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HR 4037119th CongressIn Committee
Occupational Therapy Mental Health Parity Act.
Introduced: Jun 17, 2025
Healthcare
Standard Summary
Comprehensive overview in 1-2 paragraphs
This bill, titled the Occupational Therapy Mental Health Parity Act, would clarify how occupational therapy (OT) is covered under Medicare when used to treat substance use disorders or mental health conditions. Specifically, it requires the Secretary of Health and Human Services to provide education and outreach to stakeholders within one year of enactment, focused on the Medicare Benefit Policy Manual and how OT services should be billed (via HCPCS codes) for these diagnoses. The intent appears to be improving clarity and promoting parity in coverage for OT in mental health and substance use care, though the bill does not by itself expand benefits or funding.
Key Points
- 1Short title: Occupational Therapy Mental Health Parity Act.
- 2Purpose: To clarify Medicare coverage of occupational therapy, with a focus on mental health and substance use disorder treatment.
- 3Action required: The Secretary of Health and Human Services must conduct education and outreach to stakeholders.
- 4Timeline: Education and outreach must occur not later than one year after enactment.
- 5Mechanism: Education/outreach centered on the Medicare Benefit Policy Manual and the use of applicable HCPCS codes for OT services.
Impact Areas
Primary group/area affected: Medicare beneficiaries receiving occupational therapy for mental health or substance use disorder diagnoses; occupational therapists and other providers delivering OT services under Medicare.Secondary group/area affected: Medicare program policymakers, healthcare facilities, billing staff, and professional associations involved in OT and mental health care.Additional impacts: May reduce ambiguity around billing and coverage, potentially improving access to OT services for these conditions; could influence provider coding practices and stakeholder understanding of Medicare rules; no explicit new funding or benefit expansion is created by the bill.
Generated by gpt-5-nano on Oct 7, 2025