It’s Not Too Early
It is not too early to prepare for the new Category III CPT codes, which will be implemented on July 1, 2025. As a reminder, Category III codes are temporary codes created for emerging technologies, procedures, and other services.
Every year, the AMA releases Category III updates as appropriate for each specialty. The following Category III codes were accepted and/or revised at the September 2024 CPT Editorial Panel Meeting and released by the AMA in December 2024.
While approved by the Editorial Panel, the acceptance and reimbursement by payors will vary. The final description of the codes listed below may change prior to publication in the AMA CPT Manual.
NOTE: A Category III code, versus an Unlisted Code, must be reported once the code becomes “Effective.”
Next Steps:
Add the Category III Codes Effective 7/1/25 to your practice management system.
Notify the physicians and staff whose practice supports these codes.
Reach out to payors to confirm if they will reimburse these Category III Codes; if confirmed, update the practice management system with the expected allowable amounts.
Develop ABNs or waivers for payors that do not reimburse these codes.
Assess and adjust internal processes, including patient scheduling, financial discussions, and any necessary staff education.
Revisit these steps in December to prepare for the 2026 code updates.