Opioid treatment providers would be able to offer more services through telehealth under CMS' proposed Medicare payment rules for 2025.
The agency published its proposed physician fee schedule for 2025 on July 10. The proposal includes several updates to policies surrounding opioid use disorder treatment.
Here are three things to know:
- CMS proposed making permanent the current flexibility allowing OUD treatment providers to provide periodic assessments for patients through audio-only telehealth. The proposal would also allow intake appointments for OUD treatment over two-way audio-video communication.
- The agency is proposing adding a payment code for providers to bill Medicare for social determinants of health risk assessments as part of OUD treatment.
- CMS also proposed establishing Medicare payment for two new opioid agonist and antagonist medications approved by the FDA. Under the proposed rules, Medicare would reimburse for Opvee, a nasal spray for suspected opioid overdose, and the weekly and monthly formulations of a new injectable buprenorphine, Brixadi.
CMS also proposed several updates to behavioral health payments as part of the fee schedule, including reimbursement for the creation of safety plans for patients at risk of suicide.
The proposed schedule is open for comment until Sept. 9. Read more here.