Endocrinology CPT Codes and Modifiers for 2025

Stay updated with the latest 2025 endocrinology CPT codes and modifiers.

Read Time: 4 minutes
Mar 1, 2025

Navigating the ever-evolving world of medical billing can be challenging—especially in specialties like endocrinology, where both evaluation and management (E/M) and procedure codes are common. To help practices stay up to date, we’ve compiled the most relevant Endocrinology CPT codes and modifiers for 2025.

Whether you’re managing diabetes, thyroid disorders, or hormone imbalances, accurate coding ensures proper reimbursement and minimizes claim denials.

Common Endocrinology CPT Codes (2025)

Evaluation & Management (E/M) Codes

These are used for office visits and consultations:

CPT Code	Description
99202–99205	New patient office visit (levels 2–5)
99212–99215	Established patient office visit (levels 2–5)
99221–99223	Initial hospital care (levels 1–3)
99231–99233	Subsequent hospital care
99238–99239	Hospital discharge services

Diabetes Management

Endocrinologists often bill for diabetes education, insulin pump training, and CGM (continuous glucose monitoring):

CPT Code	Description
95249	Ambulatory CGM setup, patient-owned equipment
95250	CGM setup, sensor placement, training (clinic-provided)
95251	CGM data interpretation (minimum 72 hours)
99091	Collection and interpretation of physiologic data (e.g., CGM, insulin pump)
G0108	Individual diabetes outpatient self-management training
G0109	Group diabetes outpatient self-management training

Thyroid & Hormonal Testing

Common in-office and lab services:

CPT Code	Description
84436	Free thyroxine (T4)
84443	Thyroid stimulating hormone (TSH)
84439	Total triiodothyronine (T3)
84480	Cortisol (adrenal function)
82043	Microalbumin, urine (for diabetic nephropathy screening)

Commonly Used Modifiers in Endocrinology

Modifiers add important context to CPT codes—such as indicating a separate service or a specific location. Here are the most relevant ones for endocrinology practices in 2025:

Modifier	Description
-25	Significant, separately identifiable E/M service by the same physician on the same day of a procedure
-59	Distinct procedural service (often used for CGM setup and training on the same day)
-76	Repeat procedure by the same provider
-77	Repeat procedure by another provider
-95	Telehealth service delivered in real-time via interactive audio and video
-GC	Service performed in part by a resident under the direction of a teaching physician

ICD-10 Codes Often Paired With Endocrinology CPT Codes

To maximize reimbursement accuracy, pair CPT codes with the correct ICD-10 codes. Here are some common diagnosis codes:

ICD-10 Code	Description
E11.9	Type 2 diabetes mellitus without complications
E03.9	Hypothyroidism, unspecified
E05.00	Thyrotoxicosis without thyrotoxic crisis or storm
E28.2	Polycystic ovarian syndrome
E23.0	Hypopituitarism

2025 Endocrinology Coding Tips

Document thoroughly: Medical necessity must be crystal clear, especially when using modifier -25.
Verify payer guidelines: Some insurers require prior authorization for CGM or insulin pump training.
Use time-based coding when applicable: This is especially useful for prolonged services or complex visits.

Stay Compliant in 2025

Coding errors can lead to costly audits or delays in payment. Make sure your billing team stays current with CPT and ICD-10 updates, as well as payer-specific policies.

Need help streamlining your endocrinology billing in 2025? Consider partnering with a medical billing service that knows your specialty inside and out.

For informational purposes only.