Congress Proposes Medicare and Medicaid Coverage for Prescription Medical Apps and Software
This bill is currently sitting in the House Energy and Commerce and Ways and Means committees. It has not moved since May 2025, which means nothing has happened with this proposal for 14 months. It is considered stalled because the committees have not taken any action to advance it.
No action since May 2025
This bill’s path across every version that has carried it.
Reintroduced
Reintroduced from H.R. 1458 (118th), which died when its Congress ended.
H.R. 1458 (118th) →Scores run from -100 (strongly harmful) to +100 (strongly beneficial) for each group, combining impact, certainty, scope, and duration ratings of 1-5. How impact scoring works
Small companies that develop FDA-cleared digital therapeutics would gain access to a massive new customer base through Medicare and Medicaid. The bill creates a formal payment system and product-specific billing codes, which would make it much easier for these companies to get paid for their products. However, they would also face new reporting requirements and potential fines of up to $10,000 per day for inaccurate reporting.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Sent to a congressional committee for expert review. The committee decides whether this bill moves forward.
Introduced in House
The bill was officially filed and given a number. It now enters the legislative queue.
Senators Shelley Moore Capito and Jeanne Shaheen reintroduced the Access to Prescription Digital Therapeutics (PDT) Act to expand Medicare and Medicaid access to software-based treatments. The bill aims to create a new benefit category for FDA-cleared apps treating conditions like autism and PTSD.
Bipartisan legislation has been reintroduced to increase access to prescription digital therapeutics (PDTs) by creating a Medicare reimbursement pathway. Advocates are using new economic data from Germany to address previous concerns regarding the potential multi-billion dollar cost to Medicare.
Startups developing software-based disease treatments are pushing for federal legislation to overcome reimbursement hurdles. The Access to Prescription Digital Therapeutics Act would require CMS to establish payment methodologies for apps prescribed to treat chronic and behavioral conditions.
No votes recorded for this bill yet.
Document Type
Congressional Bill
Official Title
Access to Prescription Digital Therapeutics Act of 2025
Analysis generated by AI. Always verify with official sources.