clinical social work association

CSWA President Susanna Ward, CSWA Deputy Director of Policy and Practice Margot Aronson, and I met with Sean Cavanaugh, the Director of Medicare, and 7 Deputy Directors last week (four by webcam from Baltimore) about the disparity between Medicare reimbursement for LCSWs providing psychotherapy services. Medicare currently will reimburse clinical social workers only 75% of the amount psychiatrists and psychologists receive for psychotherapy codes.

President Ward, Margot, and I were pleased to find that Dir. Cavanagh and others at the meeting were well-versed in the clinical work we do and appreciative of the documentation and explanatory materials we presented, i.e., the CSWA 4-point description of clinical social work; the list of numbers of LCSWs by state; and the Medicare Position Paper (all available on the CSWA website).

Dir. Cavanaugh explained that neither he nor anyone on his staff could express a stance without first having a go-ahead from the Office of the President. He then generously offered to put us in touch with the relevant White House Office staff to whom we could make our case urging that resources be found to add needed funding to the President's budget next year to fund the request. Additionally we have introductions to staff from the Departments of Management and Budget and Health and Human Services Planning and Evaluation.  We are currently following up with these contacts. 

CSWA has also been in contact with NASW and hopes to reach agreement with our sister organization about seeking full parity for Medicare reimbursement, i.e., 100% of what psychologists and psychiatrists are paid for the psychotherapy codes that LCSWs use. Currently, NASW is seeking 85% of what the other two groups are paid.

Additionally, our visit to the Hill focused on two omnibus mental health bills, one (House) which was developed last year, and one (Senate) which is about to be dropped. CSWA has concerns about how these bills approach evidence-based practice, the Medicare lifetime limit of 190 days of psychiatric hospital treatment, block grant funding, and integration of primary care and mental health treatment.

The relationships we are developing with the prime sponsors of these bills will help us influence these issues of concern. It is gratifying to see that the mental health omnibus bills now have many references to clinical social workers as psychotherapy providers due to our advocacy work earlier this year; the bill last year had only one reference to social work, as discharge planners.

CSWA will continue to keep you informed about the progress of our advocacy efforts and welcomes your thoughts.