S1797119th CongressWALLET

Expanding Seniors Access to Mental Health Services Act

Sponsored By: Senator John Barrasso

Introduced

Summary

Expand Medicare coverage for clinical social worker mental health services. This bill would remove those services from the Skilled Nursing Facility prospective payment system and widen which social work mental‑health services Medicare covers, including specified health and behavior assessment and intervention codes.

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Bill Overview

Analyzed Economic Effects

1 provisions identified: 1 benefits, 0 costs, 0 mixed.

More Medicare mental-health visits for seniors

If enacted, Medicare would expand which clinical social worker visits it covers. The bill would add mental-health diagnosis/treatment and health-and-behavior assessment and intervention (HBAI). It lists HCPCS codes as of January 1, 2023: 96156, 96158–96161, 96164–96168, and 96170–96171. The change would not cover hospital inpatients. The bill would also stop including clinical social worker services when calculating skilled nursing facility payment rates. These changes would apply to items and services furnished on or after January 1, 2026. The bill does not set new payment rates, so billing or patient cost effects could vary.

Sponsors & CoSponsors

Sponsor

John Barrasso

WY • R

Cosponsors

  • Christopher Coons

    DE • D

    Sponsored 5/15/2025

Roll Call Votes

No roll call votes available for this bill.

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