The 2025 Medicare Physician Fee Schedule introduced several new billing opportunities for behavioral health practices. From digital mental health tools to crisis intervention services, CMS is expanding reimbursement options that can improve both patient care and practice revenue.
💡 Key Update
While the 2025 conversion factor decreased by 2.93% to $32.35, new codes and expanded services create opportunities to offset this reduction through previously unbillable services.
Digital Mental Health Treatment Codes
Medicare now reimburses for FDA-cleared digital mental health treatment devices when used as part of an ongoing behavioral health treatment plan. These are designed to complement (not replace) traditional therapy.
New Digital Mental Health HCPCS Codes
G0552 G0553 G0554These codes cover initial setup, training, and ongoing monitoring of FDA-cleared digital mental health treatment devices as part of a clinician's care plan.
Requirements for Digital Mental Health Billing
- Device must be FDA-cleared for mental health treatment
- Must be prescribed as part of an active treatment plan
- Patient must be receiving concurrent behavioral health services
- Documentation must show integration with overall care
Safety Planning Intervention Code
CMS introduced separate coding and payment for safety planning interventions, recognizing this as a critical evidence-based practice for patients in crisis.
Safety Planning Code
G0560Billable in 20-minute increments for safety planning interventions with patients experiencing suicidal ideation or crisis.
This is a significant development because safety planning was previously bundled into E/M or psychotherapy codes, often resulting in lost revenue for time-intensive crisis interventions.
Crisis Follow-Up Services
New billing codes are available for post-discharge follow-up for patients who leave the emergency department after a mental health crisis.
Post-Discharge Follow-Up
Bundled payment covering up to four follow-up contacts within one month after discharge from an emergency department for a mental health crisis.
Interprofessional Consultation Expansion
Clinical psychologists and clinical social workers can now bill for interprofessional consultations focused on mental health management.
Interprofessional Consultation Codes
G0546 G0547 G0548 G0549 G0550 G0551These codes allow mental health professionals to bill for consultations with other clinicians regarding a patient's care, expanding collaborative care reimbursement.
Telehealth Updates
CMS finalized important telehealth provisions for behavioral health:
- Audio-Only Services: Permanent allowance for audio-only communications when the patient's home is the originating site (if video is unavailable or patient doesn't consent)
- Caregiver Training: Services added to Medicare Telehealth Services list provisionally for 2025
- Extended Waivers: CMS is considering a two-year extension of pandemic-era telehealth waivers
Reimbursement Changes Summary
| Category | Change |
|---|---|
| Conversion Factor | Decreased 2.93% to $32.35 |
| Inpatient Psychiatric Facilities | Increased 2.8% |
| Electroconvulsive Therapy (ECT) | Nearly doubled |
| Average Psychiatric Visit | 2-3% lower than 2024 |
Action Items for Your Practice
- Review your service mix – identify opportunities to bill new codes
- Update your charge capture – ensure new codes are in your billing system
- Train clinical staff – document requirements for new codes
- Evaluate digital tools – consider FDA-cleared options that qualify
- Audit existing claims – ensure you're capturing all billable services
New Codes Won't Help Old Claims
These 2025 updates apply to new services going forward. If you have aged claims from 2024 or earlier sitting in A/R limbo, specialized recovery can help turn those into revenue.
Start Free 20-Claim Pilot →Looking Ahead
The CMS Innovation in Behavioral Health (IBH) Model, running from 2025-2032, signals a broader shift toward integrated, whole-person care with value-based payment structures. Practices that adapt now will be better positioned for future changes.
For the complete 2025 Medicare Physician Fee Schedule, visit the CMS website.