NASW Urges Support for Rise in Reimbursement Rate

Practice

Since receiving Medicare Part B standing in the early 1990s, the reimbursement rate for clinical social workers has remained at the initially established 75% of the clinical psychologist rate under the Medicare Physician Fee Schedule–even though other non-physician providers are reimbursed at 85%.

NASW is advocating for an increase in Medicare reimbursement and for making the pandemic-era Medicare telehealth flexibilities permanent. With clinical social workers authorized as Medicare Part B mental health providers, these efforts can improve the ability of Medicare beneficiaries to access critical mental health care.

U.S Sens. John Barrasso, R-Wyo., and Christopher Coons, D-Del., and U.S. Reps. Brian Fitzpatrick, R-Penn., and Paul Tonko, D-N.Y., have taken steps to correct this inequity through the introduction of the Mental Health Access and Provider Support Act (S.4202/ H.R. 8081). The legislation aligns CSWs’ Medicare reimbursement rate with other non-physician providers through a 10% increase, to the 85% clinical psychologist rate.

This realignment comes at a time when more Medicare beneficiaries are seeking mental health services while facing significant provider shortages, particularly in rural and underserved areas. According to the U.S. Government Accountability Office, CSWs currently account for 20 percent of Medicare mental health services and will continue to serve as a critical source of access to meet the growing demand.

NASW is urging members to contact their representatives to support this bill along with the CONNECT for Health Act (S. 1261 / H.R. 4206). It would make permanent telehealth flexibilities in Medicare that were expanded during the Public Health Emergency.