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Billing and coding system needed for US psychedelic therapies

Published

9 months ago

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First professional practice guidelines for psychedelic therapy published

When psychedelic therapies begin to gain regulatory approval, they will need to be incorporated into the medical billing and coding system in a way that ensures equitable patient access, say experts.

As increasing evidence from psychedelic research shows their potential as treatments for mental health conditions, states such as Oregon and Alberta have begun regulating for the delivery of psychedelic-assisted therapies, likely with more to follow.

See also  Awakn: democratising access to psychedelic treatments

While these are positive developments for patients, a group of experts has highlighted the importance of ensuring affordable access to the therapies for patients.

In this regard, the experts have published an article that presents a robust medical billing and coding strategy in the inaugural issue of Psychedelic Medicine, titled “Psychedelic Medicine’s Future Depends on Proactive Development of a Robust Medical Billing and Coding Strategy”.

Ensuring access for patients

Co-authored by Brian Barnett, from US-based Cleveland Clinic, the authors note that investigational psychedelic therapies are likely to begin gaining regulatory approval as medical treatments in the US within the next two years. 

When this happens, however, a number of barriers to equitable patient access will remain – including its incorporation into the United State’s medical billing and coding system, which the authors highlight plays a central role in reimbursement for health care services.

They emphasise that, if approved, equitable patient access will depend on the incorporation of these novel treatments into the medical billing and coding system. 

The authors write: “Although still investigational, psychedelic therapies appear poised to begin securing regulatory approval as medical treatments in the United States within the next two years… 

“Since specific billing codes for psychedelic therapy delivery do not exist, modification of existing codes or development of de novo codes will be necessary. This reality has created uncertainty about reimbursement and the financial future of psychedelic medicine.”

The authors propose that the development of de novo billing codes is the best approach for addressing psychedelic therapy reimbursement concerns. 

Several factors make psychedelic therapy, “particularly vulnerable to development of billing codes that undervalue the complexity of its delivery,” state the authors.

They write: “We argue that development of de novo billing codes in conjunction with the American Medical Association’s Current Procedural Terminology (CPT) Editorial Panel is the best approach for addressing psychedelic therapy reimbursement concerns. 

“However, with no similar existing medical services to guide development, the potential need for multiple providers during dosing sessions, limited mental health care representation on the CPT Editorial Panel, and a number of misconceptions surrounding psychedelic therapy among critics, psychedelic therapy is particularly vulnerable to development of billing codes that undervalue the complexity of its delivery.”

An industry-sponsored application for new CPT codes for psychedelic drug monitoring services is soon to be reviewed by the CPT Editorial Panel, say the authors, which they describe as a critical step toward maximising psychedelic therapy’s societal impact. 

“Whether these proposed codes ultimately become the bedrock of billing for psychedelic therapy or future codes are developed to augment or replace them is not known, but it is a promising sign that efforts to create a robust medical billing and coding strategy for psychedelic medicine are now underway,” they write.

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Policy

Now is the time for psychedelic access, says campaigner

Published

1 week ago

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21st November 2023

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Now is the time for psychedelic access, says campaigner

Activists in Oakland recently filed a ballot put forward by Dave Hodges seeking to legalise safe and legal access to psychedelics for therapeutic uses. 

In the face of critics, Hodges has said now is the time for safe access to psychedelics.

The Psychedelic Wellness & Healing Initiative would enable the sale, possession and use of psychedelics for therapeutic purposes if passed. Psychedelics that would be allowed under the ballot include Psilocybin, MDMA, DMT, and Mescaline.

If passed, the initiative would give doctors and mental health specialists the right to recommend psychedelics to ease the debilitating symptoms of a range of problems, including obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), depression, anxiety, addiction, suicidality and traumatic brain injury (TBI), among others.

Hodges has said: “Now is the time for safe, controlled medical access for patients in need. The way to solve the problem is not by continuing to ignore it.” 

Hodges’ solution is to create a structure for use that includes proper dosages and access to experts who can help users benefit from appropriate treatment.

The updated initiative language emphasises safety, and gives doctors and mental health specialists the right to recommend psychedelics to ease the debilitating symptoms of a range of conditions.

Research by the University of Michigan and Columbia University shows non-LSD hallucinogenic use on the rise and Hodges has stated that increase means that the initiative providing guidelines for use is needed more than ever. 

