Introduced by Reps. Jen Kiggans (R-VA), Danny Davis (D-IL), and Brittany Pettersen (D-CO) 

Clinical social workers (CSWs) do far more than treat and diagnosis mental illness - they coordinate care in complex systems, leverage clinical skills to support behavior change and engagement in care, and address the social factors that drive poor health outcomes. Yet under current Medicare law, CSWs are not reimbursed for most of this essential work.

H.R. 4185 fixes that. This bipartisan bill makes two targeted, commonsense updates to Medicare Part B, and we need your voice to help pass it. 

Medicare law currently limits reimbursement for CSWs to the "diagnosis and treatment of mental illness", language written decades ago that is not fully representative of the care provided by CSWs or how care is actually delivered. H.R. 4185 removes this restriction and aligns Medicare payment with the full scope of clinical social work practice as recognized in their state of practice. 

WHAT THE BILL DOES 

• Removes the outdated mental-health-only restriction on reimbursable clinical social worker services 
• Expands covered services by allowing Medicare to cover not only services a CSW personally provides, but also the related services and supports that are part of their care plan, aligning Medicare with team-based care. 

WHY IT MATTERS FOR YOUR COMMUNITY 

• Improves care coordination for older adults and people with chronic or serious illness 
• Better supports caregivers navigating complex medical and social systems 
• Expands access in rural and underserved communities where CSWs fill critical workforce gaps 
• Reduces avoidable hospitalizations and emergency visits, saving Medicare dollars 

H.R. 4185 does not expand scope of practice, create new benefits or bypass CMS authority. It simply ensures CSWs are not restricted from Medicare reimbursement for work they are already doing every day.

Contact your Representative TODAY and urge them to co-sponsor the Integrating Social Workers Across Health Care Settings Act. Help them understand the mental health needs of Medicare beneficiaries in your community and why this change is needed to help Medicare beneficiaries get full access to CSW services. Personalized communication goes a long way with a member of Congress.