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August 26, 2024
CMS Fee Schedule Calls for Digital Therapeutics Reimbursement
Behavioral Health Business
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Summary
The Centers for Medicare & Medicaid Services (CMS) has proposed new guidelines in its 2025 Physician Fee Schedule to include reimbursement for digital therapeutics used in behavioral health treatments. These guidelines propose three new HCPCS codes to cover the costs associated with digital mental health treatment devices that are FDA-cleared and used as part of a broader behavioral health treatment plan. Reflecting a careful approach, CMS aims to gather data on the use and effectiveness of these digital tools, which are seen as supplementary to ongoing treatment. Despite previous failures in the digital therapeutics market, CMS's move signals a growing adoption of technology in behavioral health, driven by both need and potential for improved clinical outcomes.
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