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CPT 98015: Audio-Only E/M for Established Patients, High Complexity

CPT code 98015 represents an established-patient evaluation and management visit delivered via synchronous audio-only telehealth. The service is defined by more than 10 minutes of medical discussion and either high medical decision making or 40 or more minutes of total provider time on a single date. Nationally, this code matters because it formalizes billing for higher-complexity audio-only encounters, affecting access to telemedicine for patients without video capability and shaping payer coverage policies for remote care.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what CPT code 98015 represents, how it applies to remote/telehealth service delivery, and the typical clinical contexts that may generate its use. The publication covers benchmarking elements, recent policy and coverage considerations relevant to audio-only E/M services, and clinical context around encounter complexity and time-based coding. Data not available in the input is noted where applicable.

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Billing Code Overview

CPT code 98015 describes an established patient evaluation and management visit delivered using synchronous audio-only technology. The service requires more than 10 minutes of medical discussion and involves high medical decision making, and/or the provider spends 40 or more minutes of total time on the encounter on a single date.

Service type: Audio-only telemedicine evaluation and management for established patients

Typical site of service: Remote/telehealth (audio-only), provided to the patient in a non-clinic location such as their home or other remote setting

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CPT 98015: Audio-Only E/M for Established Patients, High Complexity

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Billing Code Overview

Service type: Audio-only telemedicine evaluation and management for established patients

Typical site of service: Remote/telehealth (audio-only), provided to the patient in a non-clinic location such as their home or other remote setting

Clinical & Coding Specifications

Clinical Context

An established adult patient with chronic congestive heart failure and multiple recent medication changes requests an audio-only visit for symptom worsening, medication reconciliation, and urgent adjustment of therapy. The patient has limited internet access and cannot complete a video visit. The nurse schedules a synchronous telephone encounter with the primary care cardiology advanced practice provider. The provider conducts a focused history of present illness, reviews home weight logs and blood pressure readings, assesses symptom severity (dyspnea at rest, orthopnea, edema), reviews recent laboratory results available in the EHR, and makes high-level medication decisions including titration of diuretics and ordering same-day laboratory monitoring. The visit involves prolonged clinical discussion exceeding 10 minutes, with the provider spending a total of 40 or more minutes on the encounter date including pre- and post-encounter work (reviewing records, messaging, and care coordination). Documentation includes reason for audio-only format, consent for telephone care, detailed history, medical decision making that supports high complexity, time spent on the date, and any orders or prescriptions placed. Typical payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare. Typical site of service is the patient’s home or another non-facility location where the patient is located during the audio-only encounter.

Coding Specifications

Modifier	Description	When to Use
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system	Use when telehealth visit is provided via audio-video (not audio-only); do not use for `98015` which is audio-only.
`93`	Synchronous audio-only interaction	Use to indicate the service was provided via audio-only synchronous technology when required by payer policy.
`25`	Significant, separately identifiable E/M service by the same physician on the same day	Use when an unrelated or additional in-person or telehealth E/M is billed the same day as other procedures.
`52`	Reduced services	Use when the service provided is partially reduced or not fully performed as described by the CPT code.
`53`	Discontinued procedure	Use if the audio-only encounter was started but discontinued due to patient condition or technical issues.
`22`	Increased procedural services	Use when work is substantially greater than typical and documentation supports increased work; may support additional payment when allowed.
`23`	Unusual anesthesia	Rare for this service; included for completeness when unusual anesthesia circumstances apply in same-day procedures.
`78`	Unplanned return to the operating room by the same physician following initial procedure	Not typical for `98015`; use only when a related unplanned return to OR occurs on same day.
`95`	(duplicate intentionally excluded — see `93`)
`GT`	Via interactive audio and video telecommunication systems	Use when payer recognizes `GT` for telehealth audio-video; not applicable to audio-only `98015`.
`QY`	Qualified non-physician health professional service furnished via an asynchronous telecommunications system	Use when asynchronous store-and-forward technology is used by non-physician clinicians; not typical for synchronous audio-only `98015`.
`QX`	Service performed by a certified nurse-midwife or clinical nurse specialist with a collaborating/attending physician	Use to indicate services performed by applicable non-physician practitioners under supervision when reporting their services.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals	Not relevant to `98015`; included only if anesthesia direction is part of same-day services.

