Medicare Program Integrity Manual (Pub. 100-08), Ch. 10 § 10.2.3.7
Clinical Social Workers
10.2.3.7 – Clinical Social Workers
(Rev. 10800; Issued: 05-20-21; Effective: 06-22-21; Implementation: 06-22-21)
Federal regulations at 42 CFR § 410.73(a) define a clinical social worker as an individual
who:
1. Possesses a master's or doctor's degree in social work;
2. After obtaining the degree, has performed at least 2 years of supervised clinical social
work; and
3. Either is licensed or certified as a clinical social worker by the state in which the
services are performed or, in the case of an individual in a state that does not provide
for licensure or certification as a clinical social worker—
a. Is licensed or certified at the highest level of practice provided by the laws of the
state in which the services are performed; and
b. Has completed at least 2 years or 3,000 hours of post master's degree supervised
clinical social work practice under the supervision of a master's degree level social
worker in an appropriate setting, such as a hospital, skilled nursing facility (SNF),
or clinic.
For more information on clinical social workers, refer to Pub. 100-02, chapter 15, section
170.