I 
110TH CONGRESS 
1ST SESSION H. R. 2644 
To amend title XVIII of the Social Security Act to provide for coverage 
of marriage and family therapist services under Medicare part B, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 11, 2007 
Mr. JEFFERSON introduced the following bill; which was referred to the Com-
mittee 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 coverage of marriage and family therapist services 
under Medicare part B, 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 ‘‘Medicare Marriage and 
Family Therapist Services Improvement Act’’. 
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SEC. 2. COVERAGE OF MARRIAGE AND FAMILY THERAPIST 
SERVICES UNDER MEDICARE 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 (Z), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (AA), by adding at the end 
‘‘and’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(BB) marriage and family therapist serv-
ices (as defined in subsection (ccc)(1));’’. 
(b) DEFINITION.—Section 1861 of such Act (42 
U.S.C. 1395x) is amended by adding at the end the fol-
lowing new subsection: 
‘‘(ccc) MARRIAGE AND FAMILY THERAPIST SERV-
ICES.—(1) The term ‘marriage and family therapist serv-
ices’ means services performed by a marriage and family 
therapist (as defined in paragraph (2)) for the diagnosis 
and treatment of mental illnesses, which the marriage and 
family therapist is legally authorized to perform under 
State law (or the State regulatory mechanism provided by 
State law) of the State in which such services are per-
formed, as would otherwise be covered if furnished by a 
physician or as an incident to a physician’s professional 
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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 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 serv-
ices;’’. 
(d) AMOUNT OF PAYMENT.—Section 1833(a)(1) of 
such Act (42 U.S.C. 13951(a)(1)) is amended— 
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(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)(BB), the amounts paid shall be 90 per-
cent of the lesser of the actual charge for the serv-
ices or 85 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 defined in section 1861(ccc)(2)).’’. 
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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 
(ccc)(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 
(ccc)(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 
(ccc)(2)),’’ after ‘‘social worker,’’. 
SEC. 5. EFFECTIVE DATE. 
The amendments made by this Act apply with respect 
to services furnished on or after November 1, 2007. 
Æ 
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