The Centers for Medicare & Medicaid Services (CMS), in its draft 2025 physician fee schedule, proposed adding three new HCPCS codes for digital therapeutics (DTx) used in mental health treatment. This move represents the first step toward Medicare reimbursement for DTx.
The proposed codes are:
GMBT1: For reimbursing physicians providing FDA-approved DTx devices for mental health
GMBT2: For the first 20 minutes of managing a patient’s DTx device each month
GMBT3: For each additional 20 minutes of management.
The proposal would enable providers to be reimbursed for using FDA-cleared devices that utilize software to deliver behavioral health therapies. CMS is also seeking comment on whether physicians should be reimbursed for using devices that are not yet FDA-approved for mental health treatment but have been approved for other purposes. Among other requests, the agency is also seeking input on whether the agency should limit the number of reimbursable devices per patient each month. The comment period for the proposed rule ends September 9. Learn more here.
Last Updated on July 23, 2024 by Aimed Alliance
