Congress Proposes Medicare and Medicaid Coverage for Prescription Medical Apps and Software
Stalled
No legislative action in over 90 days.
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.
No votes have been recorded for this legislation yet.
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.
Document Type
Congressional Bill
Official Title
Access to Prescription Digital Therapeutics Act of 2025
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