More Mental Health Professionals Are Joining Medicare, But There Are Still Gaps You Should Know About

Key Takeaways

• Starting in 2024, Medicare now covers services from licensed marriage and family therapists (LMFTs) and mental health counselors (MHCs), expanding access to care across the country.

• Despite this progress, shortages of Medicare-participating therapists, geographic disparities, and access barriers still impact the mental health care you may receive under Medicare.

Medicare’s Growing Mental Health Workforce in 2025

The landscape of mental health care under Medicare is evolving. As of January 1, 2024, Medicare began covering services provided by two new categories of professionals: licensed marriage and family therapists (LMFTs) and licensed mental health counselors (MHCs). This expansion, now fully in effect in 2025, brings long-overdue recognition to providers who are often on the front lines of community-based mental health care.

These additions are significant. LMFTs and MHCs make up a large portion of the behavioral health workforce, particularly in rural or underserved areas. Including them in Medicare opens new doors for beneficiaries who may have previously struggled to find accessible care. But even with these improvements, challenges remain. Knowing what’s covered, where to find care, and how to make the most of your Medicare benefits is key.

Who Are These New Providers?

You might be wondering what makes LMFTs and MHCs different from psychologists or psychiatrists already covered by Medicare. Here’s a brief breakdown:

• Licensed Marriage and Family Therapists (LMFTs): These professionals are trained to diagnose and treat mental and emotional disorders, with a focus on relationships, family systems, and interpersonal dynamics.

• Licensed Mental Health Counselors (MHCs): Also called licensed professional counselors (LPCs) in many states, MHCs offer therapy and counseling for anxiety, depression, trauma, grief, and more.

Both types of providers must meet specific education, licensure, and supervision requirements to qualify for Medicare reimbursement in 2025. Now that they’re included, your options for talk therapy and outpatient mental health services are broader than ever.

What Medicare Covers for Mental Health in 2025

Medicare covers mental health care through both Part A (hospital insurance) and Part B (medical insurance). Here’s what you can expect this year:

Under Medicare Part A

• Inpatient psychiatric hospital care: Covered up to 190 lifetime days in a specialty psychiatric facility. If you receive care in a general hospital’s psychiatric unit, this limit may not apply.

• Skilled nursing facility services: If mental health needs follow a hospital stay, some coverage may be available under Part A for short-term skilled care.

Under Medicare Part B

Part B is where most outpatient mental health services are covered. In 2025, these include:

• Individual or group therapy

• Psychiatric evaluations and diagnostic testing

• Medication management by a psychiatrist or other eligible provider

• Services from clinical psychologists, social workers, LMFTs, and MHCs

• Preventive screenings for depression and substance use

• Partial hospitalization programs (PHP)

• Intensive outpatient programs (IOP), where available

Once you meet your Part B deductible ($257 in 2025), Medicare pays 80% of the approved amount for outpatient mental health services. You are responsible for the remaining 20% unless you have supplemental coverage that helps with those costs.

Telehealth Services Remain Available

Medicare continues to cover mental health telehealth visits in 2025. You can receive care by video or, in some cases, audio-only appointments from the comfort of your home. This flexibility is particularly important for those in rural or mobility-limited situations.

However, there is one important update to keep in mind. Starting October 1, 2025, you must have an in-person visit with your mental health provider at least once every 12 months to remain eligible for continued telehealth coverage, with some exceptions.

Where Gaps Still Exist

While expanding Medicare’s network of mental health providers is a major step forward, it doesn’t automatically solve every problem. You should still be aware of several lingering challenges that may affect your care:

1. Shortage of Medicare-Participating Therapists

Even with LMFTs and MHCs now eligible to bill Medicare, not all of them choose to enroll. Becoming a Medicare provider involves administrative burdens and relatively lower reimbursement rates, which can discourage participation.

This means that in many areas, particularly those already struggling with workforce shortages, the number of available Medicare-accepting therapists remains limited.

