A9294, Prescription digital cognitive and/or behavioral therapy, biofeedback, fda
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- Check state regulations and the member contract for coverage details.
Key Coverage Criteria
- The use of a digital therapeutic product in the treatment or prevention of any health condition is medically necessary when all of the following criteria are met: (A) prescribed by a healthcare practitioner providing medical oversight; (B) FDA-approved for the requested indication; (C) high-quality evidence showing the product improves clinically meaningful net health outcomes as much or more than an established alternative; (D) the improved net health outcome is attainable outside of investigat [...]
6 Active Policies
BCBSIL-PSY301.025, Digital Health Technologies: Therapeutic Applications
BCBSMT-PSY301.025, Digital Health Technologies: Therapeutic Applications
BCBSNM-PSY301.025, Digital Health Technologies: Therapeutic Applications
BCBSOK-PSY301.025, Digital Health Technologies: Therapeutic Applications
REGENCE-MED175, Digital Therapeutic Products
Related Codes
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