Dermatology billing involves a mix of office visits, biopsies, lesion removals, skin cancer treatments, and cosmetic procedures. With such a wide variety of services, it’s crucial to stay up to date on CPT codes and modifiers for dermatology in 2025 to avoid denials and secure full reimbursement.

Evaluation & Management (E/M) Codes

CPT Code	Description
99202–99205	New patient office visits
99212–99215	Established patient office visits
99241–99245	Consultations (payer dependent)

Skin Biopsies

CPT Code	Description
11102	Tangential biopsy, first lesion
11103	Each additional lesion (with 11102)
11104	Punch biopsy, first lesion
11105	Each additional lesion (with 11104)
11106	Incisional biopsy, first lesion
11107	Each additional lesion (with 11106)

Destruction of Benign, Premalignant, or Malignant Lesions

CPT Code	Description
17000	First premalignant lesion (e.g., actinic keratosis)
17003	Each additional premalignant lesion (up to 14)
17004	15+ premalignant lesions
17110	1–14 benign lesions (e.g., warts)
17111	15+ benign lesions

Removal of Malignant Skin Lesions

Use codes 11600–11646 for excision of malignant lesions and 11400–11446 for benign lesions. Codes are based on location and total size including margins.

Repairs & Wound Closures

Codes depend on complexity of closure:

• 12001–12021: Simple repairs
• 12031–12057: Intermediate repairs
• 13100–13160: Complex repairs

Common Dermatology Modifiers

Modifier	Description
-25	Significant, separately identifiable E/M
-59	Distinct procedural service
-76	Repeat procedure by same provider
-RT / -LT	Right or left side
-51	Multiple procedures
-24	Unrelated E/M during global period
-79	Unrelated procedure during post-op period

Common Dermatology ICD-10 Codes

ICD-10 Code	Description
L57.0	Actinic keratosis
D23.5	Benign neoplasm of skin, trunk
C44.319	Basal cell carcinoma, unspecified location
C44.01	Squamous cell carcinoma of lip
L82.1	Inflamed seborrheic keratosis
D48.5	Neoplasm of uncertain behavior, skin
Z12.83	Encounter for skin cancer screening

Dermatology Billing Tips for 2025

• Use -25 for same-day E/M and procedures (clearly documented).
• Include margins in total excision size for coding accuracy.
• Use -59 when bundling rules apply—such as biopsy plus destruction.
• Be aware of global periods—most excisions have 10-day global windows.
• Document number, type, and diagnosis of lesions treated.

Final Thoughts

Dermatology billing requires accuracy, especially when procedures and office visits are performed together. Using the correct Dermatology CPT codes and modifiers for 2025 ensures proper payment and minimizes audit risk—whether you’re managing skin cancer, treating warts, or performing cosmetic procedures.

Sleep centers play a critical role in diagnosing and managing conditions like obstructive sleep apnea, insomnia, narcolepsy, and restless leg syndrome. But with rapidly evolving technology and payer rules, proper coding is essential. This guide includes the most relevant Sleep Center CPT codes and modifiers for 2025, including polysomnography (PSG), home sleep apnea tests (HSAT), and follow-up services.

Diagnostic Sleep Studies (Polysomnography)

CPT Code	Description
95810	PSG, attended, with sleep staging, no CPAP
95811	PSG, attended, with CPAP/BiPAP titration
95782	PSG, pediatric, no CPAP
95783	PSG, pediatric, with CPAP

Home Sleep Apnea Testing (HSAT)

CPT Code	Description
95800	Sleep study, unattended, cardio-respiratory
95801	Sleep study, unattended, limited parameters
95806	HSAT, unattended, 3+ parameters
G0398	Home sleep test with type II monitor
G0399	Home sleep test with type III monitor
G0400	Home sleep test with type IV monitor

MSLT & MWT

CPT Code	Description
95805	MSLT or MWT, full day sleepiness testing

Follow-Up & Management Services

CPT Code	Description
99441–99443	Telephone E/M (5–30+ min)
99457	Remote monitoring (e.g., CPAP adherence), 20+ min
99458	Each additional 20 minutes
99212–99215	Established patient E/M visits
G0402 / G0438 / G0439	Medicare wellness visits

