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Digital Health Technologies for Attention Deficit/Hyperactivity Disorder
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
The use of EndeavorRx is considered investigational for all indications, including attention-deficit/hyperactivity disorder (ADHD). EndeavorRx received FDA marketing clearance in April 2020 through the De Novo process, and it is indicated to improve attention function in children ages 8 to 12 with primarily inattentive or combined type ADHD. The policy lists CPT 98978, HCPCS A9291, A9999, G0552, G0553 and G0554 as investigational codes.
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What to do
Action · 4 steps
01Billing team: Do not bill EndeavorRx as medically necessary for ADHD, since the policy considers its use investigational for all indications.
02Do not bill CPT 98978 (remote therapeutic monitoring to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period), HCPCS A9291, A9999, G0552, G0553 or G0554 as medically necessary, since the policy lists them as investigational codes.
03For Federal Employee Program members, FDA-approved devices, drugs or biologics may not be considered investigational and may be assessed only on the basis of medical necessity.
04BCBSMS makes no payment for services not documented to be medically necessary.
Codes mentioned
98978A9291A9999G0552G0553G0554
Original notice
Digital Health Technologies for Attention Deficit/Hyperactivity Disorder
bcbsms.com · Always check the source before changing claims.
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