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CPT 98009: Audio-Only New Patient Evaluation and Management
CPT code 98009 captures a new patient evaluation and management visit delivered via synchronous audio‑only technology when the encounter includes more than 10 minutes of medical discussion, involves low medical decision making, or the clinician documents 30 or more minutes of total time on a single date. This code matters nationally as telehealth expands access to care for patients without video capability and as payers and regulators refine coverage and payment policies for audio‑only services.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes how 98009 is defined, common billing scenarios, and the operational implications for outpatient and remote care delivery. Readers will find concise benchmarks and coding guidance context, recent policy developments relevant to audio‑only telemedicine, and clinical contexts where an audio‑only new patient evaluation may be appropriate. Where payer‑specific policies are not provided in the input, the document notes data unavailability.
The report is intended for billing managers, compliance officers, clinicians, and policy analysts who need a national overview of 98009, its clinical scope, and the payer landscape affecting reimbursement and telehealth program design.
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Billing Code Overview
CPT code 98009 describes a new patient evaluation and management visit conducted using synchronous audio‑only technology. The service requires more than 10 minutes of medical discussion and involves low medical decision making, or the provider spends 30 or more minutes of total time on the encounter on a single date.
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Service type: Audio‑only telemedicine new patient evaluation and management
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Typical site of service: Remote/telehealth setting delivered via synchronous audio‑only communication (patient located offsite from the provider)