Family Practice CPT Codes and Modifiers for 2025
Mar 3, 2025
Family medicine physicians see it all—from newborn wellness checks to chronic disease management, preventive screenings, and mental health counseling. With such a wide scope, it’s essential to use the correct CPT codes and modifiers in 2025 to get reimbursed accurately.
Below is a breakdown of the most commonly used CPT codes and modifiers in family practice, plus coding tips to help reduce denials and streamline your billing process.
Evaluation & Management (E/M) Codes
| CPT Code | Description |
|---|---|
| 99202–99205 | New patient office visit (levels 2–5) |
| 99212–99215 | Established patient office visit (levels 2–5) |
| 99381–99387 | Initial preventive visit (age-specific) |
| 99391–99397 | Periodic preventive visit (age-specific) |
| 99441–99443 | Telephone E/M (5–30 mins) |
| 99421–99423 | Online digital E/M (5–21+ mins) |
Common Procedures & Screenings in Family Medicine
| CPT Code | Description |
|---|---|
| 90471 | Immunization administration (1 vaccine) |
| 90472 | Each additional vaccine |
| 36415 | Routine venipuncture |
| 81002 | Urinalysis, non-automated |
| 87804 | Influenza test |
| 87635 | COVID-19 test (SARS-CoV-2) |
| 99395–99396 | Annual wellness visits |
Mental Health & Chronic Care Codes
| CPT Code | Description |
|---|---|
| 99406–99407 | Tobacco cessation counseling |
| 99408–99409 | Alcohol and/or substance abuse screening |
| 99490 | Chronic care management (20+ minutes/month) |
| 99439 | Additional 20 minutes CCM |
| 99417 | Prolonged office visit beyond 15 minutes |
| 96127 | Brief emotional/behavioral assessment (e.g., PHQ-9, GAD-7) |
Modifiers for Family Practice Billing
| Modifier | Description |
|---|---|
| -25 | Significant, separately identifiable E/M service on the same day as a procedure |
| -59 | Distinct procedural service (used to unbundle services) |
| -95 | Telehealth services provided via real-time video/audio |
| -33 | Preventive service (waives patient cost-sharing for ACA-compliant plans) |
| -76 | Repeat procedure by the same provider |
| -24 | Unrelated E/M service during post-op period |
ICD-10 Codes Common in Family Medicine
| ICD-10 Code | Description |
|---|---|
| Z00.00 | General adult exam without abnormal findings |
| E11.9 | Type 2 diabetes mellitus without complications |
| I10 | Essential hypertension |
| Z23 | Encounter for immunization |
| F41.1 | Generalized anxiety disorder |
| Z79.899 | Long-term use of other medication |
Family Practice Billing Tips for 2025
Final Thoughts
From preventive care to chronic disease management, family practice is the backbone of healthcare—and billing accurately helps keep your practice running smoothly. Use this guide to stay ahead of CPT code changes for 2025 and reduce claim denials.
For informational purposes only.
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