A patient can leave a doctor’s office with a new prescription in minutes. However, getting help to stop one that is no longer needed can be much harder, even when it is causing side effects or is no longer effective.
Safely tapering a drug may take months of dose adjustments, symptom monitoring, family support, and coordination among doctors, pharmacists, and therapists. For years, much of that work has been hard to see—harder for physicians to get paid for.
On May 4, the Centers for Medicare and Medicaid Services (CMS) issued new guidance clarifying that physicians and care teams may bill Medicare for supervised deprescribing under existing care management codes. The agency created no new billing codes and raised no payment rates.
However, the message is significant. For the first time, Medicare is explicitly recognizing that safely discontinuing a drug is legitimate medical care.
Acknowledging the work is only the first step. The harder challenge is building a healthcare system capable of doing it well.
What CMS Changed–and What It Didn’t
In American medicine, almost everything a doctor does is tied to a billing code that determines how much they get paid. There is no specific code for writing—or stopping—a prescription. However, the decision to start, change, or discontinue a drug can raise or lower the level of the office visit for which the doctor is allowed to bill.
The new guidance does not create a dedicated deprescribing code. Instead, it clarifies that doctors and care teams may bill Medicare for helping a patient stop a medication under several existing care-management codes—as long as they document the time spent and show it was medically necessary.
That work includes drawing up a tapering schedule, checking on patients between visits, watching for withdrawal symptoms, adjusting doses, talking with family members, coordinating with pharmacists or therapists, and reviewing the patient’s full medication list for dangerous interactions or complications. The guidance applies to common drugs such as blood pressure medications, corticosteroids, and antidepressants.
For patients, this is not a brand-new service they can ask for by name. It is a technical adjustment that may make it easier for doctors to get paid for the often-invisible work of safely getting someone off a drug.
In a statement to The Epoch Times, CMS stressed that the document is a clarification, not a major expansion. It creates no new Medicare benefit, raises no payment rates, and does not automatically cover services such as psychotherapy or nutrition counseling. Providers must still avoid billing twice for the same work, particularly medication management already paid for under Medicare Part D, the program that covers prescription drugs.
CMS Got It Right. Partially.
For Delon Canterbury, a board-certified geriatric pharmacist and founder of GeriatRx, a telehealth service focused on medication reduction for older adults, the recognition is long overdue—but incomplete.
“CMS got this right. Partially,” Canterbury told The Epoch Times. “It’s great to see federal recognition that deprescribing is real clinical work.”
However, the word “partially” carries a lot of weight. Canterbury and other experts say the guidance, while symbolically important, also reveals a deeper gap: Safe tapering often requires far more than a physician visit or a billing clarification. It demands a full team of trained professionals, months of support, and systems sophisticated enough to manage a process that can be as complex—and sometimes as risky—as starting the drug in the first place.
Certain drugs are particularly difficult. Antidepressants and benzodiazepines can cause intense withdrawal. Opioids and corticosteroids risk dangerous rebound effects. Some blood pressure drugs also carry risks, especially in older adults. In tapered too quickly or without close monitoring, any of them can lead to severe complications, including hospitalization.
Polypharmacy—taking five or more medications—is common among older Americans. Roughly one-third of adults in their 60s and 70s use at least five prescription drugs, and many take 10 or more. Adverse drug events are a major driver of hospitalizations, falls, confusion, frailty, and death in the older population. Deprescribing, when done carefully, is one of the few proven ways to reduce that burden.
The Team Absent From the Room
Canterbury’s main concern is that the new guidance still funnels the work through a physician-centered billing system—even though pharmacists are often the clinicians best equipped to handle it, and therapists are often the ones best positioned to support patients through it.
“Here we have drug experts that are grossly underutilized in the health system,” he said, “and deprescribing is a fine art that, frankly, prescribers are not trained on. You wouldn’t go to a dentist to get your heart checked.”
In practice, pharmacists are usually the ones who catch duplicative drugs, dangerous interactions, prescribing cascades, and side effects mistaken for normal aging. Yet under the guidance, their time counts only when provided “incident to” a physician—a workaround that still limits their independence and keeps them in a supporting role.
“Pharmacists are not recognized as billable providers,” Canterbury said. “We only think of pharmacists in a dispensing role.”
Pharmacists bring a unique depth of knowledge to the table: they understand the chemistry of each pill, how drugs interact at the molecular level, and how small changes in dose or timing can dramatically alter a patient’s response. That expertise, he said, is exactly what safe deprescribing demands.
The emotional demands of tapering, meanwhile, go far beyond what any billing code currently covers. Angie Peacock, a former therapist turned coach who founded HeartCore Collective to support people tapering off psychotropic medications, said withdrawal can bring waves of anxiety, depression, mood swings, and physical symptoms that doctors often mistake for relapse. For many patients, the process lasts months or years and involves rebuilding identity, learning to feel emotions that medications had numbed, and regaining trust in their own bodies.
“Five- to 15-minute med management ain’t going to cut it for deprescribing,” Peacock told The Epoch Times in an email.
A safe taper of a common antidepressant such as sertraline (Zoloft), for example, might involve reducing the dose by small increments every few weeks or months, while closely monitoring symptoms and adjusting the plan as needed. Many patients also incorporate lifestyle changes—regular exercise, better sleep, therapy, or stress-reduction techniques—to support the transition and reduce reliance on medication.
A Fine Art, Not a Quick Taper
Most physicians receive little formal training in safe tapering, especially for psychiatric drugs, benzodiazepines, opioids, and corticosteroids. Many still default to blunt methods: cut the dose in half for a few weeks, then cut again.
“That’s not deprescribing,” Canterbury said. “That’s putting people at risk.”
True deprescribing, he said, is “a fine art.” It often takes months of small dose adjustments, close monitoring, and attention to pharmacology, patient psychology, and fear. “We’ve literally told generations that this is the only way to heal,” he said, “and now you’re going to just round it down and say, ‘All right, let’s get you off.’”
Without proper training and team support, Canterbury and Peacock warn that the new billing rules risk rushed tapers, unnecessary suffering, or patients quickly being put back on the medication they just came off.
“This is a very sensitive thing,” Canterbury said, “that requires more than just a billable code.”
A Step In the Right Direction
For all its limitations, the CMS guidance marks a meaningful shift. After decades of a healthcare system built to add medications, Medicare is beginning to acknowledge that stopping them safely is also good medicine.
For patients and families worried about overmedication, the practical first step remains as it’s always been: ask. Bring a complete list of all prescriptions, over-the-counter drugs, and supplements to the next appointment. Ask directly whether each medication is still helping more than it might be harming. Consider asking the doctor to involve a geriatric pharmacist.
Canterbury and Peacock both stress that the best outcomes come when patients speak up, doctors and pharmacists collaborate, and families or caregivers work together over time.
The system remains imperfect. But for the first time, Medicare is opening the door.