CPT Codes Propel Health Innovation and Digital Health Reimbursement
Chicago, Thursday, 18 September 2025.
The CPT code set’s open, evidence-based process is crucial for integrating new technologies, supporting health innovation, and evolving payment models, particularly in digital health.
The Role of CPT Codes in Healthcare Innovation
The Current Procedural Terminology (CPT) code set serves as a fundamental element in advancing healthcare innovation. Its open, evidence-based updating process allows for the integration of new technologies into a standardized language, which is essential for defining and reporting healthcare services across the United States. This open process not only facilitates the adoption of cutting-edge medical procedures but also plays a crucial role in testing new payment models, particularly in the digital health domain [1][2].
CPT Code Set and Digital Health
The CPT code set is continually evolving to keep pace with rapid advancements in digital health technologies. This includes developments in augmented intelligence (AI), telehealth, and remote patient monitoring. By adding new codes for these services, the CPT code set helps to streamline the reporting and reimbursement processes, reducing administrative burdens and enhancing patient care [2][3]. Recent updates include codes for remote therapeutic monitoring and AI-assisted assessments, reflecting the increasingly critical role of technology in modern healthcare [3][4].
The Impact on Payment Models
While CPT codes are a pathway to payment, they do not define payment rates themselves. Instead, they provide a framework that allows for the analysis and testing of new payment models. This is essential in the digital health landscape, where innovative approaches to care delivery are constantly emerging. The American Medical Association (AMA) works closely with federal agencies and stakeholders to ensure that the CPT code set remains relevant and supports the integration of new payment models [2][5].
Future Developments and Challenges
Looking ahead, the CPT Editorial Panel, supported by over 200 advisors, will continue to play a pivotal role in adapting the code set to meet the needs of a rapidly changing healthcare environment. The upcoming CPT Editorial Panel meeting in February 2026 will be an opportunity to further refine and expand the code set to accommodate emerging medical technologies and practices [1][3]. However, challenges remain, particularly in ensuring that new codes are adequately supported by evidence to drive both physician adoption and payer reimbursement [1][3].