The NBCC Creed

Medicare and Professional Counselors

Image of medicare provided counselor with senior couple as patients.

After more than a decade of working to secure Medicare coverage for counselors’ services, NBCC, the Medicare Mental Health Workforce Coalition, and counselors across the country can celebrate the passing of the omnibus package, which achieved our goal! The package, which includes language from the Mental Health Access Improvement Act (S. 828/H.R. 432) that expands coverage of mental health counselors (MHCs) and marriage and family therapists (MFTs) under Medicare Part B, was signed into law by President Biden on Dec. 29, 2022.

Coverage of MHCs and MFTs under Part B of the Medicare program will begin Jan. 1, 2024. Medicare is the largest health care program in the country, covering more than 55 million people. It currently recognizes psychiatrists, psychologists, clinical social workers, and psychiatric nurses for outpatient mental health services, and now counselors and MFTs will be added to the list. Because Medicare is the country’s flagship health care program, counselor inclusion is key to ensuring parity with other professions.

The Centers for Medicare & Medicaid Services (CMS) will now develop specific rules on how counselors can apply for provider status, receive a Provider ID number, and bill for services. The rules will be developed in 2023 ahead of the Jan.1, 2024, implementation.

The NBCC Government Affairs team will work in conjunction with CMS to develop these rules and inform counselors about the enrollment process.

2022

On Dec. 29, 2022, the Consolidated Appropriations Act, 2023 (H.R. 2617) was signed into law by President Biden after a bipartisan vote of approval in both of the United States legislative chambers. Included in the omnibus package is language from the Mental Health Access Improvement Act (S. 828/H.R. 432), which has added mental health counselors to the list of Medicare providers. Coverage of counselors will begin Jan. 1, 2024.

2021

S. 828/H.R. 432, the Mental Health Access Improvement Act of 2021, is introduced by Sen. John Barrasso (R-WY), Sen. Debbie Stabenow (D-MI), Rep. Mike Thompson (D-CA-5), and Rep. John Katko (R-NY-24).

2020

The House Committee on Energy and Commerce reports S. 286/H.R. 945 favorably out of a markup, the first time the legislation has been included in a markup in 11 years.

2020

In response to the COVID-19 pandemic, the Centers for Medicare & Medicaid Services issues a temporary emergency rule that allows mental health counselors working in Rural Health Centers and Federally Qualified Health Centers to be reimbursed by Medicare for telehealth services.

2020

S. 286/H.R. 945 gains 123 cosponsors in the House and 31cosponsors in the Senate, the most in the bill’s history.

2019

S. 286/H.R. 945, the Mental Health Access Improvement Act of 2019, is introduced by Sen. John Barrasso (R-WY), Sen. Debbie Stabenow (D-MI), Rep. Mike Thompson (D-CA-5), and Rep. John Katko (R-NY-24).

2017

The President’s Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC), an advisory body composed of federal officials and behavioral health experts, recommended inclusion of counselors in the Medicare program. please feel free to download and read the full report.

2017

U.S. Sens. John Barrasso (R-WY) and Debbie Stabenow (D-MI) introduce S. 1879, the Seniors Mental Health Access Improvement Act of 2017, seeking to establish mental health counselors and marriage and family therapists as authorized Medicare providers.

2017

U.S. Reps. John Katko (R-NY) and Mike Thompson (D-CA) introduce H.R. 3032, the Mental Health Access Improvement Act of 2017, seeking to establish mental health counselors and marriage and family therapists as authorized Medicare providers.

2016

Representative Chris Gibson (R-NY) , Senator John Barrasso (R-WY) and counselor/MFT organizations pushed to include Medicare legislation in the pending mental health reform package.

2016

Retiring Representative Chris Gibson (R‐NY) made it a priority to pass H.R. 2759 and added 10 Republican cosponsors to the bill (the most House Republicans ever), raising the total to 50 cosponsors.

2016

Representative Robin Kelly (D-IL) introduced H.R. 5475, the Health Equity and Accountability Act. H.R. 5475 was sponsored by the House Tri-Caucus and addresses health disparities for minority populations.

2015

Senators John Barrasso (R‐WY) and Debbie Stabenow (D‐MI) introduced the Seniors Mental Health Access Improvement Act (S 1830), a companion Bill to H.R. 2759.

2015

Congressmen Chris Gibson (R‐NY) and Mike Thompson (D‐CA) introduced H.R. 2759, The Mental Health Improvement Act of 2015. The bill provides Medicare reimbursement for counselors and MFTs, mirroring bills introduced in prior sessions.

2021-2022117th Congress

On Dec. 29, 2022, the Consolidated Appropriations Act (H.R. 2617) was signed into law by President Biden after a bipartisan vote of approval in both of the United States legislative chambers. Included in the omnibus package is language from the Mental Health Access Improvement Act (S. 828/H.R. 432) adding mental health counselors as providers. Coverage of counselors will begin Jan. 1, 2024.

2016 - 2017115th Congress

Congressmen John Katko (R-NY) and Mike Thompson (D-CA) introduced H.R. 3032, the Mental Health Access Improvement Act, on June 23. Senators John Barrasso (R-WY) and Debbie Stabenow (D-MI) introduced a companion bill in the Senate, S.1879, the Seniors Mental Health Access Improvement Act, on September 27.

2015 - 2016114th Congress

Companion stand-alone bills S. 1830, the Seniors Mental Health Access Improvement Act of 2015, and H.R. 2759, the Mental Health Access Improvement Act, are introduced by Sens. John Barrasso (R-WY) and Debbie Stabenow (D-MI) and Reps. Chris Gibson (R-NY) and Mike Thompson (D-CA). The House TriCaucus health disparities bill, H.R. 5475, is introduced by Rep. Robin Kelly (D-IL).

2013 - 2014113th Congress

Sen. Ron Wyden (D-OR) introduces stand-alone bill S. 604, the Seniors Mental Health Access Improvement Act of 2011. The MHC and MFT language is also included in S. 1680, the Craig Thomas Rural Hospital and Provider Equity Act of 2011, introduced by Sens. John Barrasso (R-WY), Pat Roberts (R-KS), Kent Conrad (D-ND) and Tom Harkin (D-IA).

2011 - 2012112th Congress

Sen. Ron Wyden (D-OR) introduces stand-alone bill S. 604, the Seniors Mental Health Access Improvement Act of 2011. The MHC and MFT language is also included in S. 1680, the Craig Thomas Rural Hospital and Provider Equity Act of 2011, introduced by Sens. John Barrasso (R-WY), Pat Roberts (R-KS), Kent Conrad (D-ND) and Tom Harkin (D-IA).

2009 - 2010111th Congress

The provision is re-introduced in companion stand-alone bills S. 671 and H.R. 1693 by Sens. Blanche Lincoln (D-AR) and John Barrasso (R-WY) and Rep. Bart Gordon (D-TN). The provision is included in H.R. 3200, the House reform legislation that passed the Energy and Commerce, Ways and Means, and Education and Labor Committees. The language passes the House as part of the health reform bill (H.R. 3962). The provision was reportedly in the final House-Senate compromise legislation until the election of Sen. Scott Brown (R-MA) changed the Senate balance.

2007 - 2008110th Congress

Companion stand-alone bills S. 921 and H.R. 1588 are introduced by Sens. Craig Thomas (R-WY) and Blanche Lincoln (D-AR) and Rep. Barbara Cubin (R-WY). Rep. Pete Stark (D-CA) includes the MHC and MFT language in his omnibus Medicare mental health bill (H.R. 1663). The provision passes the House as part of the SCHIP Reauthorization Act (H.R. 3162). The Senate declines to consider the SCHIP bill.

2005 - 2006 109th Congress

In addition to companion bills S. 784 and H.R. 5324, introduced by Sens. Craig Thomas (R-WY) and Blanche Lincoln (D-AR) and Rep. Barbara Cubin (R-WY), the MHC and MFT provision is again included in the omnibus Medicare mental health bill (S. 927 and H.R. 1946) and the Medicare rural access bills (S. 3500 and H.R. 6030). The provision passes the Senate as part of the Deficit Reduction Act of 2005 (S. 1932) but does not make it through conference.

2003 - 2004 108th Congress

Sen. Craig Thomas (R-WY) introduces S. 310 as a stand-alone bill. The language is also included in the omnibus Medicare mental health bill (S. 646) and the omnibus Medicare rural access bill (S. 1185 and H.R. 2333). In 2003, the provision passes the Senate in the Medicare prescription drug bill (S. 1) but is not accepted during conference.

2001 - 2002107th Congress

The provision to provide reimbursement for MHCs and MFTs in the Medicare program is introduced as stand-alone bill S.1760 by Sens. Craig Thomas (R-WY) and Blanche Lincoln (D-AR). The companion bill, H.R. 3899, is subsequently introduced on the House side by Rep. Brad Carson (D-OK). The same provision is additionally included in an omnibus Medicare mental health bill (S. 690 and H.R. 1522), but does not make it out of committee.

For more than a decade, NBCC worked as part of a coalition of counselor and marriage and family therapist (MFT) organizations to pass legislation to add counselors and MFTs to Medicare. Like counselors, MFTs were excluded from Medicare despite meeting education and training requirements comparable to those of included professions. Only a federal law could accomplish this objective. Throughout the years, over 30 bills included language adding counselors and MFTs to Medicare, and the legislation finally passed both the Senate and House and was signed into law in 2022.

The first stand-alone bill adding counselors to Medicare was introduced in 2001 in the 107th Congress. Since then, NBCC’s Government Affairs team has ensured that such a bill has been introduced by at least one of the houses of Congress during every subsequent session. Both chambers of Congress had passed legislation adding Medicare recognition of counselors, but until 2022, they had not passed it at the same time.

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