Care Management Blog

The Centers for Medicare and Medicaid Services (CMS) have updated the CPT code for the Social Determinants of Health (SDoH) assessment for 2025.

Health equity remains a central priority in healthcare policy and provider strategy. On the one hand, The Centers for Medicare and Medicaid Services (CMS) is moving forward to support fair access to high-quality care regardless of socioeconomic or demographic factors. On the other, regulatory changes in 2025 could prove tumultuous, shifting under a new administration.

The Centers for Medicare & Medicaid Services (CMS) reimburses for an optional assessment of social determinants of health (SDOH). When the evaluation is conducted as part of the Medicare Annual Wellness Visit (AWV), the beneficiary will not be burdened by a cost-sharing obligation.

According to the Centers for Medicare & Medicaid Services (CMS), research shows that 5.8 million people in the US do not receive medical care each year due to transportation issues. More recent research from 2022 found that 21% of adults without a vehicle or public transportation went without needed medical care.

ThoroughCare's clinical team recently hosted a webinar, “The Impacts of Social Determinants of Health (SDOH) on Patient Care and Outcomes.” They were joined by Dr. Maya Bell, PharmD, MBA, Director of Clinical Services at PharmaClin.

Understanding the socioeconomic needs of your patients is crucial for improving their overall health outcomes. Deprivation of basic necessities like food, housing, clean water, transportation, and employment, among other challenges, can have significant adverse impacts on even healthy patients. This is why it's essential to talk about Social Determinants of Health (SDOH) with your patients in order to identify their unique needs and challenges.

Medicare now covers an optional screening for social determinants of health (SDOH). As detailed in the 2024 Physician Fee Schedule Final Rule, this assessment can be conducted during an Annual Wellness Visit (AWV).

For 2024, Medicare has introduced a new Social Determinants of Health (SDoH) assessment. An SDoH assessment is a valuable tool to help to identify known or suspected SDoH needs that may interfere with the diagnosis or treatment of a patient and can help lead to improved outcomes.

Screening for health-related social needs (HRSN) is evolving into a care standard.