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Expanding Seniors Access to Mental Health Services Act
To amend title XVIII of the Social Security Act to improve access to mental health services under the Medicare program.
Summary
This bill would expand Medicare coverage for clinical social worker mental health services for seniors. The bill would exclude clinical social worker services from the skilled nursing facility payment system, meaning facilities would bill Medicare separately for these services rather than having them bundled into the facility's overall payment. The bill would also expand the types of services clinical social workers can provide under Medicare to include health and behavior assessment and intervention services in addition to mental illness diagnosis and treatment, effective January 1, 2026.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
18 cosponsors
- Rep. Balint, Becca [D-VT-At Large] (D-VT)
- Rep. Bresnahan, Robert P. [R-PA-8] (R-PA)
- Rep. Gillen, Laura [D-NY-4] (D-NY)
- Rep. Goodlander, Maggie [D-NH-2] (D-NH)
- Rep. Gottheimer, Josh [D-NJ-5] (D-NJ)
- Rep. Harder, Josh [D-CA-9] (D-CA)
- Rep. Kiggans, Jennifer A. [R-VA-2] (R-VA)
- Rep. Matsui, Doris O. [D-CA-7] (D-CA)
- Rep. Neguse, Joe [D-CO-2] (D-CO)
- Rep. Pingree, Chellie [D-ME-1] (D-ME)
- Rep. Pocan, Mark [D-WI-2] (D-WI)
- Rep. Riley, Josh [D-NY-19] (D-NY)
- Rep. Ross, Deborah K. [D-NC-2] (D-NC)
- Rep. Scholten, Hillary J. [D-MI-3] (D-MI)
- Rep. Smith, Adam [D-WA-9] (D-WA)
- Rep. Tonko, Paul [D-NY-20] (D-NY)
- Rep. Vasquez, Gabe [D-NM-2] (D-NM)
- Rep. Vindman, Eugene Simon [D-VA-7] (D-VA)
Money behind the sponsor
Top reported contributors to Brian K. Fitzpatrick’s campaign committee (2024 cycle) — who funds the bill’s sponsor, not a claim about this bill. Data from FEC.
Organizations whose employees gave the most — itemized individual contributions grouped by the donor’s reported employer (FEC Schedule A). Full finance for Brian K. Fitzpatrick → · Outside spending →
Actions (2)
- Jun 6, 2025 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. · house
- Jun 6, 2025 Introduced in House
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Text versions (1)
Bills are re-published as they move (Introduced → Reported → Engrossed → Enrolled …). Each stage below is a separate text; pick two to see what changed. Data from Congress.gov.
Full text
IN THE HOUSE OF REPRESENTATIVES
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
A BILL
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) 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,”.
(c) Effective Date.—The amendments made by this section shall apply to items and services furnished on or after January 1, 2026. <all>
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