as would otherwise be covered if furnished by a physician 
or as incident to a physician’s professional service, but 
only if no facility or other provider charges or is paid any 
amounts with respect to the furnishing of such services. 
‘‘(2) The term ‘marriage and family therapist’ means 
an individual who— 
‘‘(A) possesses a master’s or doctoral degree 
which qualifies for licensure or certification as a 
marriage and family therapist pursuant to State 
law; 
‘‘(B) after obtaining such degree has performed 
at least 2 years of clinical supervised experience in 
marriage and family therapy; and 
‘‘(C) is licensed or certified as a marriage and 
family therapist in the State in which marriage and 
family therapist services are performed.’’. 
(c) PROVISION FOR PAYMENT UNDER PART B.—Sec-
tion 1832(a)(2)(B) of the Social Security Act (42 U.S.C. 
1395k(a)(2)(B)) is amended by adding at the end the fol-
lowing new clause: 
‘‘(v) marriage and family therapist 
services;’’. 
(d) AMOUNT OF PAYMENT.— 
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(1) IN GENERAL.—Section 1833(a)(1) of the 
Social Security Act (42 U.S.C. 1395l(a)(1)) is 
amended— 
(A) by striking ‘‘and’’ before ‘‘(V)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (W) with respect 
to marriage and family therapist services under 
section 1861(s)(2)(BB), the amounts paid shall 
be 80 percent of the lesser of (i) the actual 
charge for the services or (ii) 75 percent of the 
amount determined for payment of a psycholo-
gist under subparagraph (L)’’. 
(2) DEVELOPMENT
OF
CRITERIA
WITH
RE-
SPECT TO CONSULTATION WITH A PHYSICIAN.—The 
Secretary of Health and Human Services shall, tak-
ing into consideration concerns for patient confiden-
tiality, develop criteria with respect to payment for 
marriage and family therapist services for which 
payment may be made directly to the marriage and 
family therapist under part B of title XVIII of the 
Social Security Act (42 U.S.C. 1395j et seq.) under 
which such a therapist must agree to consult with a 
patient’s attending or primary care physician in ac-
cordance with such criteria. 
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(e) EXCLUSION OF MARRIAGE AND FAMILY THERA-
PIST SERVICES FROM SKILLED NURSING FACILITY PRO-
SPECTIVE PAYMENT SYSTEM.—Section 1888(e)(2)(A)(ii) 
of the Social Security Act (42 U.S.C. 1395yy(e)(2)(A)(ii)), 
as amended in section 301(a), is amended by inserting 
‘‘marriage and family therapist services (as defined in sub-
section (eee)(1)),’’ after ‘‘clinical social worker services,’’. 
(f) COVERAGE OF MARRIAGE AND FAMILY THERA-
PIST SERVICES PROVIDED IN RURAL HEALTH CLINICS 
AND FEDERALLY QUALIFIED HEALTH CENTERS.—Sec-
tion 1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 
1395x(aa)(1)(B)) is amended by striking ‘‘or by a clinical 
social worker (as defined in subsection (hh)(1)),’’ and in-
serting ‘‘, by a clinical social worker (as defined in sub-
section (hh)(1)), or by a marriage and family therapist 
(as defined in subsection (eee)(2)),’’. 
(g) INCLUSION OF MARRIAGE AND FAMILY THERA-
PISTS
AS
PRACTITIONERS
FOR
ASSIGNMENT
OF 
CLAIMS.—Section 1842(b)(18)(C) of the Social Security 
Act (42 U.S.C. 1395u(b)(18)(C)) is amended by adding 
at the end the following new clause: 
‘‘(vii) A marriage and family therapist (as de-
fined in section 1861(eee)(2)).’’. 
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(h) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after January 1, 2008. 
SEC. 303. COVERAGE OF MENTAL HEALTH COUNSELOR 
SERVICES. 
(a) COVERAGE OF SERVICES.—Section 1861(s)(2) of 
the Social Security Act (42 U.S.C. 1395x(s)(2)), as 
amended in section 302(a), is amended— 
(1) in subparagraph (AA), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (BB), by inserting ‘‘and’’ 
at the end; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(CC) mental health counselor services (as 
defined in subsection (fff)(2));’’. 
(b) DEFINITION.—Section 1861 of the Social Secu-
rity Act (42 U.S.C. 1395x), as amended by sections 
201(b), 202(b), and 302(b), is amended by adding at the 
end the following new subsection: 
‘‘(fff) MENTAL
HEALTH
COUNSELOR; MENTAL 
HEALTH COUNSELOR SERVICES.—(1) The term ‘mental 
health counselor’ means an individual who— 
‘‘(A) possesses a master’s or doctor’s degree in 
mental health counseling or a related field; 
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‘‘(B) after obtaining such a degree has per-
formed at least 2 years of supervised mental health 
counselor practice; and 
‘‘(C) is licensed or certified as a mental health 
counselor or professional counselor by the State in 
which the services are performed. 
