Coverage of marriage and family therapist services under Medicare part B

(a)

Coverage of services

Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is amended— (1)in subparagraph (Z), by striking and at the end; (2)in subparagraph (AA), by adding at the end and; and (3)by adding at the end the following new subparagraph:

(BB)marriage and family therapist services (as defined in subsection (ccc)(1));

(b)

Definition

Section 1861 of such Act (42 U.S.C. 1395x) is amended by adding at the end the following new subsection:

(ccc)

Marriage and family therapist services

(1)The term marriage and family therapist services means services performed by a marriage and family therapist (as defined in paragraph (2)) for the diagnosis and treatment of mental illnesses, which the marriage and family therapist is legally authorized to perform under State law (or the State regulatory mechanism provided by State law) of the State in which such services are performed, as would otherwise be covered if furnished by a physician or as an incident to a physician’s professional service, but only if no facility or other provider charges or is paid any amounts with respect to the furnishing of such services. (2)The term marriage and family therapist means an individual who— (A)possesses a master’s or doctoral degree which qualifies for licensure or certification as a marriage and family therapist pursuant to State law; (B)after obtaining such degree has performed at least two years of clinical supervised experience in marriage and family therapy; and (C)in the case of an individual performing services in a State that provides for licensure or certification of marriage or family therapists, is licensed or certified as a marriage and family therapist in such State.

(c)

Provision for payment under part B

Section 1832(a)(2)(B) of such Act (42 U.S.C. 1395k(a)(2)(B)) is amended by adding at the end the following new clause:

(v)marriage and family therapist services;

(d)

Amount of payment

Section 1833(a)(1) of such Act (42 U.S.C. 13951(a)(1)) is amended— (1)by striking and (V) and inserting (V); and (2)by inserting before the semicolon at the end the following: , and (W) with respect to marriage and family therapist services under section 1861(s)(2)(BB), the amounts paid shall be 90 percent of the lesser of the actual charge for the services or 85 percent of the amount determined for payment of a psychologist under clause (L). (e)

Exclusion of marriage and family therapist services from skilled nursing facility prospective payment system

Section 1888(e)(2)(A)(ii) of such Act (42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended by inserting marriage and family therapist services, after qualified psychologist services,. (f)

Inclusion of marriage and family therapists as practitioners for assignment of claims

Section 1842(b)(18)(C) of such Act (42 U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following new clause:

(vii)A marriage and family therapist (as defined in section 1861(ccc)(2)).