory system, each 30 days [16 readings minimum each 30 days]

    CPT Code 98977  CMS Description
    Remote therapeutic monitoring (e.g., musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s), manual reporting by patient, and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days [16 readings minimum each 30 days]

    CPT Code 98980  CMS Description
    Remote therapeutic monitoring treatment management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, requiring at least one interactive communication with the patient/caregiver during the calendar month

    CPT Code 98981  CMS Description
    Remote therapeutic monitoring treatment management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure)

  • CPT Code 99484  CMS Description
    BHI services, at least 20 minutes of clinical staff time (does not require specialized Behavioral Health Care Manager) per calendar month, may be delivered under general supervision of a physician or other qualified health care professional, with the following required elements: registry for time and documentation recording and documentation, initial assessment and follow-up utilizing rating scales (e.g. PHQ-9), coordinating care as needed under the mental health umbrella.

    CPT Code 99492  CMS Description
    Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, under general supervision of the treating physician or other qualified health care professional. Includes time-tracking and documentation in registry, initial assessment including rating scales (e.g. PHQ-9), assignment of treatment plan.

    CPT Code 99493  CMS Description 
    Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of Behavioral Health Care Manager activities, in consultation with a psychiatric consultant, and under general supervision of the treating physician or other qualified health care professional, with the following required elements: registry for time and documentation recording and documentation, initial assessment and follow up utilizing rating scales (e.g. PHQ-9), coordinating care as needed under the mental health umbrella. 

    CPT Code 99494  CMS Description
    Subsequent psychiatric collaborative care management, each additional 30 minutes in a subsequent month of Behavioral Health Care Manager activities (beyond the 99493 60 minutes), in consultation with a psychiatric consultant, under the general supervision of the treating physician or other qualified health care professional, with the following required elements: registry for time and documentation recording and documentation, initial assessment and follow up utilizing rating scales (e.g. PHQ-9), coordinating care as needed under the mental health umbrella.