AMA Introduces Psychedelic Therapy Codes Amidst FDA Review of Prescription MDMA

-LOS ANGELES The American Medical Association (AMA) has taken a significant step in the realm of psychedelic therapy by introducing specific codes for these treatments. This development aligns with the Food and Drug Administration’s (FDA) ongoing evaluation of MDMA as a potential prescription medication for post-traumatic stress disorder (PTSD).

In July, the AMA, in collaboration with the Multidisciplinary Association for Psychedelic Studies Public Benefit Corporation (MAPS) and COMPASS Pathways, established Current Procedural Terminology (CPT) III codes. These codes aim to standardize psychedelic treatments, paving the way for insurance coverage and reimbursement, contingent on FDA approval.

This initiative follows the publication of MAPS’ latest Phase 3 Trial findings in the esteemed journal Nature Medicine on September 13, 2023. The study involved 104 participants with PTSD, who were randomly assigned to receive either MDMA or a placebo across three sessions. Remarkably, 72% of those in the MDMA group no longer met PTSD criteria post-treatment, compared to 48% in the placebo group.

Effective from January 1, 2024, these new codes represent a significant milestone in making psychedelic treatments more accessible and affordable, especially for those financially constrained, like many veterans. The integration of these therapies into insurance coverage has long been seen as a challenging endeavor, and this development could dramatically lower the barrier to entry for many seeking relief from PTSD.

The FDA is currently reviewing a drug application from MAPS for MDMA-assisted therapy, with a decision deadline set for mid-February. This review, if favorable, would be completed within a six-month window, shorter than the typical 10-month period.

MAPS CEO Amy Emerson underscores the importance of these new CPT codes, emphasizing their role in paving the way for MDMA-assisted therapy’s potential FDA approval and subsequent insurance coverage.

CPT III codes are provisional classifications designed to track the utilization of emerging technologies and facilitate reimbursement processes. If proven effective, these codes could transition to permanent CPT I codes, further streamlining coverage and reimbursement. The AMA has approved specific codes for healthcare professionals overseeing psychedelic-assisted therapy, as well as ancillary health professionals and clinical staff involved in these treatments.

If approved, MDMA would become the first FDA-endorsed psychedelic for treating a mental health condition, marking a historic moment in psychedelic medicine. Currently, ketamine, used off-label, is the only federally legal medication with psychedelic properties, commonly used for treating PTSD and treatment-resistant depression.

Additional research points to the potential of psilocybin, the active component in magic mushrooms, in treating treatment-resistant depression, particularly when combined with therapy. Oregon, the first state to legalize psilocybin (still federally illegal), has witnessed overwhelming demand for psilocybin services, with over 3,000 individuals awaiting treatment. Recent studies also suggest that psilocybin could be effective in treating depression in bipolar patients.

This move by the AMA represents a groundbreaking shift in the landscape of mental health treatment, potentially unlocking new avenues for those struggling with mental health conditions. As the field of psychedelic therapy advances, the AMA’s decision could herald a new era in the treatment of mental health disorders, providing hope and healing to many.