CPT code 98011 covers a new patient evaluation and management visit conducted via synchronous audio-only telecommunication when the encounter involves more than 10 minutes of medical discussion and meets criteria for high medical decision making or 60+ minutes of total provider time on a single date. The code formalizes billing for audio-only telemedicine used for comprehensive new-patient evaluations when video is not available or appropriate, reflecting expanded remote care options nationwide.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how this code is defined clinically, typical sites of service, and the payer landscape relevant to audio-only telehealth claims. The publication summarizes benchmark considerations, documentation and billing elements implicit in the code definition, and recent policy activity affecting audio-only evaluation and management services. It highlights clinical contexts where a new-patient audio-only E/M might be used and outlines what to expect in payer coverage and claim adjudication at a national level.

This summary is intended for clinicians, billing professionals, and policy analysts seeking a concise briefing on CPT code 98011, its clinical scope, and its implications for telehealth practice and reimbursement.