Key Takeaways
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Medicare covers therapy for anxiety and depression, but only when certain requirements are met, such as using qualified providers and having a medically necessary diagnosis.
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Understanding these conditions ahead of time can help you avoid delays or denials in care and ensure consistent access to mental health services.
Mental Health Is Covered, but There Are Limits
Medicare recognizes anxiety and depression as real, treatable medical conditions. In 2025, you are eligible to receive therapy and related mental health services under Medicare. However, the coverage is not automatic or without conditions. For therapy to be covered, Medicare requires that certain rules be met, and not every provider or setting qualifies.
Both inpatient and outpatient mental health services are included in Medicare. Inpatient care is covered under Part A, while outpatient therapy falls under Part B. Some Medicare Advantage plans (Part C) may offer additional services, but even these are bound by certain Medicare standards.
Understanding which rules apply before you seek care is critical. Medicare does not pay for mental health services simply because you ask for them. Coverage depends on your diagnosis, the type of provider you see, the setting where you receive care, and how often you attend therapy.
What Counts as Therapy for Medicare?
Medicare refers to therapy as “mental health counseling” or “psychotherapy.” This can include treatment for conditions such as:
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Generalized anxiety disorder
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Major depressive disorder
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Panic disorder
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Social anxiety disorder
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Seasonal affective disorder
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Post-traumatic stress disorder (PTSD)
To be covered, therapy must be deemed medically necessary. This means that a qualified provider must diagnose you with a recognized mental health condition, and then create a care plan aimed at improving your condition.
Who Can Provide Covered Therapy Services?
One of Medicare’s strictest conditions is the type of professional delivering your care. As of 2025, Medicare will only pay for therapy if it is provided by one of the following:
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Psychiatrists
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Clinical psychologists
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Clinical social workers (CSWs)
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Nurse practitioners (NPs) or physician assistants (PAs) with mental health training
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Licensed marriage and family therapists (LMFTs)
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Licensed mental health counselors (LMHCs)
It’s important to confirm that your provider accepts Medicare and is officially enrolled. Not all mental health professionals take Medicare, and if they don’t, Medicare won’t reimburse you—even if the provider is licensed in your state.
Where You Receive Care Also Matters
Medicare only covers therapy when it is delivered in approved settings, such as:
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A Medicare-enrolled outpatient clinic
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A psychiatrist or therapist’s private office
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A hospital outpatient department
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A community mental health center (CMHC)
Telehealth services are still covered in 2025 for mental health, including from home. However, you must have an in-person visit with your provider at least once every 12 months to continue telehealth therapy. Exceptions exist for hardship or access issues, but documentation is required.
Frequency and Duration Limits You Should Know
Medicare does not set a fixed number of covered therapy sessions per year. Instead, the care must continue to be medically necessary. Your therapist or provider must document ongoing progress and justification for continued treatment.
However, Medicare may flag services if you:
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Receive therapy more than once per week on a long-term basis
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Have little to no improvement in your documented treatment plan
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Receive care from multiple mental health providers without coordination
If Medicare reviews your case and determines that continued therapy is not necessary, you may be responsible for the cost.
What You Pay for Therapy in 2025
Under Part B, after meeting the annual deductible of $257 in 2025, you are responsible for 20% of the Medicare-approved amount for therapy services.
If you are enrolled in a Medicare Advantage plan, your copayments and cost-sharing will vary, but the plan must at minimum cover what Original Medicare offers. You should review your plan materials or Annual Notice of Change to understand your cost responsibility.
Part D covers medications prescribed to treat anxiety and depression. In 2025, there is a $2,000 out-of-pocket cap for prescription drug costs, which helps manage the cost of mental health medications. You should ensure your Part D plan includes the drugs you need.
The Role of a Primary Care Provider
In many cases, therapy begins with a referral. While Medicare does not require a referral for outpatient mental health care, your primary care provider (PCP) may identify the need and recommend a specialist. Coordinated care can improve treatment outcomes and reduce duplication.
If you are enrolled in a Medicare Advantage plan, a referral may be required depending on the plan’s structure. You should check your plan’s provider rules before scheduling therapy.
Initial and Annual Mental Health Screenings
Medicare covers one free depression screening per year as part of your annual wellness visit. This screening is conducted in a primary care setting and must be performed by a qualified provider.
This benefit is meant to identify depression early, even if you haven’t reported symptoms. If the screening reveals concerns, your provider can recommend therapy, medications, or follow-up mental health care.
Medicare’s Coverage of Other Related Services
Medicare also covers other mental health services that may be related to therapy for anxiety and depression, including:
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Psychiatric diagnostic evaluations
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Medication management
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Partial hospitalization programs (PHPs)
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Intensive outpatient programs (IOPs)
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Family counseling when directly related to the treatment of a diagnosed individual
These services must also meet the medical necessity standard, be provided by approved professionals, and occur in eligible settings.
When Medicare May Not Cover Therapy
Medicare can deny coverage if:
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The provider is not enrolled in Medicare
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The condition does not meet the definition of a diagnosable mental illness
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Services are considered “maintenance therapy” with no expected improvement
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Documentation is missing or incomplete
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The setting is not Medicare-approved
If your therapy is denied, you can file an appeal. Start by reviewing your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) to understand the denial reason.
Steps You Can Take Now to Use Your Benefits Wisely
If you’re considering therapy for anxiety or depression, here’s what you should do to ensure your Medicare benefits apply:
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Confirm your provider is enrolled in Medicare and accepts assignment
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Ask your provider to document your diagnosis and treatment plan
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Keep track of your progress and session summaries
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Use your Annual Wellness Visit for screening opportunities
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If you use telehealth, be sure to schedule your in-person visit within the required 12-month period
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Review your Part D formulary to make sure your medications are covered
Staying informed will help you avoid unnecessary costs and maintain access to the mental health care you need.
Staying Informed About Changes in Medicare Mental Health Rules
Medicare’s mental health policies continue to evolve. The inclusion of licensed mental health counselors and marriage and family therapists in 2024 expanded access. But coverage rules, provider directories, and billing practices may still cause confusion.
In 2025, the telehealth policy allowing mental health services from home remains in effect, with the required in-person check-in now applying annually starting October 1, 2025.
Knowing these details before you schedule care can help avoid interruptions. If your needs change, speak with a provider who understands Medicare documentation requirements.
Therapy Access Is Possible, If You Know the Rules
Medicare’s mental health coverage gives you access to valuable therapy for anxiety and depression. But this access comes with conditions: qualified providers, approved locations, proper documentation, and adherence to care plans.
If you’re uncertain about whether your current or potential therapy is covered, it’s a good time to ask questions. Clarity today can prevent stress later.
To understand your specific options or help with finding a provider, reach out to a licensed agent listed on this website. They can help you understand your Medicare benefits and ensure your therapy is properly supported.
