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SEC. 605. EXCEPTION TO 60-DAY LIMIT ON MEDICARE SUB-
STITUTE BILLING ARRANGEMENTS IN CASE 
OF PHYSICIANS ORDERED TO ACTIVE DUTY 
IN THE ARMED FORCES. 
(a) IN GENERAL.—Section 1842(b)(6)(D)(iii) of the 
Social Security Act (42 U.S.C. 1395u(b)(6)(D)(iii)) is 
amended by inserting after ‘‘of more than 60 days’’ the 
following: ‘‘or are provided over a longer continuous period 
during all of which the first physician has been called or 
ordered to active duty as a member of a reserve component 
of the Armed Forces’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to services furnished on or after 
the date of the enactment of this section. 
SEC. 606. EXCLUDING CLINICAL SOCIAL WORKER SERVICES 
FROM COVERAGE UNDER THE MEDICARE 
SKILLED NURSING FACILITY PROSPECTIVE 
PAYMENT SYSTEM AND CONSOLIDATED PAY-
MENT. 
(a) IN GENERAL.—Section 1888(e)(2)(A)(ii) of the 
Social Security Act (42 U.S.C. 1395yy(e)(2)(A)(ii)) is 
amended by inserting ‘‘clinical social worker services,’’ 
after ‘‘qualified psychologist services,’’. 
(b) 
CONFORMING
AMENDMENT.—Section 
1861(hh)(2) of the Social Security Act (42 U.S.C. 
1395x(hh)(2)) is amended by striking ‘‘and other than 
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services furnished to an inpatient of a skilled nursing facil-
ity which the facility is required to provide as a require-
ment for participation’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after January 1, 2008. 
SEC. 607. COVERAGE OF MARRIAGE AND FAMILY THERA-
PIST SERVICES AND MENTAL HEALTH COUN-
SELOR SERVICES. 
(a) COVERAGE OF MARRIAGE AND FAMILY THERA-
PIST SERVICES.— 
(1) 
COVERAGE
OF
SERVICES.—Section 
1861(s)(2) of the Social Security Act (42 U.S.C. 
1395x(s)(2)), as amended by section 201(a)(1), is 
amended— 
(A) in subparagraph (AA), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (BB), by adding 
‘‘and’’ at the end; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(CC) marriage and family therapist services 
(as defined in subsection (eee));’’. 
(2) DEFINITION.—Section 1861 of the Social 
Security Act (42 U.S.C. 1395x), as amended by sec-
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tions 201(a)(2) and 503(b)(1), is amended by add-
ing at the end the following new subsection: 
‘‘Marriage and Family Therapist Services 
‘‘(eee)(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, provided such services are covered under 
this title, 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 
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‘‘(C) is licensed or certified as a marriage and 
family therapist in the State in which marriage and 
family therapist services are performed.’’. 
(3) PROVISION
FOR
PAYMENT
UNDER
PART 
B.—Section 1832(a)(2)(B) of the Social Security 
Act (42 U.S.C. 1395k(a)(2)(B)) is amended by add-
ing at the end the following new clause: 
‘‘(v) marriage and family therapist 
services;’’. 
(4) AMOUNT OF PAYMENT.— 
(A) IN GENERAL.—Section 1833(a)(1) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395l(a)(1)), as amended by section 201(b)(1), 
is amended— 
(i) by striking ‘‘and’’ before ‘‘(W)’’; 
and 
(ii) by inserting before the semicolon 
at the end the following: ‘‘, and (X) with 
respect to marriage and family therapist 
services under section 1861(s)(2)(CC), the 
amounts paid shall be 80 percent of the 
lesser of: (i) the actual charge for the serv-
ices; or (ii) 75 percent of the amount de-
termined for payment of a psychologist 
under subparagraph (L)’’. 
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(B) DEVELOPMENT OF CRITERIA WITH RE-
SPECT TO CONSULTATION WITH A PHYSICIAN.— 
The Secretary of Health and Human Services 
shall, taking into consideration concerns for pa-
tient confidentiality, develop criteria with re-
spect to payment for marriage and family ther-
apist services for which payment may be made 
directly to the marriage and family therapist 
under part B of title XVIII of the Social Secu-
rity 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 
accordance with such criteria. 
(5) EXCLUSION
OF
MARRIAGE
AND
FAMILY 
THERAPIST SERVICES FROM SKILLED NURSING FA-
CILITY
PROSPECTIVE
PAYMENT
SYSTEM.—Section 
1888(e)(2)(A)(ii) of the Social Security Act (42 
U.S.C. 1395yy(e)(2)(A)(ii)), is amended by inserting 
‘‘marriage and family therapist services (as defined 
in subsection (eee)(1)),’’ after ‘‘qualified psychologist 
services,’’. 
(6) COVERAGE
OF
MARRIAGE
AND
FAMILY 
THERAPIST SERVICES PROVIDED IN RURAL HEALTH 
CLINICS AND FEDERALLY QUALIFIED HEALTH CEN-
TERS.—Section 1861(aa)(1)(B) of the Social Secu-
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rity 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 inserting ‘‘, by a clinical 
social worker (as defined in subsection (hh)(1)), or 
by a marriage and family therapist (as defined in 
subsection (eee)(2)),’’. 
(7) INCLUSION
OF
MARRIAGE
AND
FAMILY 
THERAPISTS
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 amend-
ed by adding at the end the following new clause: 
‘‘(vii) A marriage and family therapist (as de-
fined in section 1861(eee)(2)).’’. 
(b) COVERAGE OF MENTAL HEALTH COUNSELOR 
SERVICES.— 
(1) 
COVERAGE
OF
SERVICES.—Section 
1861(s)(2) of the Social Security Act (42 U.S.C. 
1395x(s)(2)), as amended by subsection (a)(1), is 
further amended— 
(A) in subparagraph (BB), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (CC), by inserting 
‘‘and’’ at the end; and 
(C) by adding at the end the following new 
subparagraph: 
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‘‘(DD) mental health counselor services (as de-
fined in subsection (fff)(2));’’. 
(2) DEFINITION.—Section 1861 of the Social 
Security Act (42 U.S.C. 1395x), as amended by sec-
tions 201(a)(2) and 503(b)(1) and subsection (a)(2), 
is amended by adding at the end the following new 
subsection: 
‘‘Mental Health Counselor; Mental Health Counselor 
Services 
‘‘(fff)(1) The term ‘mental health counselor’ means 
an individual who— 
‘‘(A) possesses a master’s or doctor’s degree 
which qualifies the individual for licensure or certifi-
cation for the practice of mental health counseling in 
the State in which the services are performed; 
‘‘(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 
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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.’’. 
(3) PROVISION
FOR
PAYMENT
UNDER
PART 
B.—Section 1832(a)(2)(B) of the Social Security 
Act (42 U.S.C. 1395k(a)(2)(B)), as amended by 
subsection (a)(3), is further amended by adding at 
the end the following new clause: 
‘‘(vi) mental health counselor serv-
ices;’’. 
(4) AMOUNT OF PAYMENT.— 
(A) IN GENERAL.—Section 1833(a)(1) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395l(a)(1)), as amended by subsection (a)(4), 
is further amended— 
(i) by striking ‘‘and’’ before ‘‘(X)’’; 
and 
(ii) by inserting before the semicolon 
at the end the following: ‘‘, and (Y) with 
respect to mental health counselor services 
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