CMS touts ‘most important’ behavioral health changes in PFS

Why This Topic Matters

CMS is signaling major Medicare policy changes that could broaden which behavioral health professionals can participate, affect how behavioral health services are paid, and influence access to care. Readers who bill or manage behavioral health services need to understand the scope of the proposal and the categories of services affected.

Article Sections

1. Behavioral health

   Overview of CMS’s proposed behavioral health priorities in the 2024 physician fee schedule and the broader Medicare context for these changes.

2. Provider participation and service expansion

   Discussion of proposed changes affecting eligible behavioral health providers, enrollment, telehealth, diagnostic testing, and other service categories.

3. Health Behavior Assessment and Intervention

   Coverage and participation changes tied to health behavior assessment and intervention services, including the provider groups implicated by the proposal.

4. Psychotherapy services and payment updates

   Proposed additions and payment adjustments related to psychotherapy services, including crisis-related service categories and work RVU revisions.

5. Substance use disorder services

   Payment and crosswalk changes affecting office-based substance use disorder treatment codes under Medicare.

6. CMS outreach and future rulemaking

   CMS’s outreach efforts to providers and its plans to seek additional information on digital therapeutics, remote therapeutic monitoring, and cognitive behavioral therapy.