US · guidance
CMS Pub. 100-04, ch. 4, § 270
Billing for Hospital Outpatient Services Furnished by Clinical
Social Workers (CSW) Marriage and Family Therapists (MFTs) and
Mental Health Counselors (MHCs)
(Rev. 12423; Issued: 12-20-23; Effective: 01-01-24; Implementation: 01-02-24)
Payment may be made for covered diagnostic and therapeutic services furnished by
CSWs, MFTs, and MHCs in a hospital outpatient setting. CSW, MFT, and MHC
services furnished under a partial hospitalization program are included in the partial
hospitalization rate. CSW, MFT, and MHC services furnished under an intensive
outpatient program are included in the intensive outpatient rate. Other CSW, MFT,
and MHC services must be billed to the A/B MAC (B) on Form CMS-1500 or the
electronic equivalent.
See chapters 13 and 15, of the Medicare Benefit Policy Manual, for a discussion of the
coverage requirements for CSWs, MFTs, and MHCs.
History
(Rev. 12423; Issued: 12-20-23; Effective: 01-01-24; Implementation: 01-02-24)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
006d0dfb0730d0f78ef85247480eba8f2afba90f5813968318a8a9fbed26b037
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