Key Takeaways
-
In 2025, Medicare now covers a broader range of mental health professionals, including marriage and family therapists (MFTs) and mental health counselors (MHCs).
-
Despite the expanded coverage, barriers such as provider shortages, reimbursement challenges, and low participation rates may still make it difficult to access therapy.
A Quiet Expansion That Could Matter More Than You Think
Medicare’s inclusion of more mental health providers in 2025 marks a significant shift. For the first time, Medicare beneficiaries can receive care from marriage and family therapists (MFTs) and mental health counselors (MHCs), alongside clinical psychologists and licensed clinical social workers. This long-awaited change reflects growing recognition of mental health’s importance, especially among older adults.
However, the expansion does not automatically guarantee you access to therapy. Whether you can actually schedule and receive treatment depends on several real-world factors that go beyond the rulebook.
Who’s Newly Covered in 2025?
Since January 1, 2024, Medicare added two major groups of mental health providers:
-
Marriage and Family Therapists (MFTs): Trained to address mental and emotional disorders within the context of family systems.
-
Mental Health Counselors (MHCs): Often hold master’s-level credentials and are licensed to treat a range of psychological issues.
This means more providers are now eligible to bill Medicare for outpatient mental health services. These professionals can offer psychotherapy, diagnosis, care planning, and even coordinate services with primary care providers.
You’re now entitled to receive care from these therapists under Part B. But finding one who accepts Medicare—and is available—may not be as simple as it sounds.
The Bigger Picture: Mental Health in Medicare
Mental health care under Medicare continues to evolve. As of 2025:
-
Psychiatrists, psychologists, and social workers remain covered.
-
Outpatient therapy sessions are covered under Medicare Part B, typically with 20% coinsurance after the Part B deductible ($257 in 2025).
-
Telehealth access continues to be available for mental health visits, especially for rural and underserved communities.
-
Partial hospitalization programs (PHPs) and inpatient psychiatric care remain available under specific guidelines.
Even with expanded coverage, the demand for services far outpaces supply in many regions.
What Might Stand Between You and a Therapist?
Several practical challenges could affect your ability to see a therapist through Medicare in 2025:
1. Limited Provider Participation
Many mental health counselors and therapists still do not enroll in Medicare. Reasons include:
-
Administrative burdens and credentialing complexity.
-
Historically low reimbursement rates.
-
Lack of awareness that they can now enroll.
Even though coverage is expanded, finding a therapist who is both qualified and Medicare-enrolled requires time and effort.
2. Shortage of Mental Health Professionals
There is a well-documented shortage of mental health professionals nationwide. The U.S. faces an aging population and increasing mental health needs. Older adults in particular often require specialized care for issues such as grief, chronic illness, anxiety, depression, and cognitive decline.
Many regions—especially rural and lower-income areas—face severe provider shortages. In these zones, even private-pay therapists are difficult to find.
3. Long Wait Times for Appointments
Even when a therapist is available and takes Medicare, getting an appointment could take weeks or months. High demand and low availability result in:
-
Limited session openings.
-
Therapists with long waitlists.
-
Preference for ongoing clients over new ones.
This may be especially frustrating for new Medicare enrollees seeking care after a recent diagnosis or crisis.
4. Telehealth Isn’t a Universal Solution
While telehealth has improved access in many cases, it’s not a one-size-fits-all answer. Some older adults may:
-
Lack access to stable internet or technology.
-
Be uncomfortable with video-based communication.
-
Prefer in-person interaction for sensitive discussions.
In these cases, expanded telehealth options under Medicare may still fall short of providing usable care.
What Does Medicare Actually Cover?
In 2025, your Medicare Part B plan covers the following mental health services:
-
Diagnostic evaluations
-
Individual and group psychotherapy
-
Family counseling when directly related to your care
-
Medication management (typically under Part D or Part B if administered in a medical setting)
-
Testing to assess cognitive status
-
Outpatient programs and psychiatric day treatment
The Part B deductible in 2025 is $257, after which you typically pay 20% of the Medicare-approved amount. Supplement plans (Medigap) may help cover these costs, if you have one.
Medicare Advantage plans must provide at least the same coverage, although costs and access can vary by plan and provider network.
How to Improve Your Chances of Getting Therapy
If you want to take advantage of this expanded coverage, you’ll need to be proactive. Here’s how:
1. Search the Medicare Provider Directory
Use the official Medicare website to look up therapists in your ZIP code. Filter by specialty to include the new therapist types.
2. Call Providers Directly
Even if a provider appears in the directory, call to confirm they are accepting new Medicare patients.
3. Ask Your Primary Care Doctor for Referrals
Doctors within the Medicare system may know local mental health professionals who accept Medicare and are open to referrals.
4. Don’t Wait Until a Crisis
Start your search before you urgently need care. Building a relationship with a therapist early makes future help more accessible.
5. Consider Federally Qualified Health Centers
These centers often offer behavioral health services and accept Medicare. Availability may be better in underserved areas.
What Therapists Are Saying About the Change
Therapists across the country have mixed feelings about the expansion. While many applaud the policy shift, some remain cautious:
-
Positive views: Recognition of their qualifications and expanded access to vulnerable populations.
-
Concerns: Burdensome billing processes, unclear enrollment guidelines, and inadequate training in navigating Medicare rules.
Advocacy groups are encouraging CMS to streamline onboarding and offer technical assistance to therapists who want to join the program.
The Policy Timeline That Led to 2025
The path to expanding therapist eligibility under Medicare has taken years. Here’s a brief timeline:
-
Before 2024: Only psychiatrists, psychologists, clinical social workers, and select nurses were eligible.
-
January 1, 2024: Medicare began allowing MFTs and MHCs to bill for services.
-
2025: Full implementation continues, with a greater focus on outreach, education, and access.
These changes are part of broader efforts to close gaps in mental health care and support aging populations.
The Outlook for Mental Health Access in Medicare
Adding more providers is only part of the solution. Improving access also means addressing:
-
Enrollment incentives for therapists.
-
Awareness campaigns to inform beneficiaries.
-
Improved provider directories and search tools.
-
Continued support for telehealth and mobile services.
If these efforts succeed, the mental health landscape for Medicare beneficiaries could look very different by the end of this decade.
Getting the Support You Deserve
Mental health care is essential—and Medicare is finally treating it that way. But whether you can benefit from these changes depends on your ability to find a provider, make an appointment, and navigate the system.
If you’re unsure how to proceed, or if you want help evaluating your plan’s mental health benefits, speak with a licensed agent listed on this website. They can walk you through your options and help you make the most of what’s now available under Medicare.