Taxonomy Code	Specialty	Notes
`207P00000X`	Family Medicine	Primary care physicians frequently provide audio-only telemedicine E/M for chronic disease management.
`208D00000X`	Cardiology	Cardiologists or cardiology APPs manage complex heart failure follow-up via audio-only encounters when appropriate.
`363L00000X`	Nurse Practitioner	Nurse practitioners commonly deliver telephonic E/M visits for medication management and care coordination.
`3086S0123X`	Physician Assistant	Physician assistants provide synchronous telephone evaluations and management under supervising physician arrangements.
`207R00000X`	Internal Medicine	Internists manage complex chronic conditions and perform high medical decision making during audio-only visits.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.33`	Acute on chronic systolic (congestive) heart failure	Common reason for audio-only urgent management and medication titration in follow-up encounters.
`I50.32`	Chronic systolic (congestive) heart failure	Ongoing management with frequent medication adjustments and monitoring via telephone encounters.
`I10`	Essential (primary) hypertension	Frequently coexists and is reviewed during medication reconciliation and clinical decision making.
`E11.9`	Type 2 diabetes mellitus without complications	Common comorbidity requiring medication review and lab monitoring discussed during the visit.
`R06.02`	Shortness of breath	Symptom prompting urgent audio-only evaluation and treatment adjustments.
`R60.0`	Localized edema	Symptom assessed during heart failure and other volume-overload management via phone.
`Z71.83`	Encounter for dietary counseling and surveillance	Counseling and self-management education often provided during extended telephone encounters.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99441`	Telephone evaluation and management service by a physician or other qualified health care professional, 5-10 minutes of medical discussion	Use for shorter audio-only telephone E/M encounters; lower-intensity alternative when total discussion time is less than required for `98015`.
`99442`	Telephone evaluation and management service by a physician or other qualified health care professional, 11-20 minutes of medical discussion	Use for moderate-length telephone E/M visits when time meets `99442` thresholds but does not meet `98015` complexity/time requirements.
`99443`	Telephone evaluation and management service by a physician or other qualified health care professional, 21-30 minutes of medical discussion	Use for longer telephone E/M visits up to 30 minutes when complexity/time fall short of `98015` criteria.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Use when an in-person established patient visit is performed instead of an audio-only encounter; may be billed on same day with appropriate modifiers when separate and distinct.
`99091`	Collection and interpretation of physiologic data digitally stored and/or transmitted by the patient to the physician or other qualified health care professional	Use adjunctively when remote physiologic monitoring data are reviewed in conjunction with the audio-only visit.

CPT 98012: Audio-only E/M Visit for Established Patient

CPT-98013-AUDIO-ONLY-EVALUATION-ESTABLISHED-PATIENT

CPT 98013: Audio-Only E/M Visit for Established Patients, Low MDM

CPT-98014-ESTABLISHED-PATIENT-AUDIO-ONLY-EM-MODERATE-COMPLEXITY

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

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system	Use when telehealth visit is provided via audio-video (not audio-only); do not use for `98015` which is audio-only.
`93`	Synchronous audio-only interaction	Use to indicate the service was provided via audio-only synchronous technology when required by payer policy.
`25`	Significant, separately identifiable E/M service by the same physician on the same day	Use when an unrelated or additional in-person or telehealth E/M is billed the same day as other procedures.
`52`	Reduced services	Use when the service provided is partially reduced or not fully performed as described by the CPT code.
`53`	Discontinued procedure	Use if the audio-only encounter was started but discontinued due to patient condition or technical issues.
`22`	Increased procedural services	Use when work is substantially greater than typical and documentation supports increased work; may support additional payment when allowed.
`23`	Unusual anesthesia	Rare for this service; included for completeness when unusual anesthesia circumstances apply in same-day procedures.
`78`	Unplanned return to the operating room by the same physician following initial procedure	Not typical for `98015`; use only when a related unplanned return to OR occurs on same day.
`95`	(duplicate intentionally excluded — see `93`)
`GT`	Via interactive audio and video telecommunication systems	Use when payer recognizes `GT` for telehealth audio-video; not applicable to audio-only `98015`.
`QY`	Qualified non-physician health professional service furnished via an asynchronous telecommunications system	Use when asynchronous store-and-forward technology is used by non-physician clinicians; not typical for synchronous audio-only `98015`.
`QX`	Service performed by a certified nurse-midwife or clinical nurse specialist with a collaborating/attending physician	Use to indicate services performed by applicable non-physician practitioners under supervision when reporting their services.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals	Not relevant to `98015`; included only if anesthesia direction is part of same-day services.

