What this is, in plain language
A telephone-only follow-up with a clinician you have seen before, about 45 minutes of total provider time or moderate-complexity decision-making.
Why a clinician orders it
Managing two or more chronic conditions or a new problem with workup when video is not available.
Medical necessity — what insurers usually look at
Plan dependent and likely to be questioned — a longer visit without video or exam needs clear documentation of why that was appropriate.
New to this? Read what medical necessity means and how to appeal a denial.
Documentation to ask about
- ✓That the visit was audio only, and why video was not used
- ✓Your location at the time of the visit
- ✓Problems addressed and data reviewed
- ✓Total time or decision-making elements
Questions for your provider
- ?Does my plan pay for phone-only visits at this level?
- ?Will I need an in-person or video follow-up?
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.