2. Rural and Underserved Areas Are Still Affected

Adding more provider types doesn’t automatically place them in the regions where they’re most needed. Rural areas, for example, often face significant mental health professional shortages. If you live in one of these communities, your closest Medicare-accepting therapist may still be hours away.

3. Limited Access to Intensive Services

While outpatient therapy is widely covered, more intensive forms of treatment like partial hospitalization programs (PHP) or intensive outpatient programs (IOP) are not consistently available across the country. These services often require specific facilities and staffing levels, which may not be present in smaller healthcare systems.

4. Long Wait Times

Even in urban areas where mental health providers are more concentrated, you may still face long waitlists. Growing demand for services, especially post-pandemic, has strained mental health systems nationwide. Wait times of several weeks or even months are not uncommon, even for Medicare beneficiaries.

5. Cultural and Language Barriers

Mental health care is most effective when you feel understood. Unfortunately, there remains a shortage of Medicare-accepting therapists from diverse backgrounds or those who offer services in multiple languages. This can make it difficult for some beneficiaries to find a provider they’re comfortable with.

How You Can Improve Access for Yourself

There are steps you can take to improve your access to mental health care under Medicare, even in the face of these gaps:

• Ask about new providers: If you’ve had trouble finding a therapist in the past, now is a good time to check again. More LMFTs and MHCs are joining Medicare this year.

• Use telehealth strategically: If in-person access is a problem, consider starting with a virtual appointment. Many therapists offer remote sessions, and Medicare continues to cover them.

• Coordinate through your primary care doctor: Your primary care physician can be a powerful ally in connecting you to behavioral health services, especially if they work in an integrated care setting.

• Explore community mental health centers: These organizations often accept Medicare and may have more flexible scheduling and lower wait times.

• Use your Medicare plan directory: If you’re enrolled in a Medicare Advantage plan, use your plan’s provider finder tool to search for mental health providers in your network. For Original Medicare, Medicare.gov has a search feature as well.

Preventive Screenings You Shouldn’t Skip

Mental health care under Medicare isn’t just reactive. Several preventive screenings are included every year at no extra cost to you:

• Annual depression screening

• Alcohol misuse screening

• Opioid use disorder screening (if risk factors are present)

• Cognitive assessments during your Annual Wellness Visit

These screenings can help catch issues early, which is especially important as mental health conditions can become more complex with age or coexisting health conditions.

Medicare Advantage: What to Watch For

Medicare Advantage (Part C) plans are required to provide at least the same mental health benefits as Original Medicare. However, they may manage care differently. Be mindful of the following factors:

• Prior authorization requirements

• Provider networks (may limit who you can see)

• Referrals needed for specialists

While some Medicare Advantage plans offer added benefits like care coordination or wellness programs, make sure to review your plan’s coverage details carefully. Not all plans are equal in terms of mental health support.

A Look at 2025’s Policy Landscape

Medicare’s mental health coverage is likely to keep expanding. In 2025, several policy discussions are ongoing:

• Reimbursement reform: Lawmakers are evaluating ways to increase reimbursement rates for mental health providers under Medicare to encourage greater participation.

• Workforce development: Grants and support are being proposed to train more providers in geriatrics and Medicare-focused care.

• Digital mental health: The role of virtual care, apps, and remote monitoring in Medicare continues to grow, though oversight and access remain top concerns.

Stay informed about policy changes during the Annual Enrollment Period (October 15 to December 7) so you can choose the coverage that best matches your mental health needs.

Making Sense of the Progress and Pitfalls

The inclusion of LMFTs and MHCs in Medicare represents major progress, especially for those who have been waiting for more flexible options in talk therapy. But adding more provider types is only one part of the equation.

You still need to navigate coverage rules, provider directories, plan types, and logistical barriers to actually receive the care you deserve. Medicare is making strides, but it’s not yet a seamless system.

If you feel overwhelmed by these choices or unsure about what your plan includes, consider speaking with a licensed agent listed on this website. They can help you understand your options and guide you toward coverage that supports your mental health goals.