Expanding Seniors Access to Mental Health Services Act
Sponsored By: Representative Fitzpatrick, Brian K. [R-PA-1]
Introduced
Summary
Would expand Medicare coverage for clinical social worker mental health services. It would also remove those services from the skilled nursing facility (SNF) prospective payment system.
Show full summary
- People on Medicare would gain coverage for a broader set of clinical social worker services for diagnosing and treating mental illnesses and for health and behavior assessment and intervention. Coverage would apply to specified HCPCS-coded services delivered outside inpatient hospitals and would take effect January 1, 2026.
- Skilled nursing facilities would no longer have clinical social worker services bundled into SNF prospective payment system payments.
- Clinical social workers and other non-inpatient providers would be able to bill Medicare for the expanded set of covered services, as defined by the HCPCS codes cited in the bill.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 1 benefits, 0 costs, 0 mixed.
Medicare covers more social worker care
If enacted, Medicare would cover a wider set of clinical social worker services. It would include mental health care and health and behavior assessment and intervention (HCPCS 96156, 96158–96161, 96164–96168, 96170–96171, and successors). Skilled nursing facilities could bill these services separately instead of having them bundled. Services for hospital inpatients would still not be covered. These changes would apply to care you get on or after January 1, 2026.
Sponsors & CoSponsors
Sponsor
Fitzpatrick, Brian K. [R-PA-1]
PA • R
Cosponsors
Rep. Tonko, Paul [D-NY-20]
NY • D
Sponsored 6/6/2025
Rep. Matsui, Doris O. [D-CA-7]
CA • D
Sponsored 7/14/2025
Rep. Vasquez, Gabe [D-NM-2]
NM • D
Sponsored 7/25/2025
Rep. Scholten, Hillary J. [D-MI-3]
MI • D
Sponsored 9/2/2025
Smith (WA)
WA • D
Sponsored 9/8/2025
Rep. Vindman, Eugene Simon [D-VA-7]
VA • D
Sponsored 9/15/2025
Rep. Gottheimer, Josh [D-NJ-5]
NJ • D
Sponsored 9/19/2025
Bresnahan
PA • R
Sponsored 9/30/2025
Rep. Gillen, Laura [D-NY-4]
NY • D
Sponsored 10/10/2025
Rep. Harder, Josh [D-CA-9]
CA • D
Sponsored 10/24/2025
Rep. Pocan, Mark [D-WI-2]
WI • D
Sponsored 11/4/2025
Pingree
ME • D
Sponsored 11/7/2025
Rep. Neguse, Joe [D-CO-2]
CO • D
Sponsored 11/17/2025
Rep. Kiggans, Jennifer A. [R-VA-2]
VA • R
Sponsored 4/29/2026
Roll Call Votes
No roll call votes available for this bill.
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