New New milestone for psychedelic-assisted psychotherapy
In July 2023, the AMA is set to release a new code, effective January 1, 2024, which will allow healthcare providers to bill for psychedelic-assisted psychotherapy services. The CPT Editorial Panel has accepted the addition of four Category III codes (X088T, X089T, X090T) and related guidelines for reporting psychedelic drug monitoring services. These temporary codes identify emerging technologies, services, and procedures not yet widely established or reimbursed by payers. Psychedelic drug therapy uses drugs like ketamine, psilocybin, and MDMA alongside therapy sessions to treat mental health conditions such as depression, anxiety, and PTSD.
Significance:
1 The new AMA code will enable healthcare providers to bill for psychedelic-assisted psychotherapy services.
2 Stimulates more research into potential benefits and paves the way for regulatory approval.
3 Collaboration between MAPS PBC and COMPASS Pathways aims to facilitate reimbursement and access to psychedelic therapies in the US if approved by the FDA.
Potential pitfalls:
1 Psychedelic therapy is a new and emerging field, which may face skepticism and regulatory hurdles.
2 As Category III codes are temporary, long-term reimbursement and coverage by payers are uncertain.
3 Psychedelic-assisted therapies must still clear FDA approval for widespread adoption.
This milestone highlights the growing recognition of psychedelic drug therapy as a valuable treatment option for mental health conditions. While there are potential pitfalls, such as regulatory hurdles and skepticism, the new AMA code is a significant step forward in making these innovative therapies more accessible to those in need.
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