Modifiers for Sleep Studies

Modifier	Description
-26	Professional component (interpretation only)
-TC	Technical component (equipment/staff)
-25	Separate E/M on same day as study
-52	Reduced service (e.g., incomplete study)
-59	Distinct procedural service
-91	Repeat diagnostic test

Common ICD-10 Codes for Sleep Centers

ICD-10 Code	Description
G47.33	Obstructive sleep apnea
G47.30	Sleep apnea, unspecified
G47.00	Insomnia, unspecified
G47.10	Hypersomnia, unspecified
G47.419	Narcolepsy without cataplexy
R06.83	Snoring
R06.89	Other abnormal breathing
Z01.89	Special exam (e.g., consult)

Sleep Center Coding Tips for 2025

• Use -26/-TC when billing separately for physician vs. lab components.
• Use -52 for early term or incomplete studies (e.g., technical failures).
• Repeat testing (e.g., HSAT) requires clear documentation for medical necessity.
• Document all parameters recorded in PSG and HSAT for compliance.

Final Thoughts

Sleep centers must navigate strict documentation, coverage policies, and coding guidelines. With this guide to Sleep Study CPT codes and modifiers for 2025, your practice can avoid denials and ensure accurate reimbursement—whether you’re conducting PSGs, interpreting HSATs, or managing long-term CPAP use.

Pathology plays a critical role in diagnosis and disease monitoring—from tissue biopsies and Pap smears to molecular testing and autopsy services. To ensure timely and accurate reimbursement, labs and providers must stay current with Pathology CPT codes and modifiers for 2025.

Common Clinical Pathology Codes

CPT Code	Description
80050	General health panel
80053	Comprehensive metabolic panel
81001	Urinalysis, automated, with microscopy
82043	Microalbumin, urine
82565	Creatinine, serum
83036	Hemoglobin A1c
84443	Thyroid-stimulating hormone (TSH)
85025	Complete blood count (CBC), automated with diff
85610	Prothrombin time (PT)
86308	H. pylori antibody test

Anatomic Pathology Codes

CPT Code	Description
88300	Gross exam only
88304	Surgical pathology, level III
88305	Surgical pathology, level IV
88307	Surgical pathology, level V
88309	Surgical pathology, level VI
88142	Pap smear, manual screening
88175	Pap smear, automated w/manual rescreen
88341	Immunohistochemistry, each additional antibody
88360	Morphometric analysis, quantitative
88365	In situ hybridization (e.g., FISH)

Molecular Pathology & Genetic Testing

CPT Code	Description
81210	BRAF gene analysis
81235	EGFR gene analysis
81314	KRAS gene mutation analysis
81445	Oncology targeted panel (5–50 genes)
81450	Exome sequencing, disease-specific
81479	Unlisted molecular pathology procedure

Common Modifiers in Pathology Billing

Modifier	Description
-26	Professional component only
-TC	Technical component only
-90	Reference (outside) laboratory
-91	Repeat diagnostic lab test
-59	Distinct procedural service
-77	Repeat test by another provider
-92	Alternative platform testing

Common ICD-10 Codes in Pathology

ICD-10 Code	Description
D50.9	Iron deficiency anemia, unspecified
E11.9	Type 2 diabetes without complications
C50.911	Malignant neoplasm, right breast
N63	Unspecified breast lump
R97.2	Elevated PSA
R94.5	Abnormal breast imaging findings
Z12.4	Screening for cervical cancer
Z12.11	Screening for colon cancer
Z13.0	Screening for diabetes

Pathology Billing Tips for 2025

• Use -26 and -TC correctly—never together.
• Use -91 only for medically necessary repeats (not quality control).
• Ensure ICD-10 codes justify the test for medical necessity.
• Some genetic tests require prior authorization—verify with payers.
• Group related tests when applicable to avoid unbundling issues.

Final Thoughts

Whether your lab is analyzing biopsies, running blood panels, or performing genetic sequencing, accuracy in coding ensures fair payment and audit readiness. Use this guide to stay current on Pathology CPT codes and modifiers for 2025 and optimize billing for every test, tissue, and report.

