The Medicare Mental Health Workforce Coalition is leading a comprehensive effort to pass legislation to increase Medicare reimbursement rates for social workers, family therapists, and counselors—ensuring equitable compensation that reflects the vital mental health services these professionals provide to Medicare beneficiaries.
The Mental Health Access and Provider Support Act (MHAPSA) (S. 4202/H.R 8081) proposes to increase Medicare reimbursement from 75% to 85% percent of the Medicare Physician Fee Schedule for clinical social workers (CSWs), marriage and family therapists (MFTs), and mental health counselors (MHCs). This reform addresses the fundamental barrier to mental health care access for older adults: low reimbursement rates that drive providers to leave Medicare. Increasing reimbursement will strengthen the behavioral health workforce, improve provider recruitment and retention, and expand mental health access for millions of Medicare beneficiaries.
- LOW REIMBURSEMENT DRIVES PROVIDER OPT-OUT AND ACCESS CRISIS
- In 2022, behavioral health clinicians accounted for 40 percent of all clinicians who opted out of Medicare. Psychiatrists have the highest opt-out rate of any physician specialty.
- Only 55 percent of mental health providers see traditional Medicare beneficiaries. In Medicare Advantage, 65 percent of plans have narrow mental health networks.
- Twenty to 30 percent of older adults experience anxiety or depression, yet only a fraction receive treatment due to provider access barriers with low reimbursement a key factor.
- REIMBURSEMENT REFORM EXPANDS ACCESS FOR CRITICAL POPULATIONS
- MHAPSA’s increase in reimbursement will make Medicare participation financially sustainable for mental health providers and enable practice expansion in Medicare networks.
- Increased reimbursement for CSWs, MFTs, and MHCs will expand the behavioral health workforce, increasing geographic diversity and improving access in underserved communities such as rural and frontier areas.
- Improved mental health access will reduce emergency department utilization and psychiatric hospitalization, lowering overall health care costs while improving outcomes.
III. REIMBURSEMENT REFORM IMPROVES CLINICAL CARE AND OUTCOMES
- Higher reimbursement enables providers to accept more complex patients and provide integrated mental health/primary care delivery.
- Research demonstrates increased reimbursement correlates with improved beneficiary utilization and better mental health outcomes.
- Reimbursement increases reduce administrative burden, enabling providers to focus on patient care.
- EVIDENCE-BASED POLICY ALIGNED WITH FEDERAL PRIORITIES
- CMS and multiple federal agencies recognize mental health reimbursement reform as critical to improving access and addressing workforce shortages.
- Reimbursement reform is fiscally responsible: increased provider participation reduces emergency and crisis utilization, reducing overall Medicare spending.
- The behavioral health workforce shortage is projected to worsen significantly over the next decade without sustained reimbursement investment. MHAPSA signals federal commitment to long-term workforce stability.
CONCLUSION
Passage of the Mental Health Access and Provider Support Act will increase Medicare reimbursement and strengthen provider participation, expand access for older adults, and support behavioral health workforce sustainability.
At a time of unprecedented mental health need, adequate Medicare reimbursement for mental health providers is essential.
Materials:
Senators John Barrasso (R-WY) and Chris Coons (D-DE) Introduce Mental Health Access and Provider Support Act, S. 4202 – March 25, 2026
Congressmen Brian Fitzpatrick (R-PA) and Paul Tonko (D-NY) Introduce Mental Health Access and Provider Support Act, H.R. 8081 – March 26, 2026