Much-needed legislation increasing Medicare reimbursement rates for Clinical Social Workers (CSWs) and ensuring access to CSW services by Medicare beneficiaries has been introduced in both chambers of Congress. This legislation will only advance if congressional lawmakers hear from CSWs in their states and districts about the crucial role we play in this major federal program!
The Improving Access to Mental Health Act (S. 870/ H.R. 2035) was introduced by Sen. Debbie Stabenow, MSW (D-MI), Sen. John Barrasso (R-WY) and Rep. Barbara Lee, MSW (D-CA).
S. 870/H.R. 2035 will:
- Increase Medicare Reimbursement Rates for CSWs: The bill aligns Medicare payment for CSWs with that of most other non-physician providers by increasing the reimbursement rate from 75% to 85% of the physician fee schedule.
- Increase Access to CSW Services for Skilled Nursing Facility (SNF) Residents: Currently, independent CSWs who are not employed by the SNF are unable to seek reimbursement under Medicare Part B for providing psychotherapy services to SNF residents receiving care under Medicare Part A. This legislation will rectify this problem by excluding CSW services from SNF consolidated billing.
- Provide Access to CSW Services that Help Medicare Beneficiaries Coping with Physical Health Conditions: Although Health and Behavior Assessment and Intervention (HBAI) services are within the scope of practice for CSWs, Medicare currently only reimburses CSWs for the “diagnosis and treatment of mental illnesses.” S. 870/H.R. 2035 would broaden the definition of CSW services to enable CSWs to receive Medicare reimbursement for HBAI services, within the CSW scope of practice. These are cognitive, behavioral, social and psychophysiological interventions to prevent, treat, and improve physical health and well-being.
Contact your Senators and Representative TODAY and urge them to co-sponsor this legislation. Help them understand the mental health needs of Medicare beneficiaries in your community, especially in the COVID-19 era, and how this legislation will help address those needs. A personalized communication goes a long way with a member of Congress.
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