As more physicians are using digitally enabled care in their practice, Current Procedural Terminology (CPT®) codes are capturing and communicating these new services. In fact, the CPT 2025 code set sought to streamline reporting of digitally enabled care. New entries pertaining to digital medicine that were incorporated into the CPT code set for 2025 do not require the traditional telemedicine modifiers that typically have been used to signify that the services have been delivered remotely.
“The reason for that is that telemedicine is inherent in these codes,” Leslie Prellwitz, the AMA’s director of CPT development, said during an AMA webinar in March about how to use the new digital medicine codes. “It does not require a modifier in order for telemedicine to occur—they were built that way.”
The AMA resource, “Digital Medicine Clinical Scenarios: Coding Handbook” (PDF), outlines CPT coding guidance for 14 common digital medicine encounters and explains place-of-service codes and modifiers. The AMA handbook also clarifies how recent changes, such as the introduction this year of telemedicine-specific CPT codes, affect reporting practices.
The scenarios covered include synchronous audio-video visits for new or established patients, online evaluation and management, self-measured blood pressure (BP), ambulatory continuous glucose monitoring and chronic care management.
“Given that many of these codes are new and there are several questions about how to use them appropriately, the AMA, with support from Manatt Health, developed this handbook to detail common clinical encounters and an overview of appropriate CPT guidance for each,” the handbook’s introduction says.
Also discussed in the handbook and during the webinar were digital medicine codes for remote physiological monitoring and self-measured BP readings taken by patients outside of the clinical setting and automatically transmitted to their physician or care team. It is important to note that all remote monitoring codes are grounded in clinical rigor and developed with extensive input from medical specialty societies, Centers for Medicare & Medicaid Services (CMS), and digital health experts.
Prellwitz also noted that, to meet CPT reporting requirements, devices need to meet the Food and Drug Administration’s definition of a medical device and that the remote service needs to be ordered by a physician or other qualified health care professional.
The handbook includes a discussion of Appendix R, the place in the code set where codes describing remote therapeutic-monitoring services are housed. These include codes for digital cognitive behavioral therapies and codes representing the review and monitoring of data related to the patient’s response to musculoskeletal and respiratory system therapies.
The thing “to remember is that those codes have been created for different service components: education, supply and monitoring treatment plans,” Prellwitz said. “The key with really using them is to make sure that you match the codes you report with the services you provided at that particular time.”
The webinar provided a discussion of three of the 14 scenarios contained in the handbook.
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A history of supporting remote monitoring
The CPT code set has supported remote monitoring for nearly 20 years. Foundational codes for blood glucose monitoring and basic remote monitoring services laid the groundwork for capturing services that extended beyond the traditional office visit, especially for patients managing chronic conditions.
In 2019, the introduction of remote physiologic monitoring (RPM) CPT codes marked a critical shift in recognizing the clinical value of continuous, remote engagement between patients and physician-led care teams. Catalyzed by input from the AMA-convened Digital Medicine Payment Advisory Group (DMPAG), the CPT Editorial Panel approved the RPM code family to reflect modern, device-enabled data collection and physician oversight.
The codes established a framework to describe:
- Setup and patient education on monitoring devices.
- Device supply from the physician’s office to the patient.
- Ongoing physician or qualified health care professional review and treatment management.
In 2021, the CPT code set expanded again to reflect remote therapeutic monitoring (RTM). Capturing non-physiologic data such as cognitive behavioral therapy, musculoskeletal therapy engagements and respiratory status, these codes enabled reporting for services managed by non-physician providers, including physical therapists and respiratory therapists.
A growing body of clinical research demonstrates that patients benefit from remote monitoring over shorter durations than were previously captured in the CPT code set. In response to these findings, the CPT 2026 code set includes new codes to report remote monitoring services over short periods and remote monitoring treatment management after a shorter threshold than previously reflected in the code set.
By enabling payers, physicians and other providers to differentiate between types of monitoring, clinical intent, provider roles and resource use, the structure of the CPT code set supports clarity for documentation, team-based care and sustainable payment methods.
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CPT codes support digital medicine
CPT codes do more than support billing and reporting. They signal to the health care system that new, digitally enabled services are legitimate, scalable and vital to modern care delivery. And as technology continues to evolve, so too will the code set.
With input from the Digital Medicine Payment Advisory Group, CPT work groups and hundreds of stakeholders across health care, the CPT Editorial Panel remains committed to updating the CPT code set to reflect emerging tools, new care models and the increasingly digital nature of health care itself.
To stay updated on timely information about the CPT code set, sign up to receive the AMA’s free monthly email newsletter, CPT News. Subscribe to CPT Assistant Online for in-depth information on the latest codes and trends in medicine, clinical scenarios that help demystify codes, and information for training staff, appealing insurance denials and validating coding to auditors, and answering day-to-day coding questions.
