June 6, 2025
Mr. Fitzpatrick (for himself and Mr. Tonko) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
To amend title XVIII of the Social Security Act to improve access to mental health services under the Medicare program.
Section 1. Short title
This Act may be cited as the Expanding Seniors Access to Mental Health Services Act
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Sec. 2. Improved access to mental health services under the Medicare program
(a) Exclusion of clinical social worker services from the skilled nursing facility prospective payment system
Section 1888(e)(2)(A)(iii) of the Social Security Act (42 U.S.C. 1395yy(e)(2)(A)(iii)) is amended by adding at the end the following new subclause:
(VII)
Clinical social worker services (as defined in section 1861(hh)(2)).
(b) Access to the complete set of clinical social worker services
Section 1861(hh)(2) of the Social Security Act (42 U.S.C. 1395x(hh)(2)), is amended by striking for the diagnosis and treatment of mental illnesses (other than services furnished to an inpatient of a hospital and other than services furnished to an inpatient of a skilled nursing facility which the facility is required to provide as a requirement for participation)
and inserting , including services for the diagnosis and treatment of mental illnesses or services for 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 succeeding codes)), but not including services furnished to an inpatient of a hospital,
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(c) Effective date
The amendments made by this section shall apply to items and services furnished on or after January 1, 2026.