Codes will provide qualified healthcare professionals a means to seek reimbursement for delivering MDMA-assisted therapy if it is approved by the U.S. Food and Drug Administration
SAN JOSE, Calif., July 6, 2023—MAPS Public Benefit Corporation (“MAPS PBC”), a clinical-stage company dedicated to changing the way mental health conditions are treated, announced that the American Medical Association (“AMA”) has published language for the new current procedural terminology (“CPT”) III codes for psychedelic-assisted therapies. The codes are expected to go into effect when they are published on January 1, 2024. Once effective, the CPT codes will provide physicians and other qualified healthcare professionals a means to seek coverage and reimbursement for delivering psychedelic-assisted therapy approved by the U.S. Food and Drug Administration (“FDA”).
“The development of these new codes highlights the potential role in mental healthcare that MDMA-assisted therapy may play in the future if approved by the FDA,” said Amy Emerson, CEO, MAPS PBC. “Given mental health treatments have historically not been reimbursed adequately, it is great to see a new potential avenue for insurance coverage and reimbursement.”
MAPS PBC and COMPASS Pathways collaborated to work with the AMA to create the CPT III codes, a set of temporary codes assigned to emerging technologies, services and procedures, to facilitate reimbursement and support access to psychedelic therapies in the United States, if such therapies receive regulatory approval by the FDA. On March 3, 2023 the AMA published the Summary of Panel Actions which included the acceptance of the new CPT III codes. The application was titled, “Continuous In-Person Monitoring and Intervention during Psychedelic Medication Therapy.” The new CPT III codes are intended to be used for data collection to substantiate sufficient usage, which could lead to them being converted to permanent CPT I codes with a valuation assigned for widespread coverage and reimbursement.
The first code (0820T) is for a health care professional to be reimbursed for monitoring and intervention during a psychedelic-assisted therapy. There are two additional modifiers (code 0821 and 0822) that are for reimbursement for a second qualified healthcare professional and for clinical staff, respectively.
MDMA-assisted therapy has not been approved by any regulatory agency. The safety and efficacy of MDMA-assisted therapy have not been established for the treatment of PTSD.
ABOUT MAPS PUBLIC BENEFIT CORPORATION (MAPS PBC)
MAPS Public Benefit Corporation (MAPS PBC) is focused on developing and commercializing prescription psychedelics to bring better treatments to those living with mental health conditions. MAPS PBC has completed two phase 3 clinical trials evaluating investigational MDMA-assisted therapy as a potential treatment for post-traumatic stress disorder (PTSD), both of which met their pre-specified primary and secondary endpoints[i][ii]. Founded in 2014, MAPS PBC is a subsidiary of the Multidisciplinary Association for Psychedelic Studies, a 501(c)(3) non-profit organization. For more information, please visit www.mapsbcorp.com.
E. Blair Clark-Schoeb
Chief Communications Officer
[i] Mitchell JM et al. Nat Med. 2021;27(6):1025-1033.
[ii] MAPS PBC Announces Positive Results from Confirmatory Phase 3 “MAPP2” Trial of MDMA-Assisted Therapy for Treatment of PTSD – MAPS Public Benefit Corporation (mapsbcorp.com). Accessed July 3, 2023.