Hospitalists are the backbone of inpatient care—managing admissions, daily rounds, critical care, discharges, and transitions. With a fast-paced workflow and frequent handoffs, hospitalist billing needs to be precise and well-documented.

This guide includes the most commonly used Hospitalist CPT codes and modifiers for 2025, plus ICD-10 codes and billing tips to help prevent denials and ensure full reimbursement.

Initial Hospital Care

CPT Code	Description
99221	Initial hospital care, level 1
99222	Initial hospital care, level 2
99223	Initial hospital care, level 3

Subsequent Hospital Visits (Daily Rounds)

CPT Code	Description
99231	Subsequent hospital care, level 1
99232	Subsequent hospital care, level 2
99233	Subsequent hospital care, level 3

Hospital Discharge Services

CPT Code	Description
99238	Hospital discharge, 30 minutes or less
99239	Hospital discharge, more than 30 minutes

Observation Care

CPT Code	Description
99234	Observation/inpatient same day, level 1
99235	Observation/inpatient same day, level 2
99236	Observation/inpatient same day, level 3
99218–99220	Initial observation care
99224–99226	Subsequent observation care
99217	Observation discharge

Critical Care Services

CPT Code	Description
99291	Critical care, first 30–74 minutes
99292	Each additional 30 minutes

Transition of Care & Prolonged Services

CPT Code	Description
99495	TCM, moderate complexity, seen within 14 days
99496	TCM, high complexity, seen within 7 days
99417	Prolonged E/M time beyond 75 minutes

Modifiers Commonly Used by Hospitalists

Modifier	Description
-25	Significant, separately identifiable E/M on same day
-24	Unrelated E/M during post-op period
-AI	Principal physician of record
-57	Decision for surgery
-76	Repeat service by same provider
-95	Telehealth service (if applicable)

Common ICD-10 Codes Used in Hospital Medicine

ICD-10 Code	Description
J18.9	Pneumonia, unspecified
I10	Essential hypertension
N17.9	Acute kidney failure
R07.9	Chest pain, unspecified
E11.9	Type 2 diabetes without complications
Z51.89	Aftercare, other specified
R41.82	Altered mental status, unspecified

Hospitalist Billing Tips for 2025

• Use modifier -AI when multiple providers are involved in inpatient care.
• Only one provider may bill initial hospital care per admission.
• Time-based documentation is crucial for critical care and prolonged services.
• Verify discharge time for 99239 billing (>30 minutes).
• Support medical necessity for high-level follow-up codes like 99233.

Final Thoughts

Hospitalists handle some of the most complex billing scenarios in modern medicine. With proper documentation and up-to-date coding knowledge, your practice can reduce errors, avoid audits, and get paid what it deserves. Use this Hospitalist CPT coding guide for 2025 to keep your billing on track.

Dialysis billing is highly specialized and closely regulated—especially when managing ESRD patients and submitting monthly capitation codes (MCP). Using the correct dialysis CPT codes and modifiers in 2025 helps ensure compliance with CMS rules and secures proper reimbursement for both routine and complex services.

Monthly ESRD-Related Services (MCP)

CPT Code	Description
90951	ESRD-related services, <2 years, 4+ visits
90952	<2 years, 2–3 visits
90953	<2 years, 1 visit
90954	Age 2–11, 4+ visits
90955	Age 2–11, 2–3 visits
90956	Age 2–11, 1 visit
90957	Age 12–19, 4+ visits
90958	Age 12–19, 2–3 visits
90959	Age 12–19, 1 visit
90960	Age 20+, 4+ visits
90961	Age 20+, 2–3 visits
90962	Age 20+, 1 visit
90963	Home dialysis, <2 years
90964	Home dialysis, age 2–11
90965	Home dialysis, age 12–19
90966	Home dialysis, age 20+

Individual Dialysis Sessions

CPT Code	Description
90935	Hemodialysis, single evaluation
90937	Hemodialysis, repeated evaluations
90945	Peritoneal dialysis, one-time
90947	Peritoneal dialysis, repeated evaluations

