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.
