CPT 2025 Anticipated Code Changes 

The 2025 Current Procedural Terminology (CPT®) updates bring significant shifts to the way radiology, telemedicine, and various procedural services are coded. With new introductions and revisions, providers will need to understand how these changes will influence their practice workflows, documentation, and billing. 

This article breaks down the major anticipated changes, focusing on new codes, revisions, and deletions across critical areas such as MRI-monitored procedures, transcranial Doppler studies, percutaneous radiofrequency ablation of the thyroid, fascial plane blocks, and telemedicine services. Providers are encouraged to review these updates in detail to ensure smooth implementation and avoid any disruptions in reporting or reimbursements. 

Category I: New Codes Effective January 1, 2025 

MR Examination Safety Procedures 

A completely new subsection will be introduced under the Radiology/Diagnostic Imaging section to address Magnetic Resonance (MR) Safety Implant/Foreign Body Procedures. Six new codes will describe the specialized work associated with MRI safety services for patients with implants, devices, or foreign bodies. 

These codes will include procedures such as: 

• Safety consultation 

• Implant or foreign body evaluation 

• Customized medical physics exam preparation 

• Implant positioning or immobilization 

For radiology practices, these new codes underscore the growing emphasis on ensuring patient safety and proper assessment before MRI examinations, particularly in complex cases involving implants or foreign materials. 

MRI-Monitored Transurethral Ultrasound Ablation (TULSA) 

MRI-monitored TULSA employs advanced, robotically driven thermal ultrasound technology with closed-loop temperature feedback to deliver precise prostate tissue ablation. This minimally invasive procedure is gaining traction for treating localized prostate cancer. 

The addition of this new code reflects the increasing utilization of MRI technologies in therapeutic applications, highlighting their importance in delivering predictable, physician-guided outcomes. 

MRI-Guided High-Intensity Focused Ultrasound (MRgFUS) 

The existing Category III code 0398T, which reports MRI-guided high-intensity focused ultrasound, will be elevated to Category I status and subsequently deleted. Three new Category I codes will be established to report this procedure, which is used for non-invasive ablation of tissue within the skull for movement disorders. 

The new codes will account for key components of the procedure: 

1. Treatment planning 

2. Insertion and guidance 

3. Ablation of the targeted tissue 

The elevation to Category I solidifies MRgFUS as a well-established procedure, aligning it with current clinical usage and growing provider adoption. 

Transcranial Doppler (TCD) 

Three new add-on codes will expand reporting for procedures performed alongside transcranial Doppler studies, focusing on: 

• Vasoreactivity studies 

• Emboli detection without intravenous microbubble injection 

• Venous-arterial shunt detection with intravenous microbubble injection 

Additionally: 

• Code 93893 will be revised to specify venous-arterial shunt detection. 

• Code 93890 will be deleted. 

These changes streamline and clarify transcranial Doppler reporting, ensuring more accurate coding for studies involving emboli detection and shunt evaluations. 

Percutaneous Radiofrequency Ablation (RF) of Thyroid 

A major advancement for thyroid procedures, the 2025 CPT set introduces a new code for percutaneous RF ablation of the thyroid under imaging guidance. An add-on code will also be available for reporting the ablation of additional thyroid nodules. 

This change addresses a long-standing gap in the CPT code set, as RF ablation of thyroid nodules had no dedicated code prior to 2025. 

Fascial Plane Blocks (FPB) 

Six new codes will describe fascial plane block (FPB) procedures for postoperative pain management in the: 

• Thoracic 

• Lower extremity 

• Abdominal regions 

The revisions include updates to codes 64486-64489 for Transversus Abdominis Plane (TAP) blocks and corresponding guidelines. These changes reflect the evolving clinical use of fascial plane blocks and the increasing need for precision in post-surgical pain management. 

Telemedicine Services: A New E/M Subsection 

One of the most notable changes in the 2025 CPT code set is the addition of 17 new telemedicine codes under a dedicated subsection for E/M office visits and other outpatient services. 

The new telemedicine codes will cover both: 

• Audio-visual visits 

• Audio-only visits 

Structured similarly to existing E/M codes, they will include four levels of service based on: 

1. Medical decision-making 

2. Time spent on the encounter 

Separate codes will distinguish between new and established patients. 

Additionally: 

• A new virtual check-in code will allow providers to report brief assessments to determine if an in-person visit is necessary. This new service mirrors HCPCS code G2012. 

• Codes 99441, 99442, and 99443 (previous telephone E/M services) will be deleted. 

These changes aim to streamline telemedicine reporting and accommodate the growing demand for remote care options. 

Revisions to Vascular Procedures 

Guidelines in the Vascular Procedures subsection of the Radiology section will be revised to clarify the use of add-on code 75774. This code, which reports angiography for each additional vessel studied, will now explicitly apply to arteries and veins. 

The parenthetical notes directing providers to codes 75600-75756 (angiography) and 36215-36248 (catheterization) will be deleted to reduce confusion and redundancy. 

Revised and Deleted Codes 

The following notable revisions and deletions will take effect in 2025: 

• Revised: Codes 64486-64489 (TAP blocks) and 93893 (TCD studies) 

• Deleted: 

• 0398T (MRgFUS for intracranial ablation) 

• 93890 (TCD vasoreactivity study) 

• 99441-99443 (Telephone E/M services) 

Category III Extensions 

Several Category III codes, originally scheduled to sunset in 2025, will be extended until December 2030. Notable extensions include: 

• 0071T/0072T: Focused ultrasound ablation of uterine leiomyomata 

• 0075T/0076T: Extracranial vertebral artery stenting 

• 0200T/0201T: Sacroplasty procedures 

• 0554T-0558T: Bone strength and fracture risk analysis using finite element analysis 

• 0561T/0562T: 3D-printed anatomical guides 

These extensions ensure continued access to innovative technologies while additional clinical evidence accumulates. 

Preparing for the Changes 

Providers must proactively prepare for the 2025 CPT code changes to ensure accurate documentation, billing, and reimbursement. Here are key steps to consider: 

1. Educate staff and coders on new, revised, and deleted codes. 

2. Update EHR systems and coding tools to reflect the changes. 

3. Review workflows for MR safety procedures, telemedicine visits, and new procedural services. 

4. Consider training on evolving technologies like MRI-monitored TULSA and MRgFUS. 

By understanding and integrating these updates, practices can minimize disruptions and optimize reporting accuracy for the year ahead. 

The 2025 CPT code changes reflect the dynamic nature of healthcare and the ongoing adoption of advanced technologies in radiology, telemedicine, and pain management. From new codes for MR safety procedures and transcranial Doppler studies to the formalization of telemedicine E/M visits, these updates mark a significant step toward improved clarity and precision in medical coding. 

As always, providers are encouraged to stay informed, adapt to changes, and leverage these updates to enhance patient care and practice efficiency.