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Posted On: 02/26/2025 8:21:08 AM
Post# of 86525
Interesting little development, could this help ?
As of January 1, 2025, the Centers for Medicare and Medicaid Services (CMS) introduced three new reimbursement codes that provider organizations can use to bill Medicare for Food and Drug Administration (FDA)-cleared digital mental health therapies (DMHT) (see Medicare Finalizes New Codes & Payment For Digital Mental Health Treatment Devices For 2025). This marks the first time CMS has established Medicare-reimbursable codes specifically for digital therapeutic products under the physician services benefit. The implications of this shift are significant: DTx can now be incorporated into reimbursable treatment plans.
The new codes cover two therapeutic treatment management services (G0553 and G0554) as well as a supply code for behavioral health treatment devices (G0552). Billable services include initial education and onboarding, monthly treatment management, and a qualified professional’s time spent reviewing information related to the use of the DTx device, with at least one interactive communication with the patient/caregiver during the calendar month (see HHS Centers For Medicare & Medicaid Services 42 CFR).
As of January 1, 2025, the Centers for Medicare and Medicaid Services (CMS) introduced three new reimbursement codes that provider organizations can use to bill Medicare for Food and Drug Administration (FDA)-cleared digital mental health therapies (DMHT) (see Medicare Finalizes New Codes & Payment For Digital Mental Health Treatment Devices For 2025). This marks the first time CMS has established Medicare-reimbursable codes specifically for digital therapeutic products under the physician services benefit. The implications of this shift are significant: DTx can now be incorporated into reimbursable treatment plans.
The new codes cover two therapeutic treatment management services (G0553 and G0554) as well as a supply code for behavioral health treatment devices (G0552). Billable services include initial education and onboarding, monthly treatment management, and a qualified professional’s time spent reviewing information related to the use of the DTx device, with at least one interactive communication with the patient/caregiver during the calendar month (see HHS Centers For Medicare & Medicaid Services 42 CFR).
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