Key Takeaways
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Medicare continues to cover teletherapy in 2025, but new in-person requirements return starting October 1, 2025.
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To maintain coverage for mental health telehealth services, you may need to schedule an in-person appointment at least once a year, depending on your provider type and situation.
What Teletherapy Means Under Medicare in 2025
Teletherapy refers to mental health services delivered via secure video or audio platforms. Since the COVID-19 Public Health Emergency, Medicare has allowed beneficiaries to access therapy from the comfort of home, even using smartphones or landlines when necessary.
In 2025, Medicare still covers:
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Individual and group psychotherapy
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Psychiatric diagnostic evaluations
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Medication management
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Partial Hospitalization Program (PHP) services
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Intensive Outpatient Program (IOP) services
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Care provided by clinical psychologists, psychiatrists, clinical social workers, mental health counselors, and marriage and family therapists
The current rules allow these services to be delivered by telehealth, including to your home, without geographic restrictions.
What Changes Starting October 1, 2025
Beginning October 1, 2025, Medicare brings back the in-person visit requirement for certain mental health telehealth services. This requirement had been suspended during and after the COVID-19 emergency to expand access to care.
Here is what you need to know:
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You must see your mental health provider in person once every 12 months to keep receiving teletherapy services at home.
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This applies only to certain provider types, such as clinical psychologists, clinical social workers, and other non-physician mental health professionals.
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The requirement does not apply if you are part of an opioid treatment program (OTP) or receiving services through a qualified Rural Health Clinic (RHC) or Federally Qualified Health Center (FQHC).
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You may be exempt if your provider documents that in-person visits would cause undue hardship or are clinically inappropriate. Your medical record must reflect this.
What Stays the Same in 2025
Even with the return of the in-person requirement, several teletherapy features remain unchanged for now:
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Location flexibility: You can still receive mental health telehealth services from your home or any other private location.
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No rural limitation: Previously, telehealth coverage was limited to rural areas, but that restriction is now permanently removed for mental health services.
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Eligible providers: Medicare now covers services from mental health counselors and marriage and family therapists (MFTs) as of January 1, 2024. This continues in 2025.
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Audio-only access: If video is not possible, audio-only visits may still be allowed for mental health services, provided the provider has a documented justification.
Who Needs an In-Person Visit?
The in-person visit requirement mainly affects those receiving ongoing treatment for mental health conditions through outpatient services. This includes:
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Talk therapy (individual, group, or family sessions)
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Medication follow-ups and adjustments
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Behavioral assessments
You will not need an in-person visit to:
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Use crisis hotlines
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Receive care through inpatient psychiatric facilities
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Engage in emergency consultations
To comply with the rule, you need to:
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Schedule at least one face-to-face appointment every 12 months with your mental health provider.
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Make sure your provider documents the visit in your record.
Failure to do so could result in Medicare no longer covering your telehealth sessions.
What if You Miss Your Annual In-Person Appointment?
Missing the in-person visit could lead to the denial of Medicare payment for future telehealth services. If this happens, you may be responsible for the full cost of care, unless your provider:
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Agrees not to charge you
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Helps you reschedule and backdate the required visit under certain conditions
To avoid surprises:
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Add your next required in-person visit to your calendar immediately after each session.
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Ask your provider’s office to send reminders.
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Use a Medicare-assigned provider who is familiar with the latest rules.
What About Marriage and Family Therapists and Mental Health Counselors?
Starting in 2024, Medicare began covering services from licensed marriage and family therapists (LMFTs) and mental health counselors (MHCs). This change expanded the pool of professionals you can choose from.
If your therapist is an LMFT or MHC, the in-person visit rule still applies in 2025. However, as with other providers, exceptions can be made for hardship or clinical appropriateness.
These providers can offer:
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Psychotherapy via telehealth
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Behavioral assessments
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Family or couples counseling
Always confirm that your LMFT or MHC is Medicare-approved and understands the annual visit rule.
Costs You Should Expect in 2025
Medicare Part B generally covers 80% of the approved amount for outpatient mental health services after you meet your annual deductible, which is $257 in 2025. You are responsible for the remaining 20% coinsurance unless you have supplemental coverage that helps with those costs.
Teletherapy visits follow the same cost structure as in-person visits. That means:
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No extra fee for choosing telehealth over in-office sessions
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Audio-only sessions have the same coinsurance requirements
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Supplemental coverage like Medigap or employer coverage may reduce your out-of-pocket expenses
Special Circumstances and Exemptions
You might qualify for an exemption from the in-person requirement if:
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You live in a long-term care facility or residential treatment center
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You have limited mobility or transportation barriers
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Your provider determines that travel would harm your mental or physical health
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You receive care through a certified RHC or FQHC
These exemptions must be documented. Ask your provider in advance if you qualify and make sure the documentation is placed in your medical file.
How to Prepare for the Upcoming Change
It’s important to act before October 1, 2025, to ensure you remain eligible for Medicare-covered teletherapy. Here’s how:
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Schedule an in-person appointment by September 30, 2025, if you haven’t had one in the previous 12 months.
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Confirm your provider’s status with Medicare and whether they are tracking your compliance.
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Ask about exemption eligibility during your next visit if in-person access is a challenge.
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Get everything in writing if your provider claims you are exempt.
This proactive approach will help you avoid unexpected costs or disruption in care.
Medicare Advantage and Teletherapy Rules
If you are enrolled in a Medicare Advantage plan, your coverage for teletherapy must include the same basic benefits as Original Medicare. However, plans may impose:
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Different provider networks
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Referral requirements
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Prior authorization for certain services
Plans may offer additional telehealth benefits beyond what Original Medicare covers, but the in-person visit rule still applies unless the plan has an exception process in place.
You should:
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Check your plan’s Evidence of Coverage (EOC)
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Contact your plan directly to confirm in-person requirements
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Ask if your plan offers support or transportation for in-person visits
Planning Ahead in 2025
As the October 1 deadline approaches, you should create a plan with your mental health provider. Consider the following steps:
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Discuss the new requirement during your next appointment.
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Set a date now for your annual in-person session.
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Explore transportation or telehealth-to-clinic hybrid options if mobility is an issue.
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Stay updated by reviewing your Medicare Summary Notice (MSN) and plan updates.
Staying Compliant to Keep Access Open
Teletherapy offers flexibility, privacy, and continuity of care. With the return of the in-person requirement in late 2025, Medicare beneficiaries must be diligent to stay compliant. Failure to do so could limit access to services you rely on.
If you’re unsure about the new policy or how it applies to your situation, reach out to a licensed agent listed on this website. They can help clarify requirements, find participating providers, and guide you through coverage options.
