On Wednesday, the Centers for Medicare and Medicaid Services (CMS) Proposal for 2025 physician fee scheduleThis includes recommendations on the coverage of digital health tools, including digital therapeutics and telehealth services.
CMS proposed that Medicare cover the costs of digital mental health treatment devices used in conjunction with behavioral health treatment plans to support access to behavioral health services.
“We are proposing to create three new HCPCS codes and will monitor how digital mental health treatment devices are used as part of overall behavioral health care,” the agency said in a statement.
“We also propose to create six G-codes to be billed by physicians in service delivery specialties (e.g., clinical psychologists, clinical social workers, marriage and family therapists, and mental health counselors) that are statutorily limited to services for the diagnosis and treatment of mental illness, and to mirror the current interprofessional consultation CPT codes used by physicians eligible to bill for E/M visits.”
CMS also proposed adding new services to the telehealth services list, including telehealth for caregiver training, treatment for opioid use disorder, and audio-only telehealth services for when patients cannot use or do not consent to video services.
The department also proposed continuing coverage for telehealth services implemented during the COVID-19 pandemic, but those services are set to expire at the end of the year. Congress should extend coverage to ensure those services remain in effect.
The draft PFS is open to a 60-day comment period, due on September 9th.
Larger trends
Another aspect of the PFS is a proposal to reduce physician payments by 2.93% in 2025. Reports say by MobiHealthNews Sister Publications Healthcare Finance News.
In response to the proposal, the president of the American Medical Association said, “Death by a thousand cuts continues.”
The decline contrasts with a projection that Medicare reimbursements for hospital outpatient departments will increase by 2.6 percent next year.
