Arlington, VA — November 4, 2021 – As the leading international organization on digital therapeutic thought leadership and education, the Digital Therapeutics Alliance (DTA) welcomes the American Medical Association’s (AMA) Current Procedural Terminology (CPT®) Editorial Panel’s recent decision to clarify reporting of remote cognitive behavioral therapy (CBT) monitoring services. The changes to the CPT code set reflect the growing recognition that digital therapeutics (DTx) are an effective treatment for patients with mental health conditions and physicians should ultimately be reimbursed for their time spent prescribing, monitoring, and supplying online CBT technologies.
Access and affordability are two primary obstacles for many seeking mental healthcare, particularly in the most vulnerable populations. To address these challenges, a number of DTA’s members are delivering online CBT through their innovative products, making evidence-based treatments more accessible and improving patient outcomes. Thus, we are particularly excited to see the following updates from the Panel that will ensure physicians are able to deliver these interventions:
Tab # 43: Cognitive Behavioral Therapy Monitoring – Effective Date January 2023
These changes will allow providers to adequately describe time spent delivering these types of interventions, as Dr. Tom Megerian, MD, the Chief Medical Officer of one of DTA’s member companies, Cognito Therapeutics, recently stated, “As a prescriber, I have seen the value digital therapeutics provide to patients firsthand, but integrating them into patient care was challenging without a mechanism to report delivering these treatments. This update to the code set will help to ensure physicians are able to provide the therapies that work best for their patients.”
While these changes are an important step towards ensuring physicians are eventually compensated for the care they provide, obstacles remain for DTx products to have the reach and impact they could have on patient lives. Therefore, DTA is leading efforts to establish clear and scalable pathways for reimbursement to support the wider integration of these products into the larger healthcare ecosystem. To build on the positive changes of this code set update, further code changes should be considered as this emerging market takes shape and additional therapies become available. As a part of our broader efforts to ensure appropriate reimbursement for this category of medicine, DTA is also pursuing policy and legislative changes to establish a Medicare benefit category for digital therapeutics in addition to more clarity on coverage under state Medicaid programs.
The Digital Therapeutics Alliance (DTA) is a global non-profit trade association of industry leaders and stakeholders with the mission of broadening the understanding, adoption, and integration of digital therapeutics into healthcare. DTA works to enable expanded access to high quality, evidence-based digital therapeutics for patients, clinicians, and payors to improve clinical and health economic outcomes. To learn more, please visit: www.dtxalliance.org or follow us on LinkedIn and Twitter.
CPT® is a registered trademark of the American Medical Association.
Digital Therapeutics Alliance