Taxonomy Code	Specialty	Notes
`207P00000X`	Family Medicine	Primary care physicians frequently provide audio-only telemedicine E/M for chronic disease management.
`208D00000X`	Cardiology	Cardiologists or cardiology APPs manage complex heart failure follow-up via audio-only encounters when appropriate.
`363L00000X`	Nurse Practitioner	Nurse practitioners commonly deliver telephonic E/M visits for medication management and care coordination.
`3086S0123X`	Physician Assistant	Physician assistants provide synchronous telephone evaluations and management under supervising physician arrangements.
`207R00000X`	Internal Medicine	Internists manage complex chronic conditions and perform high medical decision making during audio-only visits.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.33`	Acute on chronic systolic (congestive) heart failure	Common reason for audio-only urgent management and medication titration in follow-up encounters.
`I50.32`	Chronic systolic (congestive) heart failure	Ongoing management with frequent medication adjustments and monitoring via telephone encounters.
`I10`	Essential (primary) hypertension	Frequently coexists and is reviewed during medication reconciliation and clinical decision making.
`E11.9`	Type 2 diabetes mellitus without complications	Common comorbidity requiring medication review and lab monitoring discussed during the visit.
`R06.02`	Shortness of breath	Symptom prompting urgent audio-only evaluation and treatment adjustments.
`R60.0`	Localized edema	Symptom assessed during heart failure and other volume-overload management via phone.
`Z71.83`	Encounter for dietary counseling and surveillance	Counseling and self-management education often provided during extended telephone encounters.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99441`	Telephone evaluation and management service by a physician or other qualified health care professional, 5-10 minutes of medical discussion	Use for shorter audio-only telephone E/M encounters; lower-intensity alternative when total discussion time is less than required for `98015`.
`99442`	Telephone evaluation and management service by a physician or other qualified health care professional, 11-20 minutes of medical discussion	Use for moderate-length telephone E/M visits when time meets `99442` thresholds but does not meet `98015` complexity/time requirements.
`99443`	Telephone evaluation and management service by a physician or other qualified health care professional, 21-30 minutes of medical discussion	Use for longer telephone E/M visits up to 30 minutes when complexity/time fall short of `98015` criteria.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Use when an in-person established patient visit is performed instead of an audio-only encounter; may be billed on same day with appropriate modifiers when separate and distinct.
`99091`	Collection and interpretation of physiologic data digitally stored and/or transmitted by the patient to the physician or other qualified health care professional	Use adjunctively when remote physiologic monitoring data are reviewed in conjunction with the audio-only visit.

CPT 98012: Audio-only E/M Visit for Established Patient

CPT-98013-AUDIO-ONLY-EVALUATION-ESTABLISHED-PATIENT

CPT 98013: Audio-Only E/M Visit for Established Patients, Low MDM

CPT-98014-ESTABLISHED-PATIENT-AUDIO-ONLY-EM-MODERATE-COMPLEXITY

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

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 98015: Audio-Only E/M for Established Patients, High Complexity

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Billing Code Overview

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CPT 98015: Audio-Only E/M for Established Patients, High Complexity

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 98015: Audio-Only E/M for Established Patients, High Complexity

Sign up for cpt 98015 policy alerts

Billing Code Overview

CPT 98015: Audio-Only E/M for Established Patients, High Complexity

Sign up for cpt 98015 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical situation does CPT 98015 represent and where is it typically provided?

Which modifiers should be used when billing 98015, and which should be avoided?

How does 98015 relate to other telephone E/M codes like 99441–99443?

What documentation elements are highlighted in the clinical context to support billing 98015?

Which payers are commonly associated with CPT 98015 coverage?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical situation does CPT 98015 represent and where is it typically provided?

Which modifiers should be used when billing 98015, and which should be avoided?

How does 98015 relate to other telephone E/M codes like 99441–99443?

What documentation elements are highlighted in the clinical context to support billing 98015?

Which payers are commonly associated with CPT 98015 coverage?

References