CMS 2025 Digital Mental Health Reimbursement Pathway — Now Active

Clinical protocols that recognize the patient
before they say a word.

Prescribe turns evidence-based clinical protocols into adaptive digital interventions — CBT-I for insomnia, guided exposure for chronic pain, real-time metabolic coaching — delivered through a patient's phone and integrated with your EHR.

Health System Innovation OfficersPharma Digital CompanionsSelf-Insured Employers

What is untreated behavioral health costing your organization today?

Organization Type

Covered Lives / Employees

Top Clinical Concerns (select up to 3)

Annual BH Spend

$0

estimated annual cost

ER Diversions

0

avoidable visits/year

ROI Timeline

0 mo

to positive return

Projected Savings

$0

annual with Prescribe

Projected Savings Curve

Today12 mo24 mo
Without intervention
With Prescribe

Takes 90 seconds. Receive a personalized Readiness Score.

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FDA-Cleared Pathway
HL7 FHIR Integration
🔒HIPAA Compliant
📋CMS DMHT Codes 2025
💊EHR-Native Prescribing
🔬29 RCTs Validated

Covered By

STAT NewsNEJM CatalystHealth AffairsMedCity NewsFierce Health

One untreated insomnia diagnosis. A cascade that never stops.

Insomnia left untreated doesn't stay contained. It spreads through absenteeism, comorbidity, and escalating claims cost — an average $3,200 per employee per year before a single specialist is seen.

Untreated Insomnia
Cognitive Impairment + Absenteeism
−$1,100/yr
Comorbid Anxiety / Depression
−$2,400/yr
Opioid + Hypnotic Prescriptions
−$4,200/yr
ER Visit or Inpatient Stay
−$8,900/yr

CBT-I delivered digitally. Clinically validated. No therapist required.

Across 29 RCTs with 9,475 participants, fully automated digital CBT-I showed large effects on insomnia severity (SMD −0.76) with 77–83% retention. The module runs on the patient's phone, reports to the care team, and adapts week over week.

SMD −0.76

Insomnia Severity Reduction

83%

Retention at 12 Weeks

−42%

Depressive Symptom Reduction

CBT-I Module

Week 1 of 6

52

Sleep Quality Score

→ Building

+0 pts from baseline

W1W2W3W4W5W6

Today's Session

Sleep Restriction Therapy — 12 min

Guided exposure therapy. Pain tolerance rebuilt, session by session.

Our pain module combines graded motor imagery with behavioral exposure techniques, delivering 90-day guided protocols that measurably reduce pain interference scores — with CBT-I integration for the 52% who present with comorbid insomnia.

−46%

Pain Interference Score

−38%

Opioid Prescription Rate

90 days

Protocol Duration

Pain Exposure Protocol

Day 1 of 90

Pain Level7.2 / 10

Progress Insight

Pain tolerance ↑ 0% since baseline

Chronic pain costs more than the injury. It costs the future.

Over half of patients with chronic pain also experience insomnia. That comorbidity doubles the claims cost and triples the opioid prescription rate. Standard PT referrals address the tissue — and miss the nervous system entirely.

Chronic Musculoskeletal Complaint
Comorbid Insomnia (52% prevalence)
×2.1 claims cost
Opioid + Hypnotic Co-prescription
+$6,800/yr
Disability / Lost Productivity
+$14,200/yr

Ready to see what Prescribe can do for your population?

5 questions. Personalized Readiness Score. Instant results.

Diabetes distress is eating your benefits budget. Silently.

Behavioral non-adherence in diabetic populations drives 3.5× higher readmission rates. HRRP penalties hit hospitals up to 3% of all Medicare revenue — not just the readmitted cases. A single readmission cohort costs more than a full digital therapeutics deployment.

Diabetes Distress + Non-Adherence
Glycemic Instability
+$3,900/yr
30-Day Hospital Readmission
+$12,000 avg
HRRP Penalty Applied
Up to 3% all revenue

Real-time glucose coaching that adjusts before the crisis.

Prescribe integrates with CGM devices to deliver behavioral coaching that adapts in real time to glucose readings — meal sequencing, activity nudges, and medication reminders that respond to the patient's actual physiology, not a static care plan.

−31%

Readmission Rate

−0.8 A1c

Average HbA1c Reduction

$3,600

Per-Patient 6-Month Savings

Metabolic Coach

Live CGM Integration

142

mg/dL

High — Adjust

Real-Time Coaching

5-min walk recommended to lower glucose response

Watch the trial complete in real time.

These aren't projections. They're published outcomes from peer-reviewed trials and payer claims analyses — the evidence base that clinical strategists ask for on the first call.

0%

Fewer Inpatient Stays

Pre/post claims study, SUD population, 6-month window

0%

Fewer ER Visits

Same cohort — avoidable emergency visits diverted

$0

Per-Patient Savings

Average 6-month savings per enrolled patient

0

RCT Participants

Meta-analysis across 29 randomized controlled trials validating digital CBT-I

0%

Retention Rate

Active treatment period with human-in-loop coaching model

$0.0B

DTx Market 2025

Digital therapeutics market valuation — category-defining moment

Sources: Digital Therapeutics Alliance 2024; Systematic review of 29 RCTs (n=9,475); CMS HRRP FY2026 preliminary data; Pre/post claims analysis, SUD cohort, 6-month window. Market data: DTx market valuation 2025.

The clinical strategists who chose not to wait.

We were staring down a 2.3% HRRP penalty on heart failure readmissions. Prescribe's metabolic coaching module cut our 30-day readmit rate faster than any intervention we'd tried. The EHR integration meant our hospitalists actually used it.
Dr. Carolyn Mehta, VP Clinical Innovation at Meridian Health System

Dr. Carolyn Mehta

VP Clinical Innovation

Meridian Health System

Health System · 8 hospitals

−31%

Readmission Rate

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Watch it warm to your data.

Your clinical strategist already has context from your assessment. The first call isn't a sales call — it's a clinical consultation with your population's data already on the table.

Review the Evidence
90-second assessment
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