{"abstract":"This rule addresses 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. The requirements are based on 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). This rule also addresses the outpatient mental health treatment limitation as it applies to clinical psychologist and clinical social worker services. This final rule also conforms our regulations to section 104 of the Social Security Act Amendments of 1994. Section 104 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 under State law. In addition, this final rule requires that clinical psychologists and clinical social workers use appropriate diagnostic coding when submitting Medicare Part B claims.","action":"Final rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Health Care Financing Administration","name":"Health Care Finance Administration","id":559,"url":"https://www.federalregister.gov/agencies/health-care-finance-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/559","parent_id":221,"slug":"health-care-finance-administration"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/1998/04/23/98-10591.html","cfr_references":[{"chapter":null,"citation_url":null,"part":"410","title":42},{"chapter":null,"citation_url":null,"part":"417","title":42},{"chapter":null,"citation_url":null,"part":"424","title":42},{"chapter":null,"citation_url":null,"part":"482","title":42}],"citation":"63 FR 20110","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"This final rule has been classified as a major rule subject to congressional review. The effective date is June 22, 1998. If, however, at the conclusion of the congressional review process the effective date has been changed, the Health Care Financing Administration will publish a document in the Federal Register to establish the actual effective date or to issue a notice of termination of the final rule action.","disposition_notes":null,"docket_ids":["HCFA-3706-F"],"dockets":[],"document_number":"98-10591","effective_on":"1998-06-22","end_page":20131,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":null,"html_url":"https://www.federalregister.gov/documents/1998/04/23/98-10591/medicare-program-scope-of-medicare-benefits-and-application-of-the-outpatient-mental-health","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/98-10591?publication_date=1998-04-23","mods_url":"https://www.govinfo.gov/metadata/granule/FR-1998-04-23/98-10591/mods.xml","not_received_for_publication":null,"page_length":22,"page_views":{"count":270,"last_updated":"2026-07-26 04:15:02 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-1998-04-23/pdf/98-10591.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":null,"publication_date":"1998-04-23","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/1998/04/23/98-10591.txt","regulation_id_number_info":{"0938-AE99":{"issue":"199810","html_url":"https://www.federalregister.gov/regulations/0938-AE99/medicare-coverage-of-and-application-of-the-outpatient-mental-health-treatment-limitation-to-clinica","title":"Medicare Coverage of, and Application of the Outpatient Mental Health Treatment Limitation to, Clinical Psychologist and Clinical Social Worker Services (HCFA-3706-F)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=199810&RIN=0938-AE99&operation=OPERATION_EXPORT_XML","priority_category":"Substantive, Nonsignificant"}},"regulation_id_numbers":["0938-AE99"],"regulations_dot_gov_info":{"checked_regulationsdotgov_at":"2011-09-21T03:47:25Z"},"regulations_dot_gov_url":null,"significant":false,"signing_date":null,"start_page":20110,"subtype":null,"title":"Medicare Program; Scope of Medicare Benefits and Application of the Outpatient Mental Health Treatment Limitation to Clinical Psychologist and Clinical Social Worker Services","toc_doc":null,"toc_subject":null,"topics":[],"type":"Rule","volume":63}