On Dec. 29, 2022, President Biden signed the omnibus appropriations bill to keep the government funded. Among the many sections and provisions of the omnibus package was the content of the Mental Health Access Improvement Act. The inclusion of this language accomplishes what NBCC and the Medicare Mental Health Workforce Coalition have been working toward for years: eligibility for counselors for direct billing in Medicare.

“This is a tremendous victory for the counseling profession,” says NBCC President and CEO Kylie Dotson-Blake. “After many years of advocacy, the counselors who reached out to Congress to say, ‘We are here to serve!’ have been heard. This historic act will ensure that services provided by counselors will finally be covered under the nation’s biggest insurer. Counselors propelled this advancement of the profession through your advocacy and engagement, and we celebrate this win together!”

Joel Miller, government and legislative affairs consultant for NBCC, further illuminated the long-term, sustained engagement of counselors in advocacy efforts, noting that NBCC and certified counselors have been engaged in this advocacy for more than two decades. “Medicare coverage of counselors represents a major milestone for the profession in a long journey for provider recognition in the program. Your steadfast advocacy efforts won the day! And the real beneficiaries of this momentous advocacy and legislative outcome will be older Americans who will now have improved access to critically needed mental health care services that counselors can provide.”

The law recognizes mental health counselors as covered Medicare providers. Medicare is the largest health care program in the country, covering more than 55 million people. Medicare currently recognizes psychiatrists, psychologists, clinical social workers, and psychiatric nurses for outpatient mental health services. Now counselors will be added to the list.

Medicare is the country’s flagship health care program, and counselor inclusion is key to ensuring parity with other professions. The legislation places counselors alongside other professions as equal providers in the eyes of not only Medicare and other public insurance program officials, but also potentially with private health plans and insurers who look to Medicare as an innovator in the mental health delivery and payment space.

As we move into implementation of this legislation, the NBCC Government and Legislative Affairs team will engage in meetings with representatives of the Centers for Medicare & Medicaid Services (CMS) to review the steps that counselors will need to follow to apply for Medicare provider status. CMS will develop specific rules on how counselors can apply for provider status and receive a Provider ID number to bill for services. NBCC will advocate for the inclusion of counselors on committees developed by CMS as part of the implementation process. The rules will be developed in 2023 so they are ready by Jan. 1, 2024.

“The magnitude of this professional accomplishment cannot be overstated,” says Jolie Long, NBCC legislative manager. “The first stand-alone bill adding counselors to Medicare was introduced back in 2001, and since that time the NBCC Government Affairs team has worked tirelessly to make sure it was considered in at least one chamber of Congress in every subsequent session. Thank you for sticking with us and answering the numerous ‘Calls to Action.’ In the end, they are what propelled this over the finish line.”  

The consistent advocacy efforts of counselors and strong messaging throughout 2022 were instrumental in the passage of the Mental Health Access Improvement Act as part of the omnibus legislation. Congressional sponsors and supporters of our bill have expressed their gratitude for our advocacy efforts. We could not have achieved such a momentous outcome for the profession without counselors’ steadfast efforts.

Although there is still work to be done, the signing of this law represents a great step forward for counselors, one over two decades in the making. We hope you join us in celebrating this legislative victory for the counseling profession.