Pear Therapeutics (NSDQ:PEAR) announced that the Centers for Medicare & Medicaid Services (CMS) established new coding relevant to its prescription digital therapeutics (PDTs).
CMS established a new Level II Healthcare Common Procedure Coding System (HCPCS) code to describe prescription digital behavioral therapy — FDA-cleared — per course of treatment, which extends to PDTs including Pear’s reSET, reSET-O and Somryst.
Boston-based Pear’s offerings are the only FDA-authorized PDTs for treating substance use disorder (reSET), opioid use disorder (reSET-O) and chronic insomnia (Somryst), according to a news release.
The CMS coding decision, published on Feb. 16, 2022, becomes effective on April 1, 2022. The code for prescription digital behavioral therapy is “A9291.”
Pear Therapeutics designed its PDTs for collecting real-world data for use by prescribing clinicians and for population health management by payors and health systems. The PDTs use software to directly treat disease.
“We thank CMS for their decision to establish a new HCPCS code to describe prescription digital therapeutics and facilitate options for payers to provide access to these treatment options in response to Pear’s application,” Pear Therapeutics President and CEO Corey McCann said in the release. “This is an important reimbursement milestone for healthcare providers, payers and patients, and marks another step towards standard of care for coverage and payment for the PDT category.”
