Audio-Only Telehealth & Communication Codes
Clinii’s Audio-Only Telehealth solutions allow providers to deliver, document, and bill real-time phone-based encounters that meet CPT 98008–98016 criteria—helping practices expand access to care, maintain compliance, and capture full reimbursement for remote communication services.
What Are Audio-Only Telehealth Codes?
Introduced in 2025, CPT 98008–98016 defines a new family of audio-only evaluation and management (E/M) and communication technology-based services (CTBS). These codes replaced the discontinued telephone visit codes 99441–99443 and HCPCS G2012, bringing audio-only encounters into alignment with E/M documentation standards.
The series is divided by patient type (new vs. established) and level of complexity or duration:
- CPT 98008–98011: New patient audio-only E/M visits (10–74 min, straightforward → high MDM).
- CPT 98012–98015: Established patient audio-only E/M visits (10–74 min, straightforward → high MDM).
- CPT 98016: Established patient brief communication (5–10 min), replacing G2012.
These codes recognize the clinical and administrative work involved in phone-only encounters while ensuring documentation and compliance mirror those of audiovisual or in-person visits.
Primary Aims of Audio-Only Coding
Expand Equitable Access to Care
Audio-only codes enable providers to deliver reimbursable care for patients lacking broadband, video capability, or technical literacy. This ensures equitable access to follow-ups, chronic disease management, and acute assessments—especially in rural or underserved communities.
Maintain Clinical Quality and Compliance
Each audio-only code mirrors standard E/M structure, requiring documentation of MDM or time, patient consent, and synchronous communication. This ensures clinical quality and audit-ready compliance equal to in-person care.
Support Reimbursement for Remote Encounters
Providers can now bill for meaningful medical discussions conducted entirely by phone. Whether addressing medication management, symptom review, or lab interpretation, CPT 98008–98016 ensures compensation for legitimate telehealth care time.
Streamline Coding for Simpler Workflows
Unified E/M frameworks mean providers no longer track separate billing rules for phone calls. Documentation logic, time thresholds, and risk criteria align directly with the standard E/M structure already used in Clinii’s platform.
Preserve Patient-Initiated Flexibility
Most audio-only codes, particularly CPT 98016, require that the interaction be initiated by the patient or caregiver. This distinction prevents double-billing and preserves the integrity of on-demand, patient-driven communication.
Simplify Billing Integration with Clinii
Clinii automatically detects communication modality, captures duration, and recommends appropriate audio-only CPT codes. The workflow ensures every eligible encounter is captured without added administrative steps.
Audio-Only Codes
CPT 98008
Straightforward MDM or 10–19 minutes of total time. Used for low-complexity new-patient phone encounters addressing simple issues.
CPT 99202CPT 98009
Low MDM or 20–29 minutes of total time. Suitable for new-patient discussions involving limited data review or management decisions.
CPT 99203CPT 98010
Moderate MDM or 30–44 minutes of total time. Applies when multiple or evolving problems are discussed, requiring moderate risk assessment.
CPT 99204CPT 98011
High MDM or 60–74 minutes of total time. Reserved for complex new-patient audio-only encounters involving extensive data review and coordination.
CPT 99205CPT 98012
Straightforward MDM or 10–19 minutes of total time for established patients. Typically used for brief, low-risk audio-only follow-ups.
CPT 98012CPT 98013
Low MDM or 20–29 minutes of total time. Common for established-patient phone visits addressing stable conditions or medication management.
CPT 98013CPT 98014
Moderate MDM or 30–44 minutes of total time. Covers extended audio-only discussions involving multiple issues or moderate risk.
CPT 98015CPT 98015
High MDM or 60–74 minutes of total time. For established-patient encounters requiring complex decision making and longitudinal care coordination.
CPT 98015CPT 98016
Brief communication (CTBS) lasting 5–10 minutes, initiated by the patient. Used for follow-ups, medication checks, or clarification calls that do not result in a related E/M visit within 7 days.
CPT 98016Key Benefits
Streamlined care coordination
Reduced hospital readmissions
Medicare reimbursement
Improved operational efficiency
Why Clinii is Your Trusted Partner
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integration Frequently Asked Questions About Audio-Only E/M Coding
Can audio-only visits replace telehealth video encounters?
Not entirely. Audio-only visits are intended for situations where video isn’t possible or practical. They complement, rather than replace, full audiovisual E/M visits.
Do audio-only codes follow time or MDM selection?
Yes. Each audio-only E/M code (98008–98015) can be selected by time or medical decision making (MDM), just like standard E/M codes. Providers should choose the higher appropriate method and document it clearly.
Are audio-only services reimbursed by Medicare?
As of 2025, CPT 98008–98016 hold a status indicator “I”, meaning they are not yet payable under Medicare. Many commercial and Medicaid payers, however, are expected to adopt them for reimbursement.
Can audio-only and in-person visits be billed on the same day?
Typically not. A phone visit that leads to an in-person or video E/M within 24 hours (or the next available appointment) is considered part of that encounter and not billed separately.
Are in-person and telehealth visits reimbursed at the same rate?
In most cases, yes. CMS and many commercial payers maintain payment parity for telehealth E/M visits when criteria are met, though parity may vary by state and insurer. Providers should confirm payer policies for telehealth reimbursement each plan year.
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