Dialysis Training & Supervision

CPT Code	Description
90989	Dialysis training, initial
90993	Dialysis training, additional

Dialysis Modifiers

Modifier	Description
-25	Separate E/M on same day as dialysis
-26	Professional component only
-GC	Resident under supervision
-G1	ESRD patient with 4+ sessions/month
-G2	ESRD patient with 2–3 sessions/month
-G3	ESRD patient with 1 session/month
-G4	ESRD patient on home dialysis

ICD-10 Codes Commonly Paired With Dialysis

ICD-10 Code	Description
N18.6	End-stage renal disease (ESRD)
Z99.2	Dependence on renal dialysis
T86.10	Kidney transplant complication
Z94.0	Kidney transplant status
I12.9	Hypertensive CKD without heart failure
N17.9	Acute kidney failure, unspecified

Dialysis Billing Tips for 2025

• Only bill one MCP code per calendar month, based on visits and age group.
• Document oversight for home dialysis codes (90963–90966).
• Use -25 when billing E/M on the same day as dialysis service.
• Include N18.6 or another ESRD-related diagnosis on all relevant claims.

Final Thoughts

Dialysis coding is a core component of nephrology billing—and accuracy is essential. Use this 2025 dialysis CPT code and modifier guide to protect your practice from underpayments and denials while staying compliant with Medicare and commercial payers.

Radiology billing can get complicated quickly—between global vs. professional components, modality types, and contrast usage. To ensure accurate billing and full reimbursement, radiology practices and imaging centers must stay up to date on CPT codes and modifiers for 2025.

This guide outlines the most frequently used Radiology CPT codes, modifiers, and ICD-10 pairings, along with coding tips specific to diagnostic imaging and interventional procedures.

Common Diagnostic Imaging Codes

CPT Code	Description
71045	Chest X-ray, single view
71046	Chest X-ray, two views
73030	X-ray of shoulder, complete
73564	X-ray of knee, 4+ views
74176	CT abdomen/pelvis, without contrast
74177	CT abdomen/pelvis, with contrast
74178	CT abdomen/pelvis, with and without contrast
70551	MRI brain without contrast
70552	MRI brain with contrast
70553	MRI brain with and without contrast
76700	Abdominal ultrasound, complete
76856	Pelvic ultrasound, non-obstetric

Interventional Radiology Procedures

CPT Code	Description
36247	Selective arterial catheterization
77001	Fluoroscopy during procedure
76937	Ultrasound guidance for vascular access
37241	Vascular embolization or occlusion
75898	Angiography supervision and interpretation
49083	Paracentesis with imaging guidance

Radiology Modifiers

Modifier	Description
-26	Professional component only
-TC	Technical component only
-76	Repeat procedure by same provider
-77	Repeat procedure by different provider
-59	Distinct procedural service
-91	Repeat clinical diagnostic test
-52	Reduced services
-LT / -RT	Left or right side

Common ICD-10 Codes Used in Radiology

ICD-10 Code	Description
R07.9	Chest pain, unspecified
M54.5	Low back pain
R10.9	Abdominal pain, unspecified
I63.9	Cerebral infarction, unspecified
N20.0	Kidney stone
Z12.31	Screening mammogram
Z01.89	Other specified examination

Radiology Coding Tips for 2025

• Use -26 or -TC unless billing globally for both components.
• Repeat studies? Use -76 (same provider) or -91 (diagnostic test repeat).
• Use -59 with caution—only for separate, distinct services.
• Use correct contrast code sequencing for CT and MRI exams.
• Screening vs. diagnostic? Choose ICD-10 codes carefully to reflect intent.

Final Thoughts

Radiology billing requires attention to both clinical and technical detail. With the right Radiology CPT codes and modifiers for 2025, your practice can avoid denials, pass audits, and collect the revenue you’ve earned—whether you’re reading images or running an imaging center.

Nephrology is a complex specialty where providers frequently manage chronic kidney disease (CKD), dialysis, hypertension, and transplant care. With frequent rounding, outpatient consults, and care coordination, it’s critical to understand the correct CPT codes and modifiers for nephrology in 2025 to ensure accurate billing and compliance.

