CPT replaced the telephone visit codes with a full telemedicine family. Medicare then declined to pay most of it. Here is the map.
| Codes | What they are | Level logic | Medicare |
|---|---|---|---|
| 98000 to 98003 | Audio-video, new patient | Same MDM tiers and time thresholds as 99202 to 99215 | Not payable (status I); bill 99202 to 99215 with POS 10 or 02 and modifier 95 or 93 instead |
| 98004 to 98007 | Audio-video, established | ||
| 98008 to 98011 | Audio-only, new patient | ||
| 98012 to 98015 | Audio-only, established | ||
| 98016 | Brief virtual check-in, established, 5 to 10 minutes | Time based | PAID; replaced G2012 (0.30 wRVU) |
CPT built the family in place of the deleted telephone codes 99441 to 99443 and gave it the same engine as the office visits: each level is met by the medical decision making tier or by total time on the date of the encounter. An established audio-video visit at moderate MDM or 30 minutes is 98006 where the payer accepts the family, and 99214 with modifier 95 where it does not. The audio-only codes add one extra gate: more than 10 minutes of medical discussion.
Medicare declined to pay 98000 to 98015 in both the 2025 and 2026 fee schedules, calling them duplicative of the office codes with modifiers. So the same telehealth visit is coded two different ways depending on the payer: for Medicare, 99202 to 99215 with place of service 10 when the patient is home (which pays the higher non facility rate) or 02 elsewhere, plus modifier 95 for audio-video or 93 for audio-only. For commercial payers and Medicaid plans that adopted the new family, the 98xxx code itself, with no telehealth modifier, because the modality is built into the descriptor. Billing the wrong track is an automatic denial in both directions, and several commercial plans have announced they follow Medicare and deny the whole family, so the payer policy, not the CPT book, decides.
Because these replaced the telephone codes, the established audio-only ladder gets the most questions: 98012 at straightforward MDM or 10 minutes, 98013 at low or 20, 98014 at moderate or 30, and 98015 at high MDM or 40 minutes, each requiring more than 10 minutes of medical discussion. Medicare telehealth flexibilities, including audio-only to the home, currently run through December 31, 2027.
Paste a de-identified telehealth note into the E/M Assistant; it levels the visit by MDM and time and writes the rationale, which applies on either billing track.