Clinical Social Workers to Receive Reimbursement for Digital Services in 2025

November 2024

Effective January 1, 2025, clinical social workers may receive reimbursement for services using a digital mental health treatment (DMHT) device. The device is a software approved by the Food and Drug Administration to treat a mental health condition in conjunction with ongoing mental health treatment that includes a plan of care. The device generates and delivers a mental health treatment intervention that has a positive therapeutic impact on a patient’s mental health. It is furnished incident to a clinical social worker’s professional services and is considered a practice expense. Any professional who is licensed to diagnose and treat mental illness, can seek reimbursement for the use of this type of software.

Three new reimbursement codes have been developed for use by clinical social workers and others.

• G0552- Supply of DMHT devise and initial education and onboarding, per course of treatment that augments a behavioral therapy plan
• G0553 – First 20 minutes of monthly treatment management services directly related to the CSW professional time, reviewing information related to the use of the DMHT device, including patient observations and inputs in a calendar month, and requiring at least one interactive communication with the patient/caregiver during the calendar month
• G0554 – Each additional 20 minutes of monthly treatment management services directly related to the patient’s therapeutic use of the DMHT device that augments a behavioral therapy plan, the time reviewing information related to the use of the DMHT device, including patient observations and patient-specific inputs in a calendar month, and requiring at least one interactive communication with the patient/caregiver during the calendar month.

Examples of software that have been approved by the FDA for digital therapy include,but are not limited, to the following:

• Rejoyn: A prescription smartphone app for major depressive disorder in adults aged 22 and above. It’s intended to help patients who don’t fully respond to antidepressants.
• DaylightRX: A prescription digital therapeutic for generalized anxiety disorder in patients aged 22 and older. It teaches patients techniques to reduce anxiety and worry.
• SparkRX: A mobile app-based digital therapeutic for treating depression in adolescents.

Additional information about DMHT is available at https://www.federalregister.gov/public-inspection/2024-25382/medicare-and-medicaid-programs-calendar-year-2025-payment-policies-under-the-physician-fee-schedule

NASW members may refer questions related to DMHT to clinical.practice@socialworkers.org