This guide outlines the most commonly used Nephrology CPT codes, modifiers, and ICD-10 pairings, plus tips to avoid denials and optimize reimbursement.

Evaluation & Management (E/M) Codes

CPT Code	Description
99202–99205	New patient office visits (levels 2–5)
99212–99215	Established patient office visits (levels 2–5)
99221–99223	Initial hospital care (levels 1–3)
99231–99233	Subsequent hospital care
99238–99239	Hospital discharge services
99495–99496	Transitional care management (TCM), post-discharge

Nephrology-Specific Services & Dialysis Management

CPT Code	Description
90935	Hemodialysis, single evaluation
90937	Hemodialysis, repeated evaluations
90945	Peritoneal dialysis, one-time
90947	Peritoneal dialysis, repeated evaluations
90951–90970	Monthly ESRD-related services (age- and modality-based)
90989	Dialysis training, initial
90993	Dialysis training, additional

Diagnostic Testing in Nephrology

CPT Code	Description
82043	Microalbumin, urine
82565	Creatinine, serum
84132	Potassium, serum
82306	Vitamin D, 25-hydroxy
84450	Renin activity
84520	Urea nitrogen (BUN)

Commonly Used Modifiers in Nephrology

Modifier	Description
-25	Significant, separately identifiable E/M on same day
-26	Professional component only
-59	Distinct procedural service
-76	Repeat procedure by same provider
-77	Repeat procedure by another provider
-95	Telehealth service
-GC	Performed by resident under supervision

Common ICD-10 Codes in Nephrology

ICD-10 Code	Description
N18.3	CKD stage 3 (moderate)
N18.4	CKD stage 4 (severe)
N18.5	CKD stage 5
N18.6	End-stage renal disease (ESRD)
I12.9	Hypertensive CKD without heart failure
Z99.2	Dependence on renal dialysis
Z94.0	Kidney transplant status

Nephrology Billing Tips for 2025

• Document time and complexity for ESRD-related codes.
• Use accurate modality codes (hemodialysis vs. peritoneal).
• Use -25 only when E/M is separately identifiable from dialysis services.
• Watch global periods for procedures or post-transplant care.

Final Thoughts

Nephrology billing requires a careful balance of compliance and detail. By using the correct Nephrology CPT codes and modifiers for 2025, your practice can improve cash flow, reduce denials, and stay audit-ready.

Orthopedic billing is complex due to the wide range of services—from E/M visits and injections to imaging, fracture care, and surgery. To prevent claim denials and ensure full reimbursement, practices must stay current with Orthopedic CPT codes and modifiers for 2025.

This guide covers essential orthopedic billing codes, common modifiers, and ICD-10 pairings to help your team stay compliant and efficient.

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)
99221–99223	Initial hospital care
99231–99233	Subsequent hospital care
99238–99239	Hospital discharge
99456	Work-related or medical disability exam (e.g., IME)

Injections, Aspiration, and Fracture Care

CPT Code	Description
20610	Arthrocentesis of major joint (e.g., knee, shoulder)
20605	Aspiration/injection of intermediate joint
20600	Aspiration/injection of small joint
20550	Injection of tendon sheath or ligament
29075	Application of long arm cast
29085	Application of forearm cast
29125	Short arm splint
29130	Long arm splint
29345	Long leg cast
29355	Short leg cast
29405	Short leg splint

Orthopedic Surgeries

CPT Code	Description
29881	Knee arthroscopy with meniscectomy
29888	Knee arthroscopy with ACL reconstruction
23410	Repair of rotator cuff
23472	Total shoulder arthroplasty
27130	Total hip replacement
27447	Total knee arthroplasty
25607–25609	ORIF of distal radius fractures
27786	Closed treatment of ankle fracture
27792	ORIF of ankle fracture

Common Modifiers in Orthopedic Billing

Modifier	Description
-25	Significant, separately identifiable E/M service on same day
-57	Decision for surgery made during E/M
-50	Bilateral procedure
-LT / -RT	Left or right side
-54	Surgical care only
-55	Post-op care only
-59	Distinct procedural service
-76	Repeat procedure by same provider
-58	Staged/related procedure during post-op

