Reimbursement of Apps for Mental Health: Findings From Interviews

JMIR Mental Health
Adam C PowellHenry T Harbin

Abstract

Although apps and other digital and mobile health tools are helping improve the mental health of Americans, they are currently being reimbursed through a varied range of means, and most are not being reimbursed by payers at all. The aim of this study was to shed light on the state of app reimbursement. We documented ways in which apps can be reimbursed and surveyed stakeholders to understand current reimbursement practices. Individuals from over a dozen stakeholder organizations in the domains of digital behavioral and mental health, care delivery, and managed care were interviewed. A review of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCSPCS) codes was conducted to determine potential means for reimbursement. Interviews and the review of codes revealed that potential channels for app reimbursement include direct payments by employers, providers, patients, and insurers. Insurers are additionally paying for apps using channels originally designed for devices, drugs, and laboratory tests, as well as via value-based payments and CPT and HCSPCS codes. In many cases, it is only possible to meet the requirements of a CPT or HCSPCS code if an app is used in conjunction with human time and serv...Continue Reading

References

Sep 2, 2016·Psychiatric Services : a Journal of the American Psychiatric Association·John C FortneyHenry T Harbin

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Citations

Feb 6, 2020·BJPsych Open·Adam C PowellKenneth R Kaufman
Sep 15, 2020·Journal of Technology in Behavioral Science·Samantha L ConnollyChristopher J Miller
Jan 21, 2021·Psychiatric Services : a Journal of the American Psychiatric Association·David C MohrUNKNOWN Banbury Forum on Digital Mental Health
Feb 10, 2021·Psychiatric Services : a Journal of the American Psychiatric Association·Dror Ben-ZeevCarol E Levin
May 6, 2021·Psychiatric Services : a Journal of the American Psychiatric Association·Adam C PowellStephen M Schueller
Sep 23, 2021·Cyberpsychology, Behavior and Social Networking·Brenda K Wiederhold

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Methods Mentioned

BETA
cognitive behavioral therapy

Software Mentioned

Aetna
PerformCare
Amerigroup

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