Psychedelic-assisted therapy has moved one step closer to mainstream medical practice with the approval of a new medical code that would allow billing insurance companies for the service.
The American Medical Association has approved a new temporary medical code for psychedelic therapy that will allow physicians to seek insurance reimbursement for the service starting in January 2024. The full details of the code are expected to be released by the AMA in July 2023.
The code was the result of a partnership between U.K.-based COMPASS Pathways and the Multidisciplinary Association for Psychedelic Studies (MAPS) Public Benefit Corporation to facilitate access and insurance coverage for psychedelic therapies in the United States.
COMPASS Pathways is currently conducting Phase 3 clinical trials evaluating psilocybin for treatment-resistant depression. Psilocybin is a compound found in certain mushrooms that can alter perception and mood. The company has already published positive results from a Phase 2b study, the largest of its kind, finding psilocybin therapy led to a significant reduction in depressive symptoms.
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MAPS PBC recently completed two Phase 3 clinical trials of MDMA-assisted therapy for post-traumatic stress disorder. Both studies found the therapy led to a clinically meaningful alleviation of PTSD symptoms.
The new medical code will provide a mechanism for these treatments to be reimbursed by insurance if approved by the U.S. Food and Drug Administration, according to a joint statement from the companies.
“This is a major step forward to enabling broad and equitable access to psychedelic therapies,” said Kabir Nath, CEO of COMPASS Pathways. “This collaboration with MAPS PBC to develop a new medical code aims to ensure that psychedelic therapies if approved, could be integrated into health-care systems, reimbursed by payers, and made available to the people who need them.”
Amy Emerson, CEO of MAPS PBC, said psychedelic-assisted therapies represent a potential new frontier in the treatment of mental health conditions.
“Our top priority is ensuring there is a path forward to integrate them into the health-care system if FDA approved,” she said. “Strong collaborations like this one demonstrate that by working together, we can move closer to our collective goal of helping people currently underserved by existing treatments for mental health conditions.”
The new medical code, published March 3 as part of a summary of actions taken by the AMA, is for “continuous in-person monitoring and intervention during psychedelic medication therapy.” The temporary code will allow the AMA to collect data on the use of the therapies to determine if a permanent code should be created.