Common ICD-10 Codes in Orthopedics

ICD-10 Code	Description
M17.11	Osteoarthritis of right knee
M75.101	Unspecified rotator cuff tear
S83.241A	Bucket-handle tear of meniscus, right knee
S82.301A	Fracture of right tibia shaft
M16.11	Osteoarthritis of right hip
M54.5	Low back pain
M51.26	Disc displacement, lumbar

Orthopedic Coding Tips for 2025

• Use -57 with major surgeries when the decision is made during the E/M visit.
• Apply -54/-55 for co-managed surgical/post-op care.
• Use -25 judiciously when E/M is unrelated to the procedure.
• Confirm global periods before billing follow-up care.

Final Thoughts

Orthopedic coding requires precision, especially when managing surgery, injections, and casting. With the correct Orthopedic CPT codes and modifiers for 2025, your team can streamline billing and reduce audit risk—while ensuring you’re fully reimbursed for the care you provide.

Mental health professionals—whether you’re a psychiatrist, psychologist, therapist, or clinical social worker—must stay on top of the latest CPT codes and modifiers to ensure timely and accurate reimbursement. With growing demand for behavioral health services and evolving telehealth regulations, 2025 CPT coding for mental health comes with both opportunities and challenges.

This guide outlines the most commonly used Mental Health CPT codes and modifiers for 2025, including psychotherapy, evaluations, testing, and telehealth services.

Psychiatric Diagnostic Evaluations

CPT Code	Description
90791	Psychiatric diagnostic evaluation (without medical services)
90792	Psychiatric diagnostic evaluation (with medical services)

Psychotherapy CPT Codes (Individual)

CPT Code	Description
90832	Psychotherapy, 30 minutes with patient
90834	Psychotherapy, 45 minutes with patient
90837	Psychotherapy, 60 minutes with patient

Psychotherapy With Evaluation & Management

CPT Code	Description
90833	Psychotherapy, 30 minutes with E/M
90836	Psychotherapy, 45 minutes with E/M
90838	Psychotherapy, 60 minutes with E/M

Family & Group Therapy

CPT Code	Description
90846	Family psychotherapy (without patient present)
90847	Family psychotherapy (with patient present)
90849	Multiple-family group psychotherapy
90853	Group psychotherapy (non-family)

Psychological & Neuropsychological Testing

CPT Code	Description
96130	Psychological testing evaluation services, first hour
96131	Each additional hour
96136	Test administration and scoring by clinician, first 30 mins
96137	Each additional 30 mins
96138	Technician-administered testing, first 30 mins
96139	Each additional 30 mins

Common Mental Health Modifiers (2025)

Modifier	Description
-25	Significant, separately identifiable E/M service on the same day
-59	Distinct procedural service
-95	Synchronous telemedicine service (real-time audio + video)
-GT	Telehealth services (Medicare legacy)
-33	Preventive service (may reduce patient cost-sharing)
-KX	Requirements specified in medical policy have been met

Common ICD-10 Codes in Mental Health

ICD-10 Code	Description
F32.9	Major depressive disorder, single episode, unspecified
F33.1	Major depressive disorder, recurrent, moderate
F41.1	Generalized anxiety disorder
F43.10	Post-traumatic stress disorder (PTSD), unspecified
F90.0	ADHD, predominantly inattentive
Z13.89	Encounter for screening for mental health conditions

Mental Health Billing Tips for 2025

• Telehealth documentation matters: Use modifier -95 and document patient consent and technology used.
• Use time-based codes accurately: Psychotherapy CPT codes are tied to specific durations.
• Separate services need clear documentation: Especially when billing therapy and med management together.

Final Thoughts

Mental health providers play a crucial role in healthcare—and correct coding ensures you’re compensated for the care you give. Use this 2025 guide to make your billing smarter, faster, and more compliant.

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

• Use -25 correctly: Justify separate E/M services when performing procedures during the same visit.
• Stay updated on telehealth: Modifier -95 remains valid for many services in 2025.
• Track time: Bill prolonged visits appropriately with time-based codes like 99417.

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.