Here’s What You Need to Know About Using Medicare to Pay for Your Therapy and Counseling

Key Takeaways

• Medicare covers a broad range of outpatient and inpatient mental health services in 2025, including therapy and counseling. However, understanding which providers and services are eligible is crucial before seeking care.

• New policies now allow licensed marriage and family therapists (LMFTs) and mental health counselors (MHCs) to be Medicare-approved providers, expanding your access to therapy options.

Understanding Mental Health Coverage Under Medicare

Mental health is now recognized as equally important as physical health, and Medicare reflects this with robust coverage options. Whether you’re newly enrolled or reviewing your benefits, knowing what Medicare pays for when it comes to therapy and counseling is key to getting the support you need.

In 2025, Medicare offers coverage through both Original Medicare and Medicare Advantage plans, though there are some distinctions in how services are accessed. Coverage includes outpatient therapy, inpatient psychiatric hospitalization, preventive screenings, and medication management.

Who Can Provide Therapy Under Medicare?

To receive reimbursement from Medicare, mental health services must be provided by professionals who are approved under Medicare law. As of 2025, this includes:

• Psychiatrists

• Clinical psychologists

• Clinical social workers

• Licensed clinical professional counselors (LCPCs)

• Licensed marriage and family therapists (LMFTs)

• Nurse practitioners and physician assistants with mental health training

You must ensure your provider accepts Medicare assignment. If they don’t, you may pay more out-of-pocket or need to find another professional.

What Medicare Part B Covers for Mental Health

Medicare Part B covers most outpatient mental health services. These are the core components of your therapy coverage:

Individual and Group Therapy

You can attend individual or group therapy sessions with a Medicare-approved provider. These sessions typically involve cognitive behavioral therapy, talk therapy, or other evidence-based modalities.

Psychiatric Evaluations and Diagnoses

Initial and follow-up assessments are covered, allowing your provider to diagnose conditions such as depression, anxiety, bipolar disorder, and more.

Medication Management

If you need prescriptions for mental health conditions, Medicare Part B will cover visits to providers who evaluate and manage your medications, often a psychiatrist or a primary care provider with mental health training.

Telehealth Therapy

Medicare permanently covers telehealth therapy services via video and audio-only devices for mental health, especially for beneficiaries in rural or underserved areas. A new rule in 2025 requires at least one in-person visit every 12 months for continued telehealth coverage, with some exceptions.

Preventive Screenings

Medicare covers annual depression screenings in primary care settings. These are usually done during a wellness visit and must be provided by qualified personnel in a clinical environment.

What Medicare Part A Covers for Mental Health

Part A typically covers inpatient services and psychiatric hospital stays. If your condition requires 24-hour supervision, you may be admitted to a general hospital or a psychiatric hospital.

Hospitalization Costs

Medicare Part A pays for:

• Up to 90 days per benefit period in a general hospital

• Up to 190 lifetime days in a psychiatric hospital

• A 60-day lifetime reserve after regular hospital days are used

Skilled Nursing and Rehab

If your mental health condition also affects your ability to perform daily activities, Medicare may cover post-acute care in a skilled nursing facility under certain conditions.

What’s Not Covered Under Medicare

Medicare offers robust coverage but still has limitations. In 2025, you should be aware that the following are not generally covered:

• Services from providers who are not Medicare-approved

• Counseling provided by clergy or spiritual advisors

• Life coaching, wellness programs, or unlicensed counseling

• Alternative therapies such as acupuncture for mental health

Additionally, Medicare typically does not cover 24/7 custodial care or assisted living for mental health reasons unless medically necessary.

Your Costs for Therapy Under Medicare

You are responsible for some out-of-pocket expenses even if the service is covered. Here’s how costs typically break down in 2025:

• Part B Deductible: $257 annually

• Coinsurance: After meeting your deductible, you pay 20% of the Medicare-approved amount for outpatient therapy

• Excess Charges: Some non-participating providers may charge up to 15% more, though this is rare with mental health professionals

If you’re hospitalized for psychiatric care:

• Part A Deductible: $1,676 per benefit period

• Coinsurance for Days 61–90: $419 per day

• Coinsurance for Lifetime Reserve Days: $838 per day

Medicare Advantage plans must provide the same core mental health services, but costs and provider networks may vary. You should review your plan’s summary of benefits to understand copays and network restrictions.

Expanding Access Through New Providers in 2025

Starting January 1, 2024, and continuing into 2025, Medicare now allows LMFTs and MHCs to bill for services. This expands access to care, especially in communities where psychiatrists and psychologists are in short supply.

This change is particularly significant for beneficiaries who prefer therapy from a counselor who specializes in relationship issues, grief, or trauma—all areas where LMFTs and MHCs excel.

Coordination with Part D for Mental Health Medications

While Part B covers medication management appointments, your actual prescription drugs are covered under Medicare Part D. In 2025:

• The maximum deductible for Part D plans is $590

• There is a $2,000 annual cap on out-of-pocket spending for prescriptions

If you take antidepressants, antipsychotics, or mood stabilizers, ensure your chosen Part D plan includes your medications on its formulary.

How to Start Therapy with Medicare

If you’re considering therapy, here’s a step-by-step approach:

1. Speak with Your Primary Care Provider: Ask for a mental health evaluation or a referral to a Medicare-approved therapist.

2. Find a Qualified Provider: Use Medicare’s online provider search tool or ask your primary care provider for referrals.

3. Verify Coverage: Confirm that your selected therapist accepts Medicare and is currently billing for covered services.

4. Schedule Your Appointment: You may be eligible for weekly, biweekly, or monthly sessions depending on your needs and the provider’s availability.

5. Track Your Costs: Review your Medicare Summary Notices or EOBs to ensure billing accuracy.

Tips to Make the Most of Your Medicare Mental Health Benefits

• Use Preventive Screenings: Annual depression screenings can help identify early symptoms before they worsen.

• Ask About Telehealth: Remote sessions can be a convenient way to access care, especially for mobility-challenged individuals.

• Know the Limits: Be aware of the 190-day lifetime limit in psychiatric hospitals.

• Explore Additional Resources: Some local organizations offer group therapy or community mental health programs that coordinate with Medicare.

Why Early Action Matters for Your Mental Health

The sooner you begin the process of addressing mental health concerns, the better your long-term outcomes. Medicare provides a structure that supports early intervention through preventive screenings and ongoing therapy. Delaying care not only worsens symptoms but can also increase costs if hospitalization becomes necessary.

You don’t need to wait for a crisis to access therapy. You can proactively schedule appointments, manage medications, and use telehealth services to build a consistent routine that supports your emotional and psychological well-being.

Therapy Is Covered, But Finding the Right Path Takes Support

You have a wide range of therapy and counseling services available under Medicare in 2025. The key is knowing where to begin, which providers are eligible, and what steps to take to avoid unnecessary costs. With the addition of new provider types like LMFTs and MHCs, your access to qualified help is broader than ever.

If you’re unsure which steps to take or how to begin using your Medicare mental health benefits, speak with a licensed agent listed on this website. They can help you understand plan options, find eligible providers, and review potential costs.