Thinking of Starting Therapy While on Medicare? These Changes in 2025 Could Help You Start

Key Takeaways

• In 2025, Medicare now covers therapy provided by licensed marriage and family therapists (MFTs) and mental health counselors (MHCs), expanding access to outpatient care.

• Telehealth mental health services remain permanently covered under Medicare, but new in-person visit rules apply annually starting October 1, 2025.

Medicare Has Opened New Doors for Mental Health Treatment

Mental health care is now an essential part of Medicare, not just a supplementary benefit. With expanded coverage in 2025, you have more options than ever to seek the help you need, including talk therapy, medication management, psychiatric services, and now sessions with newly recognized mental health professionals.

This article explains what these 2025 changes mean for you and how to make the most of your Medicare coverage when starting therapy.

Who You Can Now See for Therapy Under Medicare

Medicare Part B already covered services from psychiatrists, clinical psychologists, and licensed clinical social workers. In 2025, Medicare added two new types of licensed professionals:

• Licensed Marriage and Family Therapists (LMFTs)

• Licensed Mental Health Counselors (LMHCs) (also known as LPCs, LPCCs, or similar based on state licensing)

These providers can now bill Medicare for outpatient mental health services. That means you don’t need to rely only on social workers or psychologists. If your therapist is licensed and enrolled in Medicare, you can see them under Part B.

Requirements for Coverage

To be eligible for coverage, the provider must:

• Be properly licensed in your state.

• Enroll in Medicare and accept Medicare assignment.

• Provide covered services, such as individual or group therapy, diagnostic evaluations, or care coordination.

What Services Medicare Covers for Mental Health in 2025

Medicare Part A and Part B cover different parts of mental health care:

Inpatient Mental Health Services (Part A)

Covered if you’re admitted to:

• A general hospital for mental health conditions.

• A psychiatric hospital (with a 190-day lifetime limit).

Costs in 2025 include:

• $1,676 deductible per benefit period.

• Daily coinsurance starting on day 61.

Outpatient Mental Health Services (Part B)

This is where most therapy happens. Covered services include:

• Individual and group therapy.

• Family counseling related to your treatment.

• Diagnostic tests.

• Medication management.

• Partial hospitalization programs (PHP).

• Intensive outpatient programs (IOP), now more widely covered.

You pay:

• Annual Part B deductible ($257 in 2025).

• 20% coinsurance for most services (after deductible).

2025 Telehealth Rules You Should Know

Telehealth remains a permanent part of Medicare mental health coverage. You can still receive therapy services through:

• Secure video conferencing.

• Audio-only calls (if appropriate and your provider allows it).

However, starting October 1, 2025, Medicare requires:

• An in-person visit with your provider every 12 months if you receive telehealth mental health care from home.

• Exceptions may apply if you have access issues or health limitations. Your provider must document this.

This change is meant to balance flexibility with continuity of care.

How to Start Therapy Through Medicare in 2025

If you’re ready to seek mental health support, here’s how you can get started:

1. Confirm Your Medicare Coverage

Make sure you are enrolled in:

• Original Medicare (Parts A and B), or

• Medicare Advantage (Part C), which must cover at least the same mental health benefits as Original Medicare.

If you’re in a Medicare Advantage plan, check whether:

• Your plan covers your preferred therapists.

• You need a referral.

• There are network limitations.

2. Find a Medicare-Approved Therapist

Use the following resources to locate a therapist:

• Medicare.gov’s Care Compare tool.

• Ask your primary care provider for a referral.

• Contact your Medicare Advantage plan for a provider directory.

Make sure the therapist:

• Accepts Medicare.

• Is licensed and enrolled in Medicare.

• Provides the services you’re looking for (e.g., cognitive behavioral therapy, couples counseling, trauma therapy).

3. Understand What You’ll Pay

Under Original Medicare:

• After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.

• Providers who accept Medicare assignment cannot charge you more than this amount.

Medicare Advantage plans may charge:

• Copayments per visit.

