G0554 — Each additional 20 minutes of monthly treatment management services directly related to the patient's therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the dmht device from patient observations and patient specific inputs in a calendar month and requiring at least one interactive communication with the patient/caregiver during the calendar month
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.61
Facility
$25.38
Non-Facility
$41.42
Documentation Required
- Prescription or order from a licensed healthcare provider specifying the digital therapeutic product.
- Documentation verifying FDA marketing clearance or approval for the specific software (de novo, 510(k), or PMA).