ADAPT Act Expands Medicare Coverage for Mental Health Services Provided by Psychology Trainees Starting Next Year

The new Accelerating the Development of Advanced Psychology Trainees Act (ADAPT Act) is looking to tackle the mental health provider shortage by changing who can bill Medicare for psychological services. Essentially, this bill opens the door for advanced psychology trainees—the folks deep into their doctoral or post-doctoral training—to get paid through Medicare for the services they provide under supervision.

Who Gets to Bill Now?

This isn't just for anyone in school. The bill specifically defines two groups who qualify under Section 2:

1. Doctoral Interns: These are psychology students completing a required, year-long supervised training period as part of an American Psychological Association (APA) accredited program before they get their Ph.D. or Psy.D.
2. Postdoctoral Residents: These are people who already have their doctorate but are finishing up the one or two years of supervised training required for full state licensure, also through an APA-accredited program or an equivalent recognized group.

Why does this matter? If you or a family member relies on Medicare for mental healthcare, this change means a potential increase in available providers. For the trainees themselves, it means they can gain crucial, billable experience while accelerating their path to becoming fully licensed providers, which is a win for the entire mental health workforce.

The 'General Supervision' Catch

One key detail in Section 2 is the supervision requirement. Services provided by these trainees must be under "general supervision." This is where the policy meets the real world. Unlike "direct supervision," where the licensed professional has to be in the room, general supervision means the supervising clinical psychologist only needs to be in overall control and direction of the work. They don't have to be physically present.

On the one hand, this flexibility is what makes it possible for trainees to work in settings like rural clinics or community centers where the supervising psychologist might be juggling a full caseload across multiple locations. On the other hand, for patients, this means the person signing off on the bill isn't necessarily the person who was physically there when the service was provided. While this is common practice in many medical training environments, it’s a detail worth noting, especially for those who prefer their care team to be immediately on-site.

Clearing the Path for Medicaid and CHIP

Beyond Medicare, Section 3 addresses the other massive public health programs: Medicaid and CHIP. The bill requires the Secretary of Health and Human Services (HHS) to issue clear instructions to all states within one year of the law passing. This guidance is designed to show states how they can remove regulatory roadblocks that currently stop them from covering services provided by these same advanced psychology trainees.

This is a big deal for low-income families and children who rely on Medicaid/CHIP. If states follow the guidance, it could significantly increase access to psychological care, particularly in areas struggling with severe provider shortages. The guidance will include legal ways to pay for services, recommended billing codes, and examples of states that have already successfully used waivers to pull this off. This move aims to standardize and simplify the process, making it easier for states to integrate trainees into their existing mental health infrastructure.

Both the Medicare coverage and the Medicaid/CHIP guidance are set to kick in within one year of the bill becoming law, giving Medicare time to create the necessary billing code (the "GC modifier code") and giving states the technical assistance they need to expand their coverage.