| Summary: | In 2002, new Current Procedural Terminology (CPT) codes were established to allow providers to indicate when behavioral therapies were employed specifically for treatment of general medical disorders. In response, regional Centers for Medicare & Medicaid Services (CMS) carriers expressed interest in developing appropriate coverage decisions, accounting for available scientific evidence. CMS, through the Agency for Healthcare Research and Quality (AHRQ), requested the Duke Evidence-based Practice Center (EPC) to perform an evaluation of the evidence regarding a limited group of potential circumstances for the use of behavioral therapies for general medical disorders. The new health and behavior codes (Appendix A) concentrate on assessments and interventions aimed at improving physical health. The focus of the current analysis is thus on physical health status. Potential intervention targets cover a wide range of possibilities including patient adherence to general medical treatment, symptom expression, health-promoting behaviors, health-related risk-taking behaviors, and overall adjustment to general medical illness. In conjunction with the CMS regional carrier medical directors, three medical conditions were selected for systematic review, based on their clinical importance and their representativeness of the variety conditions for which behavioral therapies are commonly considered. This technology assessment focuses on the first condition selected: diabetes mellitus
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