Pediatric CPT Codes for 2025 + Modifiers

Failure to maintain accurate and current codes in your pediatric practice could result in missed revenue opportunities through medical billing. Moreover, inaccuracies could lead to delays in claims processing, underscoring the necessity of staying informed about the latest code updates.

Pediatric CPT Code Ranges for 2025

Here are the latest 2025 pediatric CPT codes, including updates for telemedicine, immunizations, and remote monitoring:

New and Established Patient Preventative Care

• 99381 – New patient, preventative care for infant; <1 year of age
• 99382 – New patient, preventative care; 1-4 years old
• 99383 – New patient, preventative care; 5-11 years old
• 99384 – New patient, preventative care; 12-17 years old
• 99385 – New patient, preventative care; 18+ years old
• 99391 – Established patient, preventative care for infant
• 99392 – Established, preventative care for 1-4 years old
• 99393 – Established, preventative care for 5-11 years old
• 99394 – Established, preventative care for 12-17 years old
• 99395 – Established, preventative care for 18+ years old

New 2025 Pediatric Telemedicine Codes

These newly introduced telemedicine codes enable virtual evaluations for pediatric patients:

• 98000 – Virtual E/M for a new patient (5-10 min, audio-video)
• 98001 – Virtual E/M for a new patient (11-20 min, audio-video)
• 98002 – Virtual E/M for a new patient (21-30 min, audio-video)
• 98003 – Virtual E/M for an established patient (5-10 min, audio-video)
• 98004 – Virtual E/M for an established patient (11-20 min, audio-video)
• 98005 – Virtual E/M for an established patient (21-30 min, audio-video)
• 98006 – Audio-only E/M visit for an established patient (5-10 min)
• 98007 – Audio-only E/M visit for an established patient (11-20 min)
• 98008 – Audio-only E/M visit for an established patient (21-30 min)

Updated Immunization Codes for 2025

New codes added for pediatric immunization services:

• 90380 – RSV monoclonal antibody, 0.5 mL dose, IM injection
• 90381 – RSV monoclonal antibody, 1 mL dose, IM injection
• 90678 – New pediatric influenza vaccine, quadrivalent (2025 update)
• 96380 – Administration of RSV monoclonal antibody, with physician counseling
• 96381 – Administration of RSV monoclonal antibody, without counseling

Remote Therapeutic Monitoring (RTM) Updates

These codes reflect new digital pediatric patient monitoring services:

• 98975 – Initial setup of remote monitoring for pediatric chronic conditions
• 98976 – Remote monitoring of respiratory conditions
• 98977 – Remote monitoring of musculoskeletal conditions
• 98978 – Remote monitoring of pediatric mental health therapy

AI-Enhanced Pediatric CPT Codes (2025 Update)

With AI-driven healthcare expanding, new codes classify AI-assisted diagnostics and treatment:

• 0890T – AI-assisted pediatric radiology interpretation
• 0891T – AI-augmented neurodevelopmental disorder assessment
• 0892T – AI-assisted growth monitoring for pediatric endocrinology

Pediatric CPT Modifiers for 2025

Use these updated pediatric CPT modifiers to specify services more accurately:

• Z00.110 – Health supervision for a newborn under 8 days old
• Z00.111 – Health supervision for a newborn between 8 and 28 days old
• Z00.121 – Routine health exam for a child with abnormal findings
• Z00.129 – Routine health exam for a child with no abnormal findings
• Z71.3 – Dietary counseling or surveillance
• Z71.82 – Exercise counseling
• Z71.84 – Health counseling for travel purposes
• Z71.85 – Counseling for immunization safety
• Z71.89 – Other counseling, specified
• Z71.9 – Other counseling, unspecified

For informational purposes only.