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CPT 98010: New Patient Audio-Only Evaluation, Moderate Complexity
CPT code 98010 designates a new-patient evaluation and management visit delivered via synchronous audio-only telecommunication. The code applies when the encounter requires more than 10 minutes of medical discussion and involves moderate medical decision making, or when the clinician documents 45 or more minutes of total encounter time on a single date. As audio-only telehealth remains an access option for patients without video capability, this code clarifies billing for substantial telephonic clinical services that approximate in-person complexity.
Key payers in the national context include Aetna, Blue Cross Blue Shield plans, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code represents, payer coverage patterns, relevant billing considerations, and the clinical situations that typically generate use of this code. The publication covers benchmarks and reimbursement context where available, summarizes recent policy shifts affecting audio-only telehealth adoption, and outlines typical service lines and sites of service tied to this code.
This summary is intended for clinicians, billing professionals, and policy analysts seeking a national-level briefing on CPT code 98010, its clinical intent, and its role in telehealth service delivery.
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Billing Code Overview
CPT code 98010 describes a new patient evaluation and management visit delivered using synchronous audio–only technology. The service requires more than 10 minutes of medical discussion and involves moderate medical decision making, and/or the provider documents 45 or more minutes of total time spent on the encounter on a single date.
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Service type: Telemedicine — synchronous audio-only evaluation and management
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Typical site of service: Remote/virtual (patient location outside a clinician’s office), delivered via real-time audio-only communication