Medicare_Carriers_Manual / 2152 / 2152

Why This Topic Matters

It helps readers understand whether clinical social worker services fall within Medicare coverage, how state law affects scope of practice, and how payment limitations can apply to covered services.

Article Sections

1. Ed. Note: For further information see

   A brief editorial note pointing readers to related manual material on social workers in a clinical context.

2. 2152. Clinical Social Worker Services

   An overview of Medicare policy for clinical social worker services, including coverage and payment framework.

3. A. Clinical Social Worker Defined

   Discussion of the professional qualifications and licensure or supervised practice requirements associated with this provider type.

4. B. Clinical Social Worker Services Defined

   A summary of the general category of services addressed by the policy and the context in which they are considered.

5. C. Covered Services

   General coverage considerations for services performed within the applicable scope of practice and Medicare framework.

6. D. Noncovered Services

   General situations in which services are not covered under the policy.

7. E. Outpatient Mental Health Services Limitation

   Discussion of the outpatient mental health payment limitation that applies to certain covered therapeutic services.