CMS will add Medicare reimbursement for additional behavioral health services in 2025.
The agency published its final physician fee schedule for 2025 Nov. 1. The agency will implement a 94 cent (2.83%) conversion factor decrease from 2024.
In 2025, Medicare will reimburse FDA-approved digital therapies for mental health and allow providers to bill for creating patient safety interventions.
Here are five things to note:
- CMS will introduce separate coding and payment for safety planning interventions. These interventions can help prevent suicide when properly implemented, according to the agency. For 2025, the agency will also create a monthly billing code for follow-up contacts for patients discharged from the emergency department for a mental health crisis.
- In 2025, CMS 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 for interprofessional consultations.
- In 2025, CMS will allow providers to bill Medicare for opioid use disorder assessments to be conducted over audio-only telehealth. The agency will also allow opioid treatment programs to conduct intake through video telehealth platforms.
- CMS will provide Medicare reimbursement for nalmefene hydrochloride nasal spray, a longer-acting opioid reversal drug. The agency will also pay for a new injectable buprenorphine product.
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