Billing / Billing Codes

ffective October 1, 2024, clinical social workers were impacted by several code changes to the International Classification of Diseases, 10th Edition, Clinical Modification (ICD-10-CM). Clinical social workers should pay attention to Chapter 5, Mental, Behavioral, and Neurodevelopmental Disorders. Six new codes have been added to mental health disorders: four are for eating disorders and two are for adults. 

Effective January 1, 2025, clinical social workers may receive reimbursement for services using a digital mental health treatment (DMHT) device. The device is a software approved by the Food and Drug Administration to treat a mental health condition in conjunction with ongoing mental health treatment that includes a plan of care.

On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the 2024 Medicare Physician Fee Schedule (CMS–1784–P). The 2024 Physician Fee Schedule details services to address health equity and health-related social needs available to Medicare beneficiaries.

NASW is developing a task force for the revision of the 2013 Child Welfare Standards. NASW reviews and revises these standards to incorporate and update the best practices in the field of Child Welfare.

The National Association of Social Workers (NASW) is participating in a national survey, Clinical Practice Information (CPI), to improve reimbursement rates for clinical social workers.

The National Association of Social Workers (NASW) has received inquiries from members regarding the Qualified Medicare Beneficiary Program (QMB). It is important for clinical social workers to understand the QMB program and billing guidelines to ensure proper reimbursement for services. This document provides an overview of the QMB program and billing guidelines for clinical social workers.