“A bill to amend title XVIII of the Social Security Act to improve access to mental health services under the Medicare program.”
No CRS summary available for this bill.
This section expands Medicare Part B coverage of clinical social worker services (i.e., diagnosis and treatment of mental illnesses provided by licensed clinical social workers), effective for services furnished on or after January 1, 2026, by (1) excluding such services from the skilled nursing facility prospective payment system (via new exclusion in SSA §1888(e)(2)(A)(iii)(VII)) and removing their prior exclusion from the statutory definition when furnished to skilled nursing facility inpatients (via amendment to SSA §1861(hh)(2)); and (2) broadening the covered services to explicitly include health and behavior assessment and intervention (identified as of January 1, 2023, by HCPCS codes 96156, 96158–96161, 96164–96168, and 96170–96171, and any successors). (Thus, these services provided to skilled nursing facility residents, previously bundled into Part A facility payments, become separately billable under Part B.)