This bill would change Medicare rules so more services from clinical social workers are recognized and not counted inside the payment bundle for skilled nursing facilities (SNFs). It adds clinical social worker services to an exclusion from the SNF prospective payment system and expands the definition of covered clinical social worker services to include health and behavior assessment and intervention services identified by specific HCPCS codes. The bill does not change coverage for services furnished to hospital inpatients. The changes would apply to items and services furnished on or after January 1, 2026.
If you are a Medicare beneficiary, the bill is intended to let clinical social workers provide a wider set of mental health and behavioral services that Medicare recognizes under current law. The bill also removes those clinical social worker services from the SNF payment bundle, which may affect how those services are billed or provided in skilled nursing facilities. Services to hospital inpatients remain excluded.
No publicly available information on expected costs or savings is included in the bill text. The bill text does not include a budget estimate or fiscal analysis.
The bill's stated purpose is to improve access to mental health services under Medicare. It would expand which clinical social worker services are recognized (listing specific HCPCS codes) and remove those services from the SNF prospective payment system, steps the sponsors present as improving seniors' access to mental health care.
No publicly available information on opposition or opposing arguments is included in the bill text or provided metadata.