Positive lifestyle medicine reimbursement changes are coming. Here is how to prepare for them.    

The world is finally waking up to the need to dramatically improve the treatment of chronic conditions by realigning incentives to reward preventive health measures, whole–person care, interdisciplinary care team delivery, clinical-community bridges, health equity and interventions that support better health outcomes.

The landscape of payment for clinicians in the field of lifestyle medicine continues to expand and improve. Not only are there new CPT codes in the  2025 Medicare Physician Fee schedule final rule that can support the work of LM clinicians in offering equitable whole person care, the continued expansion and revision of value-based care, as well as hybrid and alternative payment models (APMs) offer opportunity for lifestyle medicine clinicians who are able to achieve better health outcomes at a lower cost of care. While both fee-for-service and value-based care delivery models are far from perfect—and we acknowledge the continued reduction in physician payment presents a huge challenge for many—we still see the economic opportunities for clinicians in the field expanding.

Lifestyle medicine clinicians, as chronic disease experts, are well-positioned to play a pivotal role in healthcare transformation through the continued delivery of evidence-based, high-value, guideline-driven, whole-person care. By leveraging guideline-driven lifestyle interventions as a first therapeutic approach and guiding patients through medication de-escalation, lifestyle medicine clinicians are prepared to view disease prevention and health restoration as realistic goals for many of their patients.  

Improving treatment of chronic conditions 

The healthcare landscape is also shifting. The world is finally waking up to the need to dramatically improve the treatment of chronic conditions by realigning incentives to reward preventive health measures, whole–person care, interdisciplinary care team delivery, clinical-community bridges, health equity and interventions that support better health outcomes. We see this culture shift reflected in National Academies of Sciences, Engineering, and Medicine reports defining both high–quality primary care and whole–person health, and in the Senate Finance Committee’s hearing and white paper on Bolstering Chronic Care Thorough Physician Payment Reform. We see it in Center for Medicare and Medicaid Innovation (CMMI) models that support interdisciplinary care teams and health equity, in ACLM’s induction into the American Medical Association House of Delegates, and in the launch of the Food Is Medicine toolkit by the Department of Health and Human Services, which featured several of ACLM’s resources. 

New payment resources  

Navigating the world of payment for lifestyle medicine can be complicated, and ACLM is dedicated to supporting our members with resources and our advocacy efforts. This year, ACLM developed several new payment-specific resources, including the shared medical appointment financial calculator, the list of billable lifestyle medicine clinician services, and the updated Reimbursement Roadmap, which features both fee-for-service and alternative payment models that are successfully being leveraged in the field of lifestyle medicine.  

It’s worth noting that a few of the most financially successful and scalable clinical delivery models for lifestyle medicine implementation include shared medical appointments (group medical visits), intensive cardiac rehabilitation, chronic and collaborative care management, as well as engagement with an LM-focused Accountable Care Organization, all of which are featured in depth in the Reimbursement Roadmap. We also offer an entire suite of shared medical appointment resources in our members-only Connect platform, including a new series of short videos that can be played at the beginning of shared medical appointments to introduce the basics of lifestyle medicine. ACLM also offers a collection of implementation briefs that showcase various models of lifestyle medicine implementation across a variety of clinical care settings, many of which leverage the shared medical appointment model. 

Reimbursement and group medical visit interest groups  

ACLM also supports both Reimbursement and Group Medical Visit Member Interest Groups where online discussion and resource sharing occur regularly in addition to quarterly virtual group meetings. This collection of reimbursement and delivery resources and support builds on the foundation of existing resources for members on this topic, including the inaugural Reimbursement Summit led by Padmaja Patel, MD, FACLM DipABLM, in September 2023, which showcased the variety of opportunities for payment in the field of lifestyle medicine. A recording is available for ACLM members to watch free of charge.  

In addition to resources, ACLM also has allocated and will continue to allocate much time and energy advocating for the removal of barriers, expansion of payment, and quality measure alignment for the field of lifestyle medicine, much of which you can read about in ACLM’s new quarterly advocacy report.  

ACLM is here to support members and the communities they serve in achieving health and health restoration. The Board of Directors and staff are committed to fulfilling our vision of a world wherein lifestyle medicine is the foundation of all health and healthcare as the standard of care. We know there is more work to do, and we believe that there is no limit to what we can achieve together. The time for lifestyle medicine is NOW!