What this is, in plain language
A first video visit with a clinician, about 30 minutes of total provider time or low-complexity decision-making.
Why a clinician orders it
Establishing care with a bit more history to review, or a new problem that needs some data review but no hands-on exam.
Medical necessity — what insurers usually look at
Plan dependent. Level is chosen by total time or medical decision-making, same as in-person visits. Some plans pay telehealth at a different rate or require specific platforms.
New to this? Read what medical necessity means and how to appeal a denial.
Documentation to ask about
- ✓Live audio AND video confirmed
- ✓Your location at the time of the visit
- ✓Total time or decision-making elements
Questions for your provider
- ?Does my plan cover video visits with you directly?
- ?Is my copay the same as an in-person visit?
Why this code is in our seed set
Part of the new CPT 98000–98015 telehealth E/M family introduced for 2025.
Validated against
- •AMA CPT 2025 E/M telehealth code set (98000–98015)
- •CMS telehealth services list
Terms you'll see
Medical NecessityRead more →
The insurer is reviewing whether the service is clinically appropriate for your situation.
Important: AuraCode is an educational tool. It does not provide medical, legal, or insurance advice, claims decisions, or approval guarantees. Final coverage depends on your specific plan, eligibility, diagnosis, submitted documentation, and your insurer's review.