What this is, in plain language
A first video visit with a clinician, about 45 minutes of total provider time or moderate-complexity decision-making.
Why a clinician orders it
Establishing care with multiple conditions to review, or a new problem needing prescription management or several records reviewed.
Medical necessity — what insurers usually look at
Plan dependent. Some insurers scrutinize longer new-patient telehealth visits if a hands-on exam would normally be expected — documentation should explain why video was appropriate.
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
- ✓Records reviewed and total time or decision-making elements
- ✓Why a video visit was appropriate for this problem
Questions for your provider
- ?Can everything I need be handled by video, or will I need an in-person follow-up?
- ?Does my plan cover this level of video 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.