The American Medical Association (AMA) is considering new CPT codes for behavioral health services provided remotely. The move could make it easier for providers to permanently be paid for delivering virtual and digital mental health services.
Specifically, AMA’s CPT Editorial Panel is considering new CPT codes for the following:
- Digital Behavioral Therapy Management — “Establish code 99XX0 in the Evaluation and Management section to report digital behavioral therapy management using an online cognitive behavioral program.”
- Cat III – Digital Behavioral Health Interventions — “Establish code 0X98T to report digital behavioral health interventions via a multiple function digital device.”
- Cognitive Behavioral Therapy Monitoring — “Establish code 989X6 to report remote therapeutic monitoring to monitor cognitive behavioral therapy; and delete codes 0X47T, 0X81T.”
Those codes, among others outside the behavioral health realm, will be up for discussion at the panel’s September 2021 meeting.
In general, AMA’s 17-person CPT Editorial Panel is tasked with revising and updating the CPT code set, which is used to report procedures and services to entities such as physicians, insurers and accreditation organizations.
The news comes after the Centers for Medicare & Medicaid Services (CMS) recently proposed a new category of digital health services — Remote Therapeutic Monitoring (RTM) — to be covered under Medicare. The codes, which were included in the proposed 2022 Physician Fee Schedule, add on to Medicare’s existing suite of Remote Physiological Monitoring (RPM) codes and are meant to expand providers’ ability to use — and be paid for — remote digital health technologies.
Amid the pandemic, behavioral health providers have proven their ability to deliver quality care virtually, with COVID-19-era telehealth flexibilities from the federal government making it possible. However, as the nation slowly returns to normal, many providers worry their ability to provide telehealth services will eventually be revoked, reintroducing travel- and stigma-related access issues.
As such, many are calling for permanent telehealth reform to prevent that from happening.
“Telehealth is not a COVID-19 novelty, and the regulatory flexibilities granted by Congress must not be viewed solely as pandemic response measures,” the National Council for Mental Wellbeing and 429 other stakeholders said in a recent letter to Congress. “Patient satisfaction surveys and claims data from CMS and private health plans tell a compelling story of the large-scale transformation of our nation’s health care system over the past year and, importantly, demonstrate strong patient interest and demand for telehealth access post-pandemic.”
The group urged Congress to remove restrictions on the location of the patient and provider; maintain and enhance HHS authority to determine appropriate providers, services, and modalities for telehealth; ensure FQHCs, critical access hospitals and rural health clinics can furnish telehealth services after the public health emergency; and remove restrictions on Medicare beneficiary access to mental health and substance use services offered through telehealth.
While the proposed CPT codes are a far cry from all that, they seem to be a step in the right direction.
Companies featured in this article:
American Medical Association, National Council for Mental Wellbeing
