On Wednesday, the Facilities for Medicare & Medicaid Companies (CMS) launched its proposed calendar 12 months 2025 doctor payment schedule, which incorporates suggestions on protection of digital well being instruments, together with digital therapeutics and telehealth companies.
To help entry to behavioral well being companies, CMS proposed that Medicare pay for digital psychological well being therapy units used along side a behavioral well being therapy plan.
“We’re proposing to create three new HCPCS codes and we’d monitor how digital psychological well being therapy units are used as a part of total behavioral well being care,” the company’s assertion mentioned.
“We’re additionally proposing to create six G codes to be billed by practitioners in specialties whose lined companies are restricted by statute to companies for the prognosis and therapy of psychological sickness (together with medical psychologists, medical social staff, marriage and household therapists, and psychological well being counselors) to reflect present interprofessional session CPT codes utilized by practitioners who’re eligible to invoice E/M visits.”
CMS additionally proposed including new companies to the telehealth companies listing, together with telehealth for caregiver coaching, opioid use dysfunction therapy, and audio-only telehealth companies if a affected person is incapable of utilizing video companies or doesn’t consent to video.
The company additionally proposed continued protection of telehealth companies launched in the course of the COVID-19 pandemic; nonetheless, these companies are set to run out on the finish of this 12 months. Congress might want to prolong protection for them to stay in impact.
The draft PFS is underneath a 60-day remark interval, expiring on September 9.
THE LARGER TREND
One other side of the PFS is a proposal for decreasing doctor funds by 2.93% in 2025, as reported by MobiHealthNews‘ sister publication, Healthcare Finance Information.
In response to the proposal, the president of the American Medical Affiliation mentioned, “The demise by a thousand cuts continues.”
The lower contrasts with the two.6% improve in Medicare reimbursement for hospital outpatient departments subsequent 12 months.
