On September 9, 2024, APA Services spearheaded a comment letter from a diverse array of mental health policy stakeholders, in support of the Centers for Medicare and Medicaid Services (CMS) proposal concerning digital therapeutics devices (PDF, 66KB)opens in new window. This year’s Medicare Physician Fee Schedule (PFS) proposed rule includes a provision that creates a pathway for coding and reimbursement of services furnished via FDA-cleared digital therapeutics devices. The proposal outlines a coding mechanism that reimburses not only for the device itself, but also for a clinician’s time educating patients on the technology, monitoring the patient’s usage, and providing services through the digital tool. The proposal also sets an important precedent for inclusion of these devices in other health care coverage programs.
The letter submitted to CMS on September 9 demonstrates support for the proposal from diverse stakeholders, including major mental health advocacy groups such as The Kennedy Forum, the National Alliance on Mental Illness, Mental Health America, and the American Foundation for Suicide Prevention. The final PFS rule for CY 2025 is expected later in the fall.
For more information, contact Andrew Strickland.