May 15, 2025
Mr. Barrasso (for himself and Mr. Coons) introduced the following bill; which was read twice and referred to the Committee on Finance
To amend title XVIII of the Social Security Act to improve access to mental health services under the Medicare program.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
Section 1. Short title
This Act may be cited as the Expanding Seniors Access to Mental Health Services Act
.
Sec. 2. Improved access to mental health services under the Medicare program
(a) Access to clinical social worker services provided to residents of skilled nursing facilities
(1) 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)).
(2) Conforming amendment
Section 1861(hh)(2) of the Social Security Act (42 U.S.C. 1395x(hh)(2)) is amended by striking 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
.
(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)), as amended by subsection (a)(2), is amended—
(1)
by striking for the diagnosis and treatment of mental illnesses (other than services
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
; and
(2)
by striking inpatient of a hospital)
and inserting inpatient of a hospital,
.
(c) Effective date
The amendments made by this section shall apply to items and services furnished on or after January 1, 2026.