Improve your medical practice’s financial sustainability: Leverage the 2025 ICD-10-CM, CPT, and HCPCS coding updates

Every year, hundreds of new medical codes enable healthcare providers to capture the totality of each patient’s unique story. These medical codes, along with other important details on the medical claim, unlock the who, what, where, when, and why of each healthcare encounter. 

It’s important to understand the changes and report accurate codes to promote clean claims, enhance data analytics and population health management, and improve revenue integrity.

The good news? 

In 2025, the details of that story will be richer and more specific than ever. Every year, medical codes become more specific as we learn new information about health outcomes and patterns and develop new healthcare technologies and procedures. The pace of change will likely continue to increase over time, making comprehensive revenue cycle management a necessary business strategy. 

Read on to learn about essential medical coding updates for 2025.

There are 3 types of medical codes to put on your radar: CPT, ICD-10 (CM and PCS), and HCPCS Level II codes. What is the relationship between CPT, ICD-10, and HCPCS Level II codes? 

Each type conveys different information to payers, providers, regulators, researchers, and others. However, they’re all equally important in the big picture, and they’re all necessary to tell a complete and accurate story. 

Consider the following:

Following are some common questions about medical coding updates for 2025. As you review these questions, be sure to also take a look at the list of telehealth services for calendar year (CY) 2025. These are services payable under the Medicare Physician Fee Schedule when furnished via telehealth through December 31, 2025. 

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There are 252 new ICD-10-CM diagnosis codes that took effect October 1, 2024. For example, there are new medical codes for social determinants of health, presymptomatic type 1 diabetes mellitus, nasal valve collapse, Fanconi anemia, and much more. 

Here’s how the new ICD-10-CM codes are broken down by chapter in the FY 2025 ICD-10-CM coding manual:

If you want to know how to apply these codes, be sure to check out the FY 2025 ICD-10-CM official coding guidelines — particularly the text in bold font that indicates new information.

To learn more about all of the ICD-10-CM code changes for 2025, including the 36 code deletions and 13 code revisions, visit this site. 

There are 270 new CPT codes that took effect January 1, 2025, including many new codes for medical innovations, new technologies, and cutting-edge procedures.

It’s important to note that Medicare is not covering these codes for 2025, and the existing guidelines for billing telehealth services to Medicare still apply. 

Here are some of the highlights:

Other CPT changes for 2025 include updates to CPT’s general surgery section to reflect new surgical approaches in skin grafts for wound care and recovery (CPT codes 15011–15018) and advancements in surgical techniques for the elimination of tumors within the abdomen (CPT codes 49186–49190). 

CPT changes for 2025 also include various changes to vaccination codes and proprietary laboratory analyses codes. Be sure to review those with your medical coding team. 

In addition, these 6 new CPT codes, effective January 1, 2026, cover the first 2–15 days of remote patient monitoring:

To learn more about all of the CPT changes for 2025, visit this site. 

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There are 309 HCPCS Level II codes that took effect on January 1, 2025. These include:

Be sure to review these new HCPCS codes to determine whether you may be able to generate additional revenue:

Here’s a good summary of the CY 2025 Medicare Physician Fee Schedule Final Rule that explains how to bill these and many other new codes. Be sure to review this concise document with your medical coding and billing teams, as well as physicians and other providers in the medical practice.

To learn more about HCPCS Level II coding updates, visit HCPCS Quarterly Update | CMS. 

The bottom-line answer to that question is education, education, education. 

Educate yourself on what’s new and how it might impact clinical documentation and other workflows. With the 2025 medical coding update, there are countless opportunities to capture greater specificity, address healthcare disparities, improve outcomes, and boost medical practice revenue. Understanding the changes is paramount. 

Work with your staff to identify changes impacting your medical practice and strive for data and revenue integrity in 2025 and beyond.

Editor’s note: This article has been updated to reflect 2025 coding changes.