To amend title XVIII of the Social Security Act to establish a Medicare incident to modifier for mental health services furnished through telehealth.
Sponsors
Legislative Progress
ReportedAdditional sponsor: Mrs. Peltola
Reported from the Committee on Energy and Commerce with amendments
Committee on Ways and Means discharged; committed to the Committee …
Mr. James (for himself, Mr. Schweikert, and Mr. Davis of …
Summary
What This Bill Does
Directs HHS to create billing modifier for telehealth mental health services provided by non-physician staff under physician supervision. Improves tracking of incident-to telehealth billing.
Who Benefits and How
- Medicare gains better data on telehealth service delivery
- Mental health oversight improves through modifier tracking
- Program integrity strengthened by identifying who provides care
Who Bears the Burden and How
- HHS/CMS must establish modifier by January 2026
- Mental health providers must use new billing codes
- Telehealth billing systems require updates
Key Provisions
- Modifier required for incident-to telehealth claims
- Applies to mental health services
- Implementation by January 1, 2026
- Secretary determines appropriate code or modifier
Evidence Chain:
This summary is derived from the structured analysis below. See "Detailed Analysis" for per-title beneficiaries/burden bearers with clause-level evidence links.
Primary Purpose
Requires Medicare modifier for telehealth mental health services billed incident to physician services
Policy Domains
Legislative Strategy
"Improve telehealth oversight through billing transparency"
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of HHS
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