‘‘(2) The term ‘mental health counselor services’ 
means services performed by a mental health counselor (as 
defined in paragraph (1)) for the diagnosis and treatment 
of mental illnesses which the mental health counselor is 
legally authorized to perform under State law (or the 
State regulatory mechanism provided by the State law) of 
the State in which such services are performed, provided 
such services are covered under this title, as would other-
wise be covered if furnished by a physician or as incident 
to a physician’s professional service, but only if no facility 
or other provider charges or is paid any amounts with re-
spect to the furnishing of such services.’’. 
(c) PAYMENT.— 
(1) IN GENERAL.—Section 1833(a)(1) of the 
Social Security Act (42 U.S.C. 1395l(a)(1)), as 
amended by section 302(d), is amended— 
(A) by striking ‘‘and’’ before ‘‘(W)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (X) with respect 
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to mental health counselor services under sec-
tion 1861(s)(2)(CC), the amounts paid shall be 
80 percent of the lesser of (i) the actual charge 
for the services or (ii) 75 percent of the amount 
determined for payment of a psychologist under 
subparagraph (L)’’. 
(2) DEVELOPMENT
OF
CRITERIA
WITH
RE-
SPECT TO CONSULTATION WITH A PHYSICIAN.—The 
Secretary of Health and Human Services shall, tak-
ing into consideration concerns for patient confiden-
tiality, develop criteria with respect to payment for 
mental health counselor services for which payment 
may be made directly to the mental health counselor 
under part B of title XVIII of the Social Security 
Act (42 U.S.C. 1395j et seq.) under which such a 
counselor must agree to consult with a patient’s at-
tending or primary care physician in accordance 
with such criteria. 
(d) EXCLUSION OF MENTAL HEALTH COUNSELOR 
SERVICES FROM SKILLED NURSING FACILITY PROSPEC-
TIVE PAYMENT SYSTEM.—Section 1888(e)(2)(A)(ii) of 
the Social Security Act (42 U.S.C. 1395yy(e)(2)(A)(ii)), 
as amended by sections 301(a) and 302(e), is amended 
by inserting ‘‘mental health counselor services (as defined 
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in section 1861(fff)(2)),’’ after ‘‘marriage and family ther-
apist services (as defined in subsection (eee)(1)),’’. 
(e) COVERAGE
OF MENTAL HEALTH COUNSELOR 
SERVICES PROVIDED IN RURAL HEALTH CLINICS AND 
FEDERALLY
QUALIFIED
HEALTH
CENTERS.—Section 
1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 
1395x(aa)(1)(B)), as amended by section 302(f), is 
amended— 
(1) by striking ‘‘or by a marriage’’ and insert-
ing ‘‘by a marriage’’; and 
(2) by inserting ‘‘or a mental health counselor 
(as defined in subsection (fff)(1)),’’ after ‘‘marriage 
and family therapist (as defined in subsection 
(eee)(2)),’’. 
(f) INCLUSION OF MENTAL HEALTH COUNSELORS AS 
PRACTITIONERS FOR ASSIGNMENT OF CLAIMS.—Section 
1842(b)(18)(C) of the Social Security Act (42 U.S.C. 
1395u(b)(18)(C)), as amended by section 302(g), is 
amended by adding at the end the following new clause: 
‘‘(viii) A mental health counselor (as defined in 
section 1861(fff)(1)).’’. 
(g) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after January 1, 2008. 
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SEC. 304. STUDY OF COVERAGE CRITERIA FOR ALZ-
HEIMER’S DISEASE AND RELATED MENTAL 
ILLNESSES. 
(a) STUDY.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the 
‘‘Secretary’’) shall conduct a study to determine 
whether the criteria for coverage of any therapy 
service (including occupational therapy services and 
physical therapy services) or any outpatient mental 
health care service under the medicare program 
under title XVIII of the Social Security Act (42 
U.S.C. 1395 et seq.) unduly restricts the access of 
any medicare beneficiary who has been diagnosed 
with Alzheimer’s disease or a related mental illness 
to such a service because the coverage criteria re-
quires the medicare beneficiary to display continuing 
clinical improvement to continue to receive the serv-
ice. 
(2) DETERMINATION OF NEW COVERAGE CRI-
TERIA.—If the Secretary determines that the cov-
erage criteria described in paragraph (1) unduly re-
stricts the access of any medicare beneficiary to the 
services described in such paragraph, the Secretary 
shall identify alternative coverage criteria that would 
permit a medicare beneficiary who has been diag-
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nosed with Alzheimer’s disease or a related mental 
illness to receive coverage for health care services 
under the medicare program that are designed to 
control symptoms, maintain functional capabilities, 
reduce or deter deterioration, and prevent or reduce 
hospitalization of the beneficiary. 
(b) REPORT.—Not later than 1 year after the date 
of enactment of this Act, the Secretary shall submit to 
the committees of jurisdiction of Congress a report on the 
study conducted under subsection (a) together with such 
recommendations for legislative and administrative action 
as the Secretary determines appropriate. 
Æ 
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