HCFA:

Medicare Program--Scope of Medicare Benefits and Application of the Outpatient Mental Health Treatment Limitation to Clinical Psychologist and Clinical Social Worker Services

OGC-98-47: Published: May 8, 1998. Publicly Released: May 8, 1998.

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Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) final rule on the scope of Medicare benefits and application of the outpatient mental health treatment limitation to clinical psychologist and clinical social worker services. GAO noted that: (1) the final rule would conform the requirements for Medicare coverage of services furnished by a clinical psychologist or as an incident to the services of a clinical psychologist and for services furnished by a clinical social worker with section 6113 of the Omnibus Budget Reconciliation Act of 1989, section 4157 of the Omnibus Budget Reconciliation Act of 1990, and section 147(b) of the Social Security Act Amendments of 1994 (SSA 94); (2) the rule would also address the outpatient mental health treatment limitation as it applies to clinical psychologist and clinical social worker services; (3) the final rule would also conform the Medicare program to section 104 of the SSA 94, which provides that a Medicare patient in a Medicare-participating hospital who is receiving qualified psychologist services may be under the care of a clinical psychologist with respect to those services, to the extent permitted by state law; and (4) HCFA complied with applicable requirements in promulgating the rule.

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