Integrating Social Workers Across Health Care Settings Act
Summary
What This Bill Does
The Integrating Social Workers Across Health Care Settings Act amends the Medicare definition of clinical social worker services. It adds services and supplies furnished incident to clinical social worker services and strikes language limiting the services to diagnosis and treatment of mental illnesses. The amendments apply to services furnished on or after December 1, 2025. The practical effect is broader Medicare recognition of clinical social workers across health care settings, including support services that can address social needs, care coordination, and non-psychiatric health-related barriers.
Who Benefits and How
Medicare beneficiaries using social work services benefit because covered clinical social worker services would no longer be limited to mental-illness diagnosis and treatment. Clinical social workers benefit because Medicare would recognize incident-to services and supplies tied to their work. Hospitals and clinics using care teams benefit from more flexible Medicare coverage for social-work support in health care settings. Patients with complex social needs benefit if social workers can bill for support beyond narrow mental-health treatment.
Who Bears the Burden and How
The Centers for Medicare and Medicaid Services must update billing rules and coverage guidance before the December 1, 2025 applicability date. Medicare Administrative Contractors must process a broader range of social-worker service claims. Federal Medicare spending may rise if more clinical social worker services become payable. Compliance staff at provider organizations must train billing teams on the new service definition.
Key Provisions
- Amends Medicare's clinical social worker services definition to include incident-to services and supplies.
- Removes the limitation tying clinical social worker services only to diagnosis and treatment of mental illnesses.
- Applies the expanded definition to services furnished on or after December 1, 2025.
- Expands Medicare coverage flexibility for social workers across health care settings.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Expands Medicare clinical social worker services to include incident-to services and supplies and removes the limit tying covered services only to diagnosis and treatment of mental illnesses.
Key Policy Areas
Medicare, Behavioral Health, Social Work
Primary Purpose
Expands Medicare clinical social worker services to include incident-to services and supplies and removes the limit tying covered services only to diagnosis and treatment of mental illnesses.
Policy Domains
Resolution provisions
Identified Gains
- Medicare beneficiaries using social work services
- Clinical social workers
- Hospitals using care teams
- Patients with complex social needs
Identified Costs
- Centers for Medicare and Medicaid Services
- Medicare Administrative Contractors
- Federal Medicare spending
- Provider compliance staff
Sponsors
Legislative Progress
In CommitteeMrs. Kiggans of Virginia (for herself, Mr. Davis of Illinois, …
Referred to the Committee on Energy and Commerce, and in …
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Clinical social workers, Hospitals using care teams
Centers for Medicare and Medicaid Services, Federal Medicare spending
Medicare beneficiaries using social work services
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology