I 
109TH CONGRESS 
1ST SESSION H. R. 1447
To amend title XVIII of the Social Security Act to provide for the coverage 
of marriage and family therapist services under part B of the Medicare 
Program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 17, 2005
Mr. STRICKLAND (for himself, Ms. ROS-LEHTINEN, Mr. WILSON of South 
Carolina, Mr. WESTMORELAND, Mr. TOWNS, and Mr. WAXMAN) intro-
duced the following bill; which was referred to the Committee on Energy 
and Commerce, and in addition to the Committee on Ways and Means, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of the 
committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for the coverage of marriage and family therapist services 
under part B of the Medicare Program, and for other 
purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Seniors Mental Health 
Access Improvement Act of 2005’’.
SEC. 2. COVERAGE OF MARRIAGE AND FAMILY THERAPIST 
SERVICES UNDER PART B. 
(a) COVERAGE OF SERVICES.—Section 1861(s)(2) of 
the Social Security Act (42 U.S.C. 1395x(s)(2)) is amend-
ed—
(1) in subparagraph (Y), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (Z), by striking the period 
at the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(AA) marriage and family therapist serv-
ices (as defined in subsection (bbb)(1));’’. 
(b) DEFINITION.—Section 1861 of such Act (42 
U.S.C. 1395x) is amended by adding at the end thereof 
the following new subsection: 
‘‘Marriage and Family Therapist Services 
‘‘(bbb)(1) The term ‘marriage and family therapist 
services’ means services performed by a marriage and 
family therapist (as defined in paragraph (2)) for the diag-
nosis and treatment of mental illnesses, which the mar-
riage and family therapist is legally authorized to perform 
under State law (or the State regulatory mechanism pro-
vided by State law) of the State in which such services 
are performed, as would otherwise be covered if furnished 
by a physician or as an incident to a physician’s profes-
sional service, but only if no facility or other provider 
charges or is paid any amounts with respect to the fur-
nishing 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 two years of clinical supervised experience in 
marriage and family therapy; and 
‘‘(C) in the case of an individual performing 
services in a State that provides for licensure or cer-
tification of marriage or family therapists, is li-
censed or certified as a marriage and family thera-
pist in such State.’’. 
(c) PROVISION FOR PAYMENT UNDER PART B.—Sec-
tion 
1832(a)(2)(B) 
of 
such 
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.—Section 1833(a)(1) of 
such Act (42 U.S.C. 13951(a)(1)) is amended—
(1) by striking ‘‘and (V)’’ and inserting ‘‘(V)’’; 
and 
(2) 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)(AA), the amounts paid shall be 80 per-
cent of the lesser of the actual charge for the serv-
ices or 75 percent of the amount determined for 
payment of a psychologist under clause (L)’’. 
(e) EXCLUSION OF MARRIAGE AND FAMILY THERA-
PIST SERVICES FROM SKILLED NURSING FACILITY PRO-
SPECTIVE PAYMENT SYSTEM.—Section 1888(e)(2)(A)(ii) 
of such Act (42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended 
by inserting ‘‘marriage and family therapist services,’’ 
after ‘‘qualified psychologist services,’’. 
(f) INCLUSION OF MARRIAGE AND FAMILY THERA-
PISTS
AS
PRACTITIONERS
FOR
ASSIGNMENT
OF 
CLAIMS.—Section 1842(b)(18)(C) of such 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(bbb)(2)).’’.
SEC. 3. COVERAGE OF MARRIAGE AND FAMILY THERAPIST 
SERVICES PROVIDED IN CERTAIN SETTINGS. 
(a) 
RURAL
HEALTH
CLINICS.—Section 
1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 
1395x(aa)(1)(B)) is amended by inserting ‘‘, by a mar-
riage and family therapist (as defined in subsection 
(bbb)(2)),’’ after ‘‘by a clinical psychologist (as defined by 
the Secretary)’’. 
(b) 
HOSPICE
PROGRAMS.—Section 
1861(dd)(2)(B)(i)(III) 
of 
such 
Act 
(42 
U.S.C. 
1395x(dd)(2)(B)(i)(III)) is amended by inserting ‘‘or mar-
riage and family therapist (as defined in subsection 
(bbb)(2))’’ after ‘‘social worker’’. 
SEC. 4. AUTHORIZATION OF MARRIAGE AND FAMILY 
THERAPISTS TO DEVELOP DISCHARGE PLANS 
FOR POST-HOSPITAL SERVICES. 
Section 1861(ee)(2)(G) of the Social Security Act (42 
U.S.C. 1395x(ee)(2)(G)) is amended by inserting ‘‘mar-
riage and family therapist (as defined in subsection 
(bbb)(2)),’’ after ‘‘social worker,’’. 
SEC. 5. EFFECTIVE DATE. 
The amendments made by this Act apply with respect 
to services furnished on or after January 1, 2006.
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