Medicare Added More Mental Health Providers to Help You Get the Care You Need

Key Takeaways

• Since January 1, 2024, Medicare includes licensed marriage and family therapists (LMFTs) and mental health counselors (MHCs) as covered providers under Part B, giving you more options for accessing care.

• These updates aim to close gaps in behavioral health access by expanding your Medicare-covered choices beyond psychiatrists, psychologists, and clinical social workers.

Why This Expansion Matters Right Now

Since January 1, 2024, Medicare has officially added two new categories of mental health professionals to its list of approved providers: LMFTs and MHCs. This change is a direct result of the Mental Health Access Improvement Act, and it represents a significant step forward in making behavioral health services more accessible to people like you who rely on Medicare.

Previously, you could only receive therapy services through Medicare if they were provided by certain types