• Coinsurance based on the plan’s benefit structure.

• Additional fees for out-of-network care (if applicable).

You may qualify for financial assistance through:

• Medicaid (if eligible).

• Medicare Savings Programs.

• Extra Help for prescription costs if medications are involved.

4. Book Your First Appointment

Once you’ve found a therapist who meets the requirements, you can book your session. Ask your therapist:

• If they file claims directly to Medicare.

• What their cancellation policy is.

• What types of therapy they offer and how often they recommend sessions.

When Couples Therapy Is Covered

Medicare covers family or couples therapy only if it directly supports your treatment plan. The therapy must:

• Be for your mental health condition.

• Be provided by a covered provider.

• Be documented as medically necessary.

If both you and your spouse have Medicare and mental health needs, you’ll each need your own covered diagnosis and treatment plan for individual therapy.

How Medication for Mental Health Is Covered

Medicare covers medications for mental health conditions through Part D or your Medicare Advantage plan’s drug coverage.

In 2025:

• There is a $2,000 annual cap on out-of-pocket drug costs under Part D.

• Many common antidepressants, antipsychotics, and anti-anxiety medications are included on most plan formularies.

If you’re prescribed medication by a psychiatrist or other provider, be sure to:

• Use a pharmacy in your plan’s network.

• Confirm that your medication is covered and what tier it falls under.

• Ask about generic versions to reduce costs.

Watch for These Access Issues

While Medicare has expanded mental health coverage, access to care can still be a challenge:

• Provider shortages: Many areas, especially rural regions, have limited numbers of therapists who accept Medicare.

• Waitlists: Even in urban areas, demand for therapy services is high.

• Network restrictions: If you have a Medicare Advantage plan, you may face limitations in which therapists you can see.

Tips to improve access:

• Consider telehealth to expand your provider options.

• Contact multiple therapists and ask to be placed on waitlists.

• Work with your primary care provider to find faster referrals.

Preventive Screenings Are Also Covered

Medicare also pays for annual depression screenings and alcohol misuse screenings, usually provided during primary care visits.

You pay nothing for these preventive services if:

• Your provider accepts Medicare assignment.

• The service is part of your annual wellness visit.

These screenings are a great way to begin the conversation about your mental well-being.

New in 2025: More Emphasis on Coordinated Care

Medicare is increasingly focusing on integrated behavioral health models. That means:

• Your mental health provider can coordinate with your primary care team.

• Some clinics now offer therapy, primary care, and case management in one location.

Programs like the Collaborative Care Model (CoCM) are expanding, particularly within Medicare Advantage plans. These programs help:

• Track your progress.

• Adjust medications.

• Offer additional support when needed.

Why These Changes Matter in 2025

With the inclusion of MFTs and MHCs, the mental health workforce available to Medicare enrollees has grown substantially. This change comes at a critical time when more older adults and people with disabilities are seeking mental health services.

These reforms aim to:

• Reduce wait times for therapy.

• Increase cultural and regional provider diversity.

• Encourage early intervention and ongoing support.

Medicare’s evolving structure reflects a broader shift in health policy: treating mental health with the same urgency and legitimacy as physical health.

Making the Most of Medicare’s Mental Health Benefits

Your Medicare card is more than just access to hospital and doctor visits. In 2025, it’s your pathway to mental wellness as well.

Take the time to:

• Review your benefits.

• Check your plan’s mental health providers.

• Ask questions before booking your first appointment.

• Track your mental health progress and communicate with your care team.

If you’ve been delaying therapy, now might be the best time to begin.

You Deserve to Use the Mental Health Benefits You’ve Earned

Medicare is expanding to support your full health picture, and that includes your emotional and psychological well-being. The new provider types and continued telehealth options mean fewer barriers for you to access care.

If you’re ready to take the first step into therapy, or you’re unsure how to find the right mental health provider under Medicare, now is the right time to act. Get help understanding your benefits and connect with someone who can walk you through your options.

Speak with a licensed agent listed on this website to get support tailored to your needs and your plan.