CPT 98014 Description, Billing Rules, & Use Cases

CPT 98014 is used to bill for a synchronous audio-only evaluation and management (E/M) service with an established patient that involves moderate-complexity medical decision making (MDM) or at least 30 minutes of total provider time on the date of the encounter.

Introduced in 2025 as part of the new audio-only telehealth E/M code set (98008–98015), CPT 98014 replaced the legacy telephone visit codes (99441–99443) and is used for encounters requiring extended discussion, more detailed data review, and moderate clinical complexity.

The service typically includes:

Management of multiple stable chronic conditions or one condition with potential complications
Review and interpretation of recent lab or imaging results
Adjustment of medications or coordination of ongoing treatment plans
Patient counseling or education for moderate-risk care decisions
Documentation of findings, risk factors, and next steps in the medical record

Billing Notes:

Use for established-patient audio-only E/M visits requiring moderate-complexity MDM or ≥30 minutes of total provider time.
The provider must personally perform the encounter using real-time, two-way audio-only communication.
This service cannot overlap with any in-person or audio-video E/M encounter on the same date.
Documentation must include patient consent, communication modality (audio-only), and total time or MDM level used for code selection.
Encounters shorter than 30 minutes may qualify for CPT 98013; longer or more complex encounters may meet criteria for CPT 98015 or CPT 99417 (prolonged services).

What Is CPT Code 98014?

CPT 98014 is an evaluation and management (E/M) code for audio-only telemedicine visits with established patients that involve moderate-complexity medical decision making (MDM) or at least 30 minutes of total provider time on the date of service.

Introduced in 2025, CPT 98014 belongs to the audio-only telehealth E/M series (98008–98015), which replaced the deleted telephone visit codes (99441–99443). It is used when an established-patient telehealth encounter—conducted entirely via synchronous audio communication—requires in-depth review, multiple problem management, or treatment decisions that carry a moderate level of clinical risk.

Key points about CPT 98014:

Used for established-patient audio-only visits requiring moderate MDM or ≥30 minutes of total provider time.
Must include a medically appropriate history and/or examination, as determined by the provider.
Requires real-time, two-way audio communication (not asynchronous messaging).
Suitable for encounters involving multiple stable conditions or one condition with increased complexity or risk.
Must be personally performed by a qualified healthcare provider (physician, NP, or PA).
May not be billed on the same day as an in-person or audio-video E/M encounter.

In summary: CPT 98014 represents moderate-complexity, audio-only E/M services for established patients, where the provider spends 30 minutes or more managing care, reviewing data, or coordinating treatment through real-time verbal communication.

CPT 98014 Time Thresholds and Code Combinations

CPT 98014 represents a synchronous audio-only evaluation and management (E/M) service for an established patient that involves moderate-complexity medical decision making (MDM) or at least 30 minutes of total provider time on the date of service.

Understanding the Time Component

When selecting by time, the provider must personally spend 30 minutes or more on the encounter and associated medical work performed on the same calendar date.

Included time may involve:

Reviewing test results, specialist reports, or prior notes before or during the call
Conducting an in-depth, structured audio-only evaluation
Counseling the patient about ongoing management or medication adjustments
Coordinating care with other clinicians or care teams
Documenting findings, assessment, and treatment plan in the medical record

If total time is less than 30 minutes, report CPT 98013.
Encounters that meet or exceed 45 minutes may qualify for CPT 98015, and time beyond 60 minutes may require adding CPT 99417 (prolonged services).

Understanding the MDM Component

When coding based on MDM, documentation must reflect moderate complexity, which typically includes:

Multiple problems or one condition with potential for exacerbation or complications
Moderate data review, including test interpretation or coordination with other professionals
Moderate risk of morbidity, medication side effects, or management decisions

Table titled ‘CPT 98014 Time Thresholds and Code Combinations.’ Shows billing ranges for established-patient audio-only E/M visits: ≤10 minutes not billable; 11–20 minutes = 98012; 21–30 = 98013; 31–45 = 98014; 46–60 = 98015; and >60 minutes = 98015 + 99417 (prolonged services).

When to Use CPT 98014: Common Scenarios and Use Cases

CPT 98014 is appropriate when a physician, nurse practitioner (NP), or physician assistant (PA) provides a synchronous audio-only evaluation and management (E/M) visit with an established patient that involves moderate-complexity medical decision making (MDM) or at least 30 minutes of total provider time on the same day.

Here are examples of how CPT 98014 is used in practice:

Multi-Condition Management

Care Coordination for Heart Failure

Behavioral Health Follow-Up for Dual Diagnosis

Multi-Condition Management With Medication Adjustment

A primary care provider conducts a telephonic follow-up with a patient managing diabetes and COPD to:

Review recent blood glucose logs and pulmonary function updates
Adjust insulin dosing and inhaler use
Coordinate lab follow-up and dietary counseling

Total time: 33 minutes
Billing: 98014

Smiling nurse on phone call while working on laptop in medical office, representing patient outreach, care coordination, and proactive clinical communication

Medication Reconciliation and Care Coordination for Heart Failure

A cardiologist provides an audio-only visit to:

Reconcile multiple cardiac and antihypertensive medications
Review home weight logs and discuss symptom monitoring
Coordinate care with the patient’s primary physician and pharmacy

Total time: 38 minutes
Billing: 98014

Female physician using smartphone and laptop in clinical office, illustrating digital health management, secure communication, and EHR workflow optimization

Complex Behavioral Health Follow-Up for Dual Diagnosis

A psychiatrist performs a moderate-complexity phone follow-up with a patient managing major depression and generalized anxiety disorder to:

Evaluate medication efficacy and recent side effects
Review PHQ-9 and GAD-7 results discussed verbally
Adjust treatment plan and schedule next therapy visit

Total time: 40 minutes
Billing: 98014

Nurse wearing scrubs and a stethoscope, speaking through a headset while working at a computer for monthly time tracking and documentation in Chronic Care Management (CCM).

CPT 98014 Billing Requirements and Eligibility

CPT 98014 is used to report a synchronous audio-only evaluation and management (E/M) visit with an established patient that involves moderate-complexity medical decision making (MDM) or at least 30 minutes of total provider time on the date of service.

This code represents the third level of established-patient audio-only telehealth services introduced in 2025, replacing the midrange of the discontinued telephone visit codes (99441–99443).

Patient Eligibility

To qualify for CPT 98014:

The patient must be established (seen by the same provider or group within the past three years).
The encounter must be performed using real-time, two-way audio-only communication.
The patient must verbally consent to telehealth delivery and agree to an audio-only format.
The visit must involve moderate-complexity MDM or ≥30 minutes of total provider time.
The service cannot be performed on the same day as an in-person or audio-video E/M encounter.

Provider Eligibility

The encounter must be personally performed by a physician, nurse practitioner (NP), or physician assistant (PA) qualified to report E/M services.

The provider must:

Conduct the entire encounter personally via audio-only technology.
Document the time spent or MDM level used for code selection.
Record the communication modality (audio-only) and patient consent in the visit note.
Provide a clear clinical assessment and plan consistent with E/M standards.

Service Requirements

Minimum provider time: 30 minutes on the date of service.
Countable time includes record review, direct patient discussion, clinical decision-making, and same-day documentation.
Non-countable time includes scheduling, administrative activities, or unrelated calls.
Code selection may be based on MDM or total time, but documentation must support the higher criterion.
Follow-up plans, referrals, and care coordination details should be documented.

Documentation Requirements

The visit note must clearly include:

Start and end time, or total provider time (≥30 minutes).
Patient consent for audio-only telehealth delivery.
Statement of modality (e.g., “audio-only synchronous communication, no video used”).
Chief complaint or reason for visit.
Moderate MDM elements, including:
- Problems: Multiple stable chronic conditions or one condition with potential complications.
- Data: Moderate data review, such as lab or imaging results, or coordination with external providers.
- Risk: Moderate risk of morbidity, progression, or medication side effects.
Summary of patient discussion, including assessment, care decisions, and next steps.
Provider attestation confirming personal performance and record accuracy.
Non-duplication statement confirming the service was not combined with other E/M services on the same date.

Medicare and Payer Coverage Notes

Medicare: CPT 98014 currently holds a status indicator “I” (invalid for Medicare billing).
Commercial payers: May adopt CPT 98014 for reimbursement under RBRVS valuation.
Provider action: Confirm payer-specific audio-only telehealth policies, as coverage varies by state and insurer.

CPT 98014 Billing Documentation Checklist

To support compliant billing for CPT 98014, documentation must confirm that the encounter was a real-time, audio-only telehealth visit with an established patient, requiring moderate-complexity medical decision making (MDM) or at least 30 minutes of total provider time.

Your encounter record should include:

Patient consent for the use of audio-only telehealth, documented at the start of the encounter.
Verification of patient identity using at least two identifiers (e.g., name and date of birth).
Provider credentials and role (physician, NP, or PA) clearly documented.
Statement of modality specifying “audio-only synchronous communication” (no video used).
Chief complaint or reason for visit clearly stated.
Total provider time documented as ≥30 minutes, including:
- Exact start and end times, or
- Total duration on the date of service.
Moderate-complexity MDM documentation, showing:
- Problems: Multiple stable or worsening conditions, or one condition with moderate risk.
- Data: Review of moderate data (e.g., labs, imaging, or external provider input).
- Risk: Moderate risk due to management decisions or potential complications.
Summary of clinical discussion, including:
- Patient-reported symptoms and findings discussed via audio.
- Provider’s assessment, care plan, and medication or treatment changes.
- Follow-up recommendations and next steps.
- Provider attestation confirming that the service was personally performed and accurately documented.
Non-overlap statement verifying that no other E/M service (in-person or video) was billed on the same date.
Follow-up plan documented, including next appointment, lab work, or care coordination instructions.

Common CPT 98014 Billing Mistakes (and How to Avoid Them)

❌ Billing Without 30 Minutes of Documented Time

When coding by time, providers must clearly record at least 30 minutes of total provider time on the date of service. Encounters shorter than this threshold should be billed as CPT 98013 (21–30 minutes) or CPT 98012 (11–20 minutes).

❌ Missing Moderate-Complexity MDM Justification

If selecting the code based on MDM, documentation must reflect moderate complexity — multiple stable conditions, review of test results, or decisions involving moderate risk of morbidity or medication adjustment.

❌ Failing to Specify Audio-Only Modality

Every encounter note must explicitly state that the service was provided via audio-only synchronous communication. Claims are frequently denied when this statement is missing or ambiguous.

❌ Omitting Patient Consent or Identity Verification

Providers must document verbal patient consent and identity confirmation (name and date of birth) at the beginning of the encounter.

❌ Using CPT 98014 for New Patients

CPT 98014 applies only to established-patient encounters. New-patient audio-only visits should be billed using CPT 98008–98011, depending on time and MDM complexity.

❌ Counting Non-Billable Time

Administrative work, scheduling, or unrelated communications do not count toward billable provider time. Only medically necessary activities performed on the same date of service are eligible.

❌ Reporting 98014 With Same-Day E/M Codes

Audio-only codes (98008–98015) may not be reported alongside in-person or audio-video E/M visits for the same patient on the same day.

❌ Incomplete Clinical Summary

Even for telephonic encounters, a full clinical narrative is required — including chief complaint, assessment, plan, and follow-up. Missing or incomplete summaries increase payer audit risk.