To regulate the business of offering and providing earned wage access services to consumers, and for other purposes.
Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.
Summary
What This Bill Does
This bill requires the Secretary of Health and Human Services to create a new billing code or modifier specifically for telehealth mental health services that are billed 'incident to' (under the supervision of) a physician or other healthcare practitioner. The deadline for implementation is January 1, 2026.
Who Benefits and How
Telehealth mental health providers benefit from clearer billing procedures and standardized codes for their services. Healthcare organizations offering telehealth mental health services gain regulatory clarity on how to properly bill Medicare for incident-to services. Patients may benefit from improved access to mental health services through telehealth as billing becomes more streamlined.
Who Bears the Burden and How
The Centers for Medicare & Medicaid Services (CMS) must develop and implement the new modifier/code requirements by January 1, 2026. Healthcare providers billing Medicare for telehealth mental health services will need to learn and comply with the new coding requirements.
Key Provisions
- Mandates creation of a telehealth modifier or code for mental health services billed incident to a physician's service
- Sets January 1, 2026 as the implementation deadline
- Gives the Secretary discretion in determining the appropriate code or modifier structure
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers.
At a Glance
What This Bill Does
Requires Medicare to establish billing codes or modifiers for telehealth mental health services that are billed incident to a physician or practitioner's professional service
Key Policy Areas
Healthcare, Medicare, Telehealth, Mental Health
Primary Purpose
Requires Medicare to establish billing codes or modifiers for telehealth mental health services that are billed incident to a physician or practitioner's professional service
Policy Domains
Section 2 - Establishment of Medicare incident to modifier for mental health services furnished through telehealth
Identified Gains
Contextual inference, no direct clause citation- Telehealth mental health providers
- Healthcare organizations offering telehealth services
- Medicare beneficiaries seeking mental health care
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Centers for Medicare & Medicaid Services (CMS)
- Healthcare providers billing Medicare
Contextual inference, no direct clause citation
Sponsors
Legislative Progress
ReportedAdditional sponsors: Mr. Donalds, Mr. Meuser, Mr. Barr, Mr. Luetkemeyer, …
Reported with an amendment, committed to the Committee of the …
Mr. Steil (for himself and Mr. Hill) introduced the following …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Earned wage access providers, Earned wage access providers (DailyPay, Earnin, PayActiv, etc.), Earned wage access providers (legitimacy and TILA exemption)
Positive-direction: Earned wage access providers, Earned wage access providers (legitimacy and TILA exemption), Earned wage access providers (market legitimacy)
Negative-direction: Earned wage access providers (DailyPay, Earnin, PayActiv, etc.)
Traditional payday lenders, Traditional payday lenders (subject to TILA)
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of Health and Human Services
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