Digital Mental Health Treatment Codes: How G0552, G0553 and G0554 Work

G0552, G0553 and G0554 are the three Medicare HCPCS codes for a prescribed digital mental health treatment (DMHT) device: G0552 pays for the device and onboarding, and G0553 and G0554 pay for monthly management time.

CMS created the codes in the CY2025 Physician Fee Schedule final rule, CMS-1807-F, effective January 1, 2025 (CY2026 PFS final rule, 90 FR 49473). The final descriptors for G0553 and G0554 describe practitioner time reviewing information related to the use of the DMHT device (CY2025 PFS final rule, 89 FR 97927).

Descriptors are summarized from the CY2025 PFS final rule. Pricing status is from MLN Matters MM14315.

DMHT isn't telehealth. These codes pay for a device and the time spent managing its use, and none of the three is on the CMS List of Telehealth Services for 2026. Video and phone visits stay under your telehealth billing workflow.

Next step: decide who in your practice will own DMHT claims before the first device is prescribed, since each code has its own conditions.

Medicare pays the DMHT codes only for devices that FDA cleared under 510(k) or granted De Novo authorization and that are classified at 21 CFR 882.5801 or 21 CFR 882.5803.

21 CFR 882.5801 covers a computerized behavioral therapy device for psychiatric disorders. The regulation describes it as a prescription only device that provides a computerized version of condition-specific behavioral therapy as an adjunct to clinician supervised outpatient treatment (21 CFR 882.5801).

21 CFR 882.5803 covers a digital therapy device for attention deficit hyperactivity disorder (ADHD). It is software intended to provide therapy for ADHD or any of its symptoms as an adjunct to clinician supervised treatment (21 CFR 882.5803).

What changed for 2026

In the CY2026 final rule, CMS-1832-F, CMS extended G0552, G0553 and G0554 to ADHD devices classified under 882.5803, and the same G0552 billing requirements apply to them (MM14315, pp. 3 and 4). CMS also said it was not further expanding the DMHT payment policy to other device classes in that rule (CY2026 PFS final rule, 90 FR 49476).

Medicare pays only for the use indicated under the device's FDA classification (MM14315, p. 4).

Next step: ask the manufacturer for the device's 510(k) or De Novo number and its classification regulation, and keep both in your device file.

A practitioner who can diagnose, evaluate and treat mental health disorders bills G0552 when they order the device, pay for it and furnish it as part of ongoing behavioral health treatment.

CMS lists these conditions (MLN1986542, p. 5):

• The billing practitioner prescribes or orders a device that FDA cleared under 510(k) or granted De Novo authorization, classified at 882.5801 or 882.5803.
• The billing practitioner incurs the cost of providing the device to the patient as a supply.
• The device is furnished incident to the billing practitioner's professional services, in association with ongoing behavioral health treatment under a plan of care by the billing practitioner (CY2026 PFS final rule, 90 FR 49476).
• The patient has a mental health condition diagnosis. The billing practitioner doesn't have to be the one who made it.

The diagnosis point changed. The CY2025 rule required the billing practitioner to make the diagnosis, and the CY2026 rule clarified that a diagnosis is required but can come from another practitioner (CY2026 PFS final rule, 90 FR 49473 and 49476).

When G0552 isn't payable

G0552 isn't payable when the billing practitioner incurs no cost for the device, or when the patient gets the device on their own (CY2025 PFS final rule, 89 FR 97927). Auxiliary personnel can handle part of the initial education and onboarding, but they can't report G0552 (89 FR 97927).

Prescribing also has to fit the device's FDA clearance and state prescriptive authority (MLN1986542 DMHT section). Check that for each clinician type, whether you run a psychiatry practice or a therapy and counseling practice, before you set up the workflow.

Next step: write down who orders the device, who pays the invoice and whose plan of care it supports. All three should point to the billing practitioner.

G0553 pays for the first 20 minutes of practitioner time in a calendar month on the patient's use of the device, and G0554 pays for each additional 20 minutes.

Both codes need at least one interactive communication with the patient or caregiver during the calendar month, and G0554 is listed in addition to G0553 (CY2025 PFS final rule, 89 FR 97927).

• CMS expects practitioners to report G0553 and G0554, rather than remote therapeutic monitoring codes, when the management is directly related to a device described by G0552 that meets its conditions of payment (89 FR 97927).
• Bill them only while the patient is still using the device. CMS said G0553 and G0554 should not be billed when the patient stops using it (89 FR 97925).
• CMS set no limit on a patient using different DMHT devices for different conditions at the same time (89 FR 97928).
• G0552 covers a course of treatment, not a single month. CMS declined to limit it to a monthly period (CY2025 PFS final rule discussion).

Track the minutes the same way you would for any monthly care management code. If your team already logs time for collaborative care, use the same calendar month log and add the date of the interactive communication.

Next step: add a DMHT line to your monthly time log with the minutes, the reviewer and the communication date for each patient.

For 2026, the Medicare national non-facility amounts are $54.11 for G0553 and $41.42 for G0554. G0552 is contractor priced, so your Medicare contractor (MAC) sets its amount.

CMS PFS Look-Up Tool, year 2026, national locality, data updated 10/01/2026, non-qualifying APM conversion factor. Amounts match the total RVUs in the CMS RVU26D file times $33.4009. They are before geographic adjustment and patient cost sharing. The tool returns no national amount for G0552.

CMS said the device invoices it received varied considerably and it didn't have enough information to set a national price for G0552 (CY2025 PFS final rule, 89 FR 97928). It kept G0552 contractor priced for 2026 (CY2026 PFS final rule, 90 FR 49474).

Next step: ask your Medicare contractor (MAC) how it prices G0552 and what it wants to see, and keep the device invoice with the claim record.

For DMHT claims, document the diagnosis, the plan of care, the device's FDA classification, the order, the device invoice, onboarding, monthly minutes, the interactive communication and ongoing use. CMS made G0552 payable only when its conditions are met (CY2025 PFS final rule, 89 FR 97927).

• The patient's mental health diagnosis and who made it.
• The behavioral health treatment plan of care the device supports.
• The device name, its 510(k) or De Novo number and its classification at 882.5801 or 882.5803.
• The order or prescription from the billing practitioner.
• The invoice showing the practitioner paid for the device.
• Onboarding notes, including who did each part.
• Monthly minutes, the reviewer and the date of the interactive communication.
• Whether the patient is still using the device each month.

If you already bill DMHT and want a second set of eyes on these records, start with an outside billing audit.

Next step: turn this list into a chart template so every DMHT patient record has the same fields.

As of October 30, 2026, CMS has not published the CY2027 final rule, CMS-1848-F, and the CY2027 proposed rule doesn't mention the DMHT codes.

CMS published the CY2027 proposed rule, CMS-1848-P, on July 16, 2026, and its text doesn't mention G0552, G0553, G0554 or DMHT (CY2027 PFS proposed rule, 91 FR 43842). The PFS regulation notices page lists no final rule for 2027 as of October 30, 2026 (CMS PFS federal regulation notices). Everything in this post reflects the CY2025 and CY2026 final rules.

Next step: check the CMS regulation notices page for CMS-1848-F before you plan 2027 DMHT billing.