On Wednesday, the Centers for Medicare & Medicaid Services (CMS) unveiled its proposed physician fee schedule for the calendar year 2025, which includes key recommendations on the coverage of digital health tools, such as digital therapeutics and telehealth services. One significant proposal is for Medicare to cover digital mental health treatment devices when used alongside a behavioral health treatment plan. CMS plans to introduce three new HCPCS codes to monitor the usage of these devices within the broader context of behavioral healthcare.
In addition to digital mental health devices, CMS is proposing six new G codes for billing by practitioners whose services are limited by statute to the diagnosis and treatment of mental illness. These practitioners include clinical psychologists, clinical social workers, marriage and family therapists, and mental health counselors. These new codes are designed to align with existing interprofessional consultation CPT codes used by other eligible practitioners for evaluation and management (E/M) visits.
Furthermore, the proposed schedule includes the addition of new services to the telehealth list. These new services encompass caregiver training via telehealth, treatment for opioid use disorder, and audio-only telehealth services for patients who are unable or unwilling to use video services. The proposal also aims to continue the telehealth services that were introduced during the COVID-19 pandemic, although their coverage is set to expire at the end of this year unless Congress extends it. The draft physician fee schedule is open for public comment for 60 days, ending on September 9.
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