S. 2612

119th CONGRESS 1st Session

To amend title XVIII of the Social Security Act to include physical therapists and occupational therapists as health professionals for purposes of the annual wellness visit under the Medicare program, and for other purposes.

IN THE SENATE OF THE UNITED STATES · July 31, 2025 · Sponsor: Mr. Justice · Committee: Committee on Finance

Table of contents

• S. 2612
  • SEC. 1. Short title
  • SEC. 2. Physical therapy and occupational therapy benefit in the Medicare annual wellness visit and initial preventive physical exam
  • SEC. 3. Reports to Congress

SEC. 1. Short title

• This Act may be cited as the or the .

SEC. 2. Physical therapy and occupational therapy benefit in the Medicare annual wellness visit and initial preventive physical exam

• (a) Annual wellness visit
  • (1) In general
    • Section 1861(hhh) of the Social Security Act () is amended— 42 U.S.C. 1395x(hhh)
      • in paragraph (1)—
        • (i) in subparagraph (A), by striking and inserting a semicolon;
        • (ii) in subparagraph (B)(ii), by striking the period at the end and inserting ; and; and
        • (iii) by adding at the end the following new subparagraph:
          • that, in the case of an individual who has been determined by a physician to have fallen in the previous calendar year, includes a falls risk assessment and fall prevention services.
      • in paragraph (3)—
        • (i) in subparagraph (B), by striking or at the end;
        • (ii) in subparagraph (C), by striking the period at the end and inserting ; and
        • (iii) by adding at the end the following new subparagraph:
          • in the case of an individual described in paragraph (1)(C), a physical therapist or an occupational therapist furnishing a separate falls risk assessment and fall prevention services.
  • (2) Effective date
    • The amendment made by paragraph (1) shall apply to annual wellness visits furnished on or after January 1, 2026.
• (b) Initial preventive physical examination
  • (1) In general
    • Section 1861(ww)(2) of the Social Security Act () is amended— 42 U.S.C. 1395x(ww)(2)
      • in subparagraph (N), by moving the margins of such subparagraph 2 ems to the left;
      • by redesignating subparagraph (O) as subparagraph (P); and
        • In the case of an individual that has been determined by a physician to have experienced a fall in the previous calendar year, outpatient occupational therapy services (as defined in subsection (g)) and outpatient physical therapy services (as defined in subsection (p)).
      • by inserting after subparagraph (N) the following new subparagraph:
  • (2) Effective date
    • The amendment made by paragraph (1) shall apply to initial preventive physical examinations furnished on or after January 1, 2026.

SEC. 3. Reports to Congress

• Beginning January 1, 2027, and annually thereafter, the Secretary of Health and Human Services shall submit to Congress a report on the number of falls (as reported by the Centers for Disease Control and Prevention) experienced by individuals aged 65 and older that received treatment for pain or injury related to a fall or falls experienced in the previous calendar year. With respect to each subsequent report, such Secretary shall include the data reported in previous years and describe any changes from year to year.