Hodges said he hopes Californians will read the initiative, share their thoughts about it over the holiday week and offer feedback via the initiative website, PW4CA.com, by 27 November, 2023, the deadline for modifications.

“Now is the time to provide medical and therapeutic access to psychedelics,” Hodges said. “The way to do this is through the initiative.”

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Policy

Transform Drugs releases groundbreaking book: How to regulate psychedelics

Published

2 weeks ago

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15th November 2023

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Transform Drugs releases book: How to regulate psychedelics

UK charity Transform Drug Policy Foundation has published a new book ‘How to Regulate Psychedelics: A Practical Guide’ that sets out how psychedelics can be legalised and regulated for non-medical adult use.

While an increasing amount of research is pointing to the potentially beneficial effects of psychedelic treatment on mental health conditions, many people across the globe are using psychedelics outside of the clinical setting.

The book includes a set of proposals for post-prohibition policies, covering psychedelics including psilocybin, LSD, DMT and Mescaline. 

Previously, Transform’s guides on regulating stimulants and cannabis have been used to advise governments around the world on drug policy. This book seeks to inform the debates on psychedelic drug reforms taking place across the world.

Co-author and Public Affairs and Policy Manager at Transform Drug Policy Foundation, Ester Kincová, stated: “Despite psychedelic drugs being illegal, their non-medical use within society has been steadily increasing. 

“Punitive enforcement has not decreased use or eliminated supply, but it has made use more unsafe. 

“Legalising and regulating psychedelics is a pragmatic move to reduce harm. This is no longer a theoretical debate, states in the US are already recognising the need and  making moves to regulate for non-medical adult use.”

Scientific Chair of Drug Science, Professor David Nutt, added: “Once again Transform have come up with a well thought out and practical plan for the regulation of another group of currently illegal drugs – in this case psychedelics. 

“Their ideas would be both easy to implement and to engage with and will, if adopted, radically enhance the safe use of these remarkable agents.”

Proposals for regulation

The book includes a four-tiered regulation model “that attempts to manage the variety of psychedelic preparations and the different ways in which they are used”.

These include:

  • Private use, home cultivation, foraging and not-for-profit sharing.
  • Membership-based non-for-profit associations for plant-based products.
  • Licensed production and retail adaptable to different products and environments
  • Regulated commercial guided or supervised use

Additionally, a decriminalisation model is proposed which suggests that possession for personal use should no longer be an offence of any kind or be subject to any sanctions; Drugs for personal use should not be confiscated; cultivation of small amounts of plant-based drugs for personal use should be decriminalised, among other suggestions.

The book also includes topics such as embedding social justice, equity and human rights into policy design, how to think about psychedelics regulation, why regulate psychedelics and why now, and psychedelics and the UN drug treaties.

To read the book, please visit transformdrugs.org/.

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Policy

Oakland ballot seeks to legalise medical psychedelics

Published

1 month ago

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30th October 2023

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Oakland ballot seeks to legalise medical psychedelics

Activists in Oakland have filed a ballot that seeks to legalise safe and legal access to psychedelics for therapeutic uses. 

The Psychedelic Wellness & Healing Initiative would enable the sale, possession and use of psychedelics for therapeutic purposes if passed. Psychedelics that would be allowed under the ballot include Psilocybin, MDMA, DMT, and Mescaline.

If passed, the initiative would give doctors and mental health specialists the right to recommend psychedelics to ease the debilitating symptoms of a range of problems, including obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), depression, anxiety, addiction, suicidality and traumatic brain injury (TBI), among others.

See also  Australia reschedules psilocybin and MDMA

Additionally, it would create a statewide framework for regulating the possession, use, cultivation and production of substances for medical and therapeutic use.

The initiative has been introduced by proponent and founder of the Oakland-based Church of Ambrosia, Dave Hodges, to the California Attorney General’s office for the 2024 ballot, and will need 546,651 valid signatures to qualify.

See also  CDPRG discusses the UK's Reschedule Psilocybin campaign

The filing follows California Governor Gavin Newsom’s recent veto of Senate Bill 58, the bill that sought to decriminalise the use of certain psychedelic drugs. 

Hodges emphasised that SB58 would have been a step forward, but that it had major flaws concerning its lack of provisions to ensure access, public safety and quality control. That veto, Hodges said, compelled him to move quickly on the initiative filing.

When the California Attorney General certifies the initiative for circulation, backers will have about four and a half months to gather the required signatures for ballot placement. 

Signature collecting will begin in early December.

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