Medicare Coverage of Marriage and Family Therapists

MFTs in Medicare Bill is Now Federal Law

Passage of the MFTs in Medicare Legislation

For many years, AAMFT, along with other mental health professional associations and organizations, have been advocating for Congress to pass legislation allowing MFTs and MHCs to serve as Medicare providers. This legislation, or similar versions of it, has been introduced in every Congress at least since 1999. The final version of this legislation, the Mental Health Access Improvement Act of 2021, was introduced two years ago in the House of Representatives as H.R. 432 by Rep. Mike Thompson (D-CA) and Rep. John Katko (R-NY), and in the Senate as S. 828 by Sen. John Barrasso (R-WY) and Sen. Debbie Stabenow (D-MI). This legislation made a significant amount of progress in moving through Congress, including a unanimous vote by the House Ways and Means Committee in September 2022.

Late last year, Congress started developing a massive bill (an omnibus spending package) that would fund the federal government through September 30, 2023, and enact additional policy priorities, including several changes to healthcare policy Fortunately, due to the efforts of the sponsors of the Mental Health Access Improvement Act and others, the text from this legislation was included in the omnibus legislation! The rapid timeline for passage was as follows:

·       Tuesday, December 20: Text of omnibus introduced in the Senate as an amendment to H.R. 2617. Coverage of MFTs and MHCs as Medicare providers included in Division FF, Section 4121 of the introduced text of the omnibus bill.

·       Thursday, December 22: Senate passed omnibus legislation (H.R 2617). Coverage of MFTs and MHCs as Medicare providers included in this legislation.

·       Friday, December 23: Bill sent back to House for consideration. House passed H.R. 2617.

·       Thursday, December 29: President Biden signs omnibus legislation into law, now known as Public Law No:117-328. Coverage of MFTs and MHCs as Medicare providers is included in this new law.

AAMFT would like to thank Representatives Thompson and Katko, and Senators Barrasso and Stabenow for their longtime sponsorship and support for this legislation, and their leadership in advocating for this legislation with their colleagues. This accomplishment would not have been possible without their support. We would also like to acknowledge the many Members of Congress who cosponsored the Mental Health Access Improvement Act and who advocated for its inclusion in the omnibus legislation.

We would also like to thank David Connolly of The Connolly Group, AAMFT’s federal lobbyist, for this accomplishment. Serving as lobbyist for both AAMFT and the California Association of Marriage and Family Therapists (CAMFT), David has been involved in thousands of meetings with Congress to advocate for MFTs as Medicare providers. David’s contributions were instrumental in moving this legislation forward.

We would like to recognize the many allied mental health associations and other groups that also advocated for inclusion of MFTs and MHCs as Medicare providers.

Finally, this accomplishment was only possible due to advocacy by AAMFT members and allies, who met with Congressional offices, and utilized thousands of emails and calls to Congress to push this important issue. These efforts resulted in many Senators and Representatives agreeing to support the Mental Health Access Improvement Act.

Medicare Webinars

The implementation of Medicare Part B Coverage of MFTs and Counselors will involve a comprehensive regulatory process throughout 2023. The Medicare Mental Health Workforce Coalition recently sponsored two webinars about the upcoming regulatory process. The sessions covered the basics of the Medicare Program, key provisions of the specific legislation that included MFTs and Counselors in Medicare, and overviews of key implementation features such as Enrollment Issues, the Medicare Physician Fee Schedule -- and related regulatory and administrative initiatives that will be conducted by the Centers for Medicare and Medicaid Services (CMS).  

Medicare 101 Video and Slides
Medicare 201 Video and Slides
Medicare 301 Video and Slides
Medicare 401 Video and Slides

FAQs about MFTs as Medicare Providers

In September, CMS released its initial FAQs regarding the enrollment of MFTs and MHCs. You can access these FAQs at this site. Below are a few of the most commonly asked questions pertaining to MFTs and MHCs serving as Medicare-eligible providers:

·       When can MFTs start providing services to clients as Medicare-eligible providers? - Under this new law, MFTs and MHCs would not be able to serve as Medicare-eligible providers and bill Medicare until January 1, 2024. This delay in implementing the new law is needed so that the federal government can make the necessary arrangements for MFTs and MHCs to serve as Medicare providers.

·       When can I enroll as a Medicare provider? – The omnibus legislation that includes language allowing MFTs and MHCs to serve as Medicare providers was signed into law in December 2022. It will take several months for the Centers for Medicare and Medicaid Services (CMS), the federal agency that administers the Medicare program, to draft the policies pertaining to MFTs and MHCs in Medicare and to begin the process of enrolling MFTs and MHCs. According to CMS, MFTs and MHCs can start to submit their enrollment applications around November 1, 2023 or later. AAMFT will keep members updated regarding when MFTs can enroll as Medicare providers.     

·       In what settings can MFTs see Medicare enrollees? – MFTs can enroll as a Medicare provider and offer services to enrollees in most practice settings, including private practice and most clinical settings. MFTs will also be able to serve as eligible providers in Medicare Advantage plans and provide services to Medicare enrollees in Federally Qualified Health Centers and Rural Health Clinics.

·       Which MFTs are eligible to enroll in Medicare? – Once enrollment opens, an MFT must be licensed by a State to practice independently in order to enroll as a Medicare provider. MFT associates, interns, and students are not eligible to enroll as Medicare-eligible providers. This eligibility standard is similar for other Medicare-eligible mental health professions, as well as for MHCs under the new law. To enroll in Medicare an MFT must possess a master’s or doctoral degree which qualifies for licensure as an MFT, have two years of clinical supervised experience in marriage and family therapy, and be licensed as an MFT by a State.

Next Steps

AAMFT is elated that MFTs have now been added to federal law as a Medicare-eligible profession, effective in January 2024. However, advocating for MFTs in Medicare is not over. In July 2023, CMS released the proposed regulations regarding the inclusion of MFTs and MHCs as Medicare providers. AAMFT provided feedback to CMS regarding these proposed rules. The final rules will likely be released around November 1, 2023. CMS will also be setting up the process for enrolling MFTs as Medicare providers later this year. Enrollment of MFTs and MHCs as Medicare providers is expected to start around November 1, 2023 or later. 

AAMFT has joined with its allies in the Medicare Mental Health Workforce Coalition to work with CMS this year to help ensure a smooth process for enrollment of MFTs as Medicare providers. AAMFT is planning to provide additional information to members on the Medicare program, how to enroll as a Medicare provider, and the policies MFTs will need to follow while treating Medicare enrollees.

Are you a member of AAMFT’s Family TEAM? The Family TEAM is AAMFT’s network of advocates who are interested in MFT advocacy and wiling to volunteer some time to advocate for important MFT goals. TEAM members will receive additional information on the progress of onboarding MFTs as Medicare providers throughout the year. Please click here to join the Family TEAM today!

Please contact us at FamilyTEAM@aamft.org if you have any questions.