CPT 98014 Audio-Only E/M Reimbursement & Policy

CPT code 98014 designates an evaluation-and-management visit for an established patient delivered via synchronous audio-only telehealth. It applies when the encounter involves more than 10 minutes of medical discussion, includes moderate medical decision making, and/or the clinician documents at least 30 minutes of total time on the date of service. The code captures a specific telehealth modality that has grown in relevance as payers and regulators adapt policies for remote care.

Key national payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage approaches, common billing modifiers, and operational considerations tied to audio-only E/M services. The publication summarizes benchmark elements such as typical use cases, documentation expectations, and how moderate-complexity audio-only visits are distinguished from shorter or lower-complexity remote interactions.

The piece outlines the clinical contexts where audio-only E/M is used—notably when video is unavailable—and highlights the administrative elements that affect coding and reimbursement. Data not available in the input is noted where applicable. This summary aims to inform clinicians, billing professionals, and policy analysts about the role and coding parameters of CPT code 98014 in national telehealth practice.

Billing Code Overview

CPT code 98014 describes an evaluation and management (E/M) visit for an established patient conducted using synchronous audio-only technology. The service requires more than 10 minutes of medical discussion, involves moderate medical decision making, and/or the provider documents 30 or more minutes of total time spent on the encounter on a single date.

Service Type: Established patient E/M via synchronous audio-only telehealth

Typical Site of Service: Remote/telehealth setting (audio-only encounter)

Clinical Context

A 58-year-old established patient with type 2 diabetes and hypertension calls the primary care clinic reporting progressive polyuria, increased thirst, and worsening glycemic control over the past two weeks. The practice schedules a synchronous audio-only telehealth visit because the patient lacks video capability. The provider conducts a focused review of systems and medication reconciliation, reviews recent home glucose logs, adjusts oral antihyperglycemic therapy, and spends a total of 30 minutes on the encounter including documentation and care coordination. The encounter requires moderate medical decision making due to medication changes and chronic disease management. The clinic documents consent for audio-only telehealth, documents time spent on the date of service, and bills the visit using 98014 for an established patient audio-only synchronous evaluation and management visit exceeding 10 minutes of discussion and 30 or more minutes total time on the encounter.

Coding Specifications

Modifier	Description	When to Use
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system	Use if the encounter had real-time audio and video (not applicable to audio-only `98014` but commonly relevant when visits convert to video)

Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Primary care providers commonly perform audio-only chronic disease visits billed with `98014`
`207R00000X`	Internal Medicine	Internists manage chronic conditions via telehealth and bill established patient E/M services
`208D00000X`	Cardiovascular Disease	Cardiology may use audio-only visits for medication management and follow-up
`261QP1000X`	Nurse Practitioner	Nurse practitioners provide established patient telehealth visits under their taxonomy
`363LF0000X`	Telehealth	Telehealth-specific taxonomy used by clinicians focusing on virtual care

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E11.9`	Type 2 diabetes mellitus without complications	Common chronic condition managed via audio-only telehealth visits for medication adjustment and glucose control
`I10`	Essential (primary) hypertension	Frequently co-managed during established patient telehealth encounters
`J44.9`	Chronic obstructive pulmonary disease, unspecified	COPD follow-up and medication management often handled via audio-only visits when in-person exam is not required
`F41.1`	Generalized anxiety disorder	Behavioral health follow-up and medication management can be conducted via audio-only synchronous visits
`M54.5`	Low back pain	Established patient follow-up for chronic musculoskeletal pain that may be managed or triaged by phone

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99490`	Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month	Often provided in parallel to episodic `98014` visits for ongoing chronic disease management and care coordination
`99457`	Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver	Can complement `98014` when remote monitoring data informs treatment changes discussed during the audio-only visit
`99214`	Office or other outpatient established patient visit, typically 25 minutes of face-to-face time	In-person counterpart for a moderate complexity established patient visit; use when an in-person visit occurs instead of or following `98014`
`99091`	Collection and interpretation of physiologic data (eg, ECG, blood pressure) digitally stored and/or transmitted by the patient and/or caregiver, requiring a minimum of 30 minutes of time	Related when data reviewed informs the telephonic management billed with `98014`
`99421`	Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes	Asynchronous digital communication option related to telephonic synchronous care like `98014`

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Summary & Overview

CPT 98014: Established Patient E/M via Audio-Only, Moderate Complexity