CMS will bump payment rates for inpatient behavioral health services and make other adjustments to reimbursement in 2025.
Here are five behavioral health reimbursement changes taking effect next year to note:
- CMS will increase inpatient payment rates to psychiatric facilities by 2.8%, the agency said in a final rule published in July.
- CMS will nearly double reimbursement for electroconvulsive therapy treatments. In 2025, the agency will reimburse facilities $661.52 per treatment, up from $385.58 in 2024.
- The agency will also create new codes designed to allow providers to bill for safety planning interventions and for follow-up contacts for patients discharged from the emergency room after a mental health crisis. These interventions can help prevent suicide when properly implemented, according to CMS.
- In 2025, Medicare will reimburse FDA-approved digital mental health devices when used by behavioral health providers as part of a care plan.
- CMS will allow providers limited to diagnosing and treating mental illness, including clinical psychologists, social workers and marriage and family therapists, to bill Medicare for interprofessional consultations in 2025.
In addition to reimbursement changes, mental health parity rules will take effect in 2025. The new regulations will bar health plans from using more restrictive prior authorization requirements for mental health than for other forms of care, and require insurers to evaluate the outcomes of their mental health coverage policies.