The recent changes in US Current Procedural Terminology (CPT) codes shows that mental healthcare is evolving when it comes to incorporating digital health solutions into clinical practice.
This comes off the back of evidence from the AMA that physician’s attitudes towards digital health are shifting too, and providing financial incentives that align with these changes is fundamental to enabling the incorporation of digital mental health support for patients.
Increased Adoption of Digital Health Tools by Physicians
A recent survey conducted by the American Medical Association (AMA) showed changes in attitudes and a continued increase in the adoption of digital health tools by physicians.
The key findings from the study were that:
• Improved clinical outcomes and improved work efficiency were the top motivators for physicians to use digital health tools
• There has been an increase in the number of physicians that see a definite advantage in digital tools
• Adoption of digital tools has grown significantly among all physicians regardless of gender, specialty or age
• Adoption of remote care tools such as tele-visits and remote monitoring saw the largest increases
Although plans for adoption of most emerging technologies was high, usage was still quite low, with only 20% using augmented intelligence for practice efficiency.
This may be about to change for those working within mental health, with changes to the reimbursement for the use of digital health tools coming into effect.
Changes to CPT Codes in 2023
This year, changes to Current Procedural Terminology (CPT®) codes are facilitating the expansion of digital health solutions in mental healthcare.
These modifications encompass the classification of mental and behavioral health services, introducing new codes and revisions. The categorization now extends to include digital health and evaluation and management (E/M).
The adjustments made to the mental and behavioral health E/M codes aim to align with similar changes in 2023 E/M guidelines across other categories. Notably, CPT codes 99354-99357 have been retired.
One pivotal aspect of the 2023 CPT code changes is the incorporation of remote physiological monitoring (RPM) and remote therapeutic monitoring (RTM) codes. These codes, introduced in 2019, encompass various facets of patient care, from device setup and patient education to therapy adherence monitoring and therapy response assessment.
Of particular importance is the introduction of new codes for cognitive behavioral therapy (CBT) within the RTM category, enhancing the range of services available to patients. These codes encompass a comprehensive array of activities, from device setup and education to management services during a calendar month.
Codes for remote therapeutic monitoring (RTM) that are applicable for digital CBT
98975
To report the set-up and patient education on operating any device used for therapeutic data collection.
98978
30-day device supply with scheduled recording and/or programmed alert transmission to monitor CBT.
98980
First 20 minutes of RTM management services during a calendar month.
98981
Each additional 20-minute period spent on RTM management. There must be at least one interactive communication with the patient or caregiver for 98980 and 98981.
Implications for digital health
As physician’s attitudes towards incorporating digital health tools into clinical practice have evolved, it’s encouraging to see CPT codes updated to provide financial incentives to support behavior change.
The changes to the codes means that psychologists, physicians and other eligible healthcare providers can now bill insurance providers for time spent on digital CBT.
For companies providing apps with digital CBT, this is a clear indication that funding models are catching up, with healthcare providers now better incentivized to use digital mental health support with their patients.
