Critical Medicare Social Work Provisions Reach Senate Finance Committee

Dec 3, 2007

The Senate Finance Committee is scheduled to begin consideration of Medicare legislation on December 5, 2007. It is very important that Finance Committee members hear now from social workers supporting three changes in Medicare law:

  • Remove clinical social work (CSW) services from the Medicare skilled nursing facilities (SNF) consolidated payment system, permitting CSWs to bill Medicare separately, the same as psychiatrists and psychologists, for services to Medicare Part A beneficiaries provided in SNFs.
  • Increase Medicare Part B payments to CSWs and psychologists by 5% starting on January 1, 2008. This increase will partially restore a Medicare cut for these clinical services that occurred on the first of this year.
  • Correct Medicare€™s current discriminatory co-payment on outpatient mental health services from 50/50 beneficiary cost sharing to the standard 80/20 coverage for other Part B services. This Medicare parity€ provision should go into effect on January 1, 2008.

Please email your two Senators immediately and ask them to support clinical social work services in Medicare.

The Issue at Hand

The Senate Finance Committee will soon consider crucial legislation for clinical social workers within broader Medicare legislation correcting physician and other outpatient (Part B) payment problems.

NASW hopes to score a major early victory for its Social Work Reinvestment Initiative (SWRI) by attaching provisions that will increase Medicare payment rates for all clinical social workers billing Part B independently as well as restore clinical social workers€™ ability to bill independently for services provided to Medicare nursing home residents. One key SWRI component, known as the Clinical Social Work Medicare Equity Act (S.1212) has long been sought by NASW.

NASW has sought relief for CSW payments under Part B, which were cut by 9% late last year by federal administrative action. NASW advocates that the Senate legislation increase CSW payments by 5% above their current level beginning on January 1, 2008. This special payment increase would apply only to psychotherapy and behavioral services that were cut on January 1, 2007 by 9 percent. In addition to the 5 percent increase in 2008, CSWs would receive the same percent payment change that Congress will authorize for all physician services in the program, currently a .5% positive payment update under the House version, HR 3162.


The House version of Medicare legislation, which contains the physician fee updates, already contains the three clinical social work service improvements described above. These benefit improvements are expected to be offset by cuts in managed care payments for Medicare. Early indications are that we are within reaching our legislative goals in the Senate since the House bill has already adopted them. It is vital that all Senators here the message to support clinical social work services now.

Thank you for your advocacy!

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