CPT Code 98000: What the 98000-98016 Telehealth Codes Cover

CPT codes 98000 through 98016 are a telehealth-specific evaluation and management set the AMA introduced for dates of service starting January 1, 2025. They cover synchronous audio-video visits, synchronous audio-only visits, and one brief check-in, split by whether the patient is new or established. As of July 2026, Medicare still won't pay for any of them except 98016. For a cash-pay superbill, that split is the whole story: default to the traditional 99202-99215 codes with a modifier, and treat a 98000-series code as an exception you confirm payer by payer.

This applies across telehealth specialties, though the worked examples below use a psychiatric visit. For every other CPT code question that lands on a cash-pay superbill, from E/M levels to psychotherapy add-ons, the CPT code guide for superbills is the place to start.

What does the full 98000-98016 set cover?

The 17 codes mirror the familiar 99202-99215 office-visit ladder exactly, just sorted by modality and patient status instead of living inside one code family:

Selection works the same way it does for a regular office visit: pick the level by total time on the date of service, or by medical decision-making complexity, whichever is higher, per the AMA's own explanation of the code set. A 30-minute established-patient video follow-up with moderate decision-making lands on 98006, the direct telehealth counterpart to a 99214.

Does Medicare pay for CPT codes 98000-98015?

No. CMS assigned codes 98000 through 98015 an invalid payment status on the Medicare Physician Fee Schedule the moment they took effect, and Noridian, the Medicare Administrative Contractor for several regions, states it plainly: "Medicare does not recognize the new American Medical Association (AMA) CPT codes (98000-98015) for E/M telehealth services." A claim billed with any of those 14 codes to Medicare comes back denied outright.

This isn't a one-year hiccup CMS is expected to fix. The CY2026 Medicare Physician Fee Schedule final rule reaffirmed the position for a second straight year: CMS maintains that CPT's telemedicine E/M codes aren't eligible for the Medicare telehealth services list under current statute. For Medicare patients, the instruction hasn't changed since 2025: keep billing 99202-99215 with place-of-service 02 or 10 and modifier 95 for an audio-video visit, or modifier 93 for audio-only.

What is CPT code 98016, and why does Medicare pay only that one?

98016 is a brief, established-patient check-in, 5 to 10 minutes, that can't be tied to an E/M visit in the prior 7 days or the next 24 hours. It's a direct swap for the old HCPCS code G2012, which Medicare retired the same day 98016 took effect, so the AAFP's coding guidance treats it as the current code for the same service: a quick call to decide whether a full visit is actually needed. Because it already existed in substance as G2012, adding it cost Medicare nothing structurally, which is likely why it cleared while its 14 siblings didn't. Published Medicare rates put the non-facility payment around $16, a small fee, but a real one for the phone triage most practices already do without billing it.

Do commercial payers accept the 98000-98015 codes?

Inconsistently, and that's the operative fact for anyone building a superbill around them. Some commercial plans and a handful of state Medicaid programs have adopted the set; a large share have not, and payer policy on this has kept shifting since the codes launched. There is no shortcut around checking a specific payer before you rely on one of these codes for a specific patient. Treat "does my patient's plan accept 98006" as a per-payer, date-stamped question, the same way you'd treat an allowed-amount question in how superbills work.

Should a 98000-series code go on your superbill instead of 99xxx + modifier 95?

Default to the traditional code. Put 99202-99215 with modifier 95 (or 93 for audio-only) on your superbills unless you've specifically confirmed the patient's payer processes the 98000-series cleanly. The reasoning is mechanical: a superbill only works if the patient's insurer can price the code on it, and 99202-99215 with the right modifier is the one combination every payer, Medicare included, is guaranteed to recognize. A 98xxx code is a bet that this particular payer has caught up, and if it hasn't, your patient absorbs the cost, a bounced or delayed reimbursement check.

Earn the exception payer by payer rather than assuming it broadly: if you've watched a specific commercial payer pay cleanly on a 98000-series code for one patient, it's reasonable to use it again for other patients on that same plan. Keep that as payer-specific knowledge until the codes see wider uptake. Whatever generates your superbills, self-service beats staff re-deciding the code by hand on every request; on Eureka, superbills already pull the CPT code from the visit's own coded record, so this default gets set once rather than judged per patient.

Coding rules here vary by payer and continue to shift; confirm current acceptance with the specific plan, and loop in a billing-savvy CPA for anything that affects how you code Medicare patients specifically.

What happened to the old telephone codes, 99441-99443?

They're gone. CPT deleted 99441, 99442, and 99443 effective January 1, 2025, and Medicare issued no replacement HCPCS codes for them. Audio-only visits now route one of two ways: through 98008-98015 where the payer has adopted the new set, or through 99202-99215 with modifier 93 where it hasn't, which for Medicare patients is the only option. If your service still lists an old 994xx phone code anywhere in your fee schedule or your EHR's service setup, that line needs updating regardless of which payers you see.