New CPT Codes Effective January 1, 2025
This section lists the new eyecare-related CPT codes that are effective January 1, 2025.
While AMA has proposed new telehealth codes, Medicare has not yet adopted them. VSP will continue to accept the following telehealth codes for established patients: 99421–99423.
Check with your insurance carriers to determine which telehealth codes they are accepting.
| New Code | Description | Notes |
|---|---|---|
| 92137 | Computerized ophthalmic diagnostic imaging of retina, with OCT angiography, with interpretation and report [bilateral or unilateral] | Cannot be billed on the same encounter as 92133 or 92134. |
| 66683 | Implantation of iris prosthesis [with or without suture fixation and/or repair or removal of iris] | Cannot be billed on the same encounter as 65800, 65810, 65815, 65865, 65870, 65875, 66020, 66030, 66500, 66505, 66600, 66625, 66630, 66635, 66680, 66682, 66770, 67500, 67515, or 69990 for the same eye, same surgeon, or same operative session. |
| 98000 | Synchronous audio-only visit for evaluation and management of new patient, including medically appropriate history and straightforward medical decision making If using time, at least 15 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98001 | Synchronous audio-only visit for evaluation and management of new patient, including medically appropriate history and low medical decision making If using time, at least 30 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98002 | Synchronous audio-only visit for evaluation and management of new patient, including medically appropriate history and moderate medical decision making If using time, at least 45 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98003 | Synchronous audio-only visit for evaluation and management of new patient, including medically appropriate history and high medical decision making If using time, at least 60 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98004 | Synchronous audio-only visit for evaluation and management of established patient, including medically appropriate history and straightforward medical decision making If using time, at least 10 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98005 | Synchronous audio-only visit for evaluation and management of established patient, including medically appropriate history and low medical decision making If using time, at least 20 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98006 | Synchronous audio-only visit for evaluation and management of established patient, including medically appropriate history and moderate medical decision making If using time, at least 30 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98007 | Synchronous audio-only visit for evaluation and management of established patient, including medically appropriate history and high medical decision making If using time, at least 40 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98008 | Synchronous audio-only visit for evaluation and management of new patient, including medically appropriate history and straightforward medical decision making, with more than 10 minutes of medical discussion. If using time, at least 15 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98009 | Synchronous audio-only visit for evaluation and management of new patient, including medically appropriate history and low medical decision making, with more than 10 minutes of medical discussion. If using time, at least 30 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98010 | Synchronous audio-only visit for evaluation and management of new patient, including medically appropriate history and moderate medical decision making, with more than 10 minutes of medical discussion. If using time, at least 45 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98011 | Synchronous audio-only visit for evaluation and management of new patient, including medically appropriate history and high medical decision making, with more than 10 minutes of medical discussion. If using time, at least 60 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98012 | Synchronous audio-only visit for evaluation and management of established patient, including medically appropriate history and straightforward medical decision making, with more than 10 minutes of medical discussion. If using time, at least 10 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98013 | Synchronous audio-only visit for evaluation and management of established patient, including medically appropriate history and low medical decision making, with more than 10 minutes of medical discussion. If using time, at least 20 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98014 | Synchronous audio-only visit for evaluation and management of established patient, including medically appropriate history and moderate medical decision making, with more than 10 minutes of medical discussion. If using time, at least 30 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98015 | Synchronous audio-only visit for evaluation and management of established patient, including medically appropriate history and high medical decision making, with more than 10 minutes of medical discussion. If using time, at least 40 minutes of total time on the encounter date must be met. | Medicare not accepting in 2025 |
| 98016 | Brief communication technology-based service (e.g., virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the previous 7 days nor leading to an evaluation and management service or procedure within the next 24 hours or soonest available appointment, 5-10 minutes of medical discussion | Replaces the G2012 HCPCS code |