What this is, in plain language
A video visit with a clinician you have seen before, about 60 minutes of total provider time or high-complexity decision-making.
Why a clinician orders it
Complex management of serious or multiple conditions, extensive record review, or high-risk medication decisions done remotely.
Medical necessity — what insurers usually look at
Plan dependent and more likely to be reviewed. Expect the insurer to look for documentation of why a high-complexity visit could be done by video.
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
- ✓Extensive records reviewed and total time or decision-making elements
- ✓Why a video visit was appropriate
Questions for your provider
- ?Will I need an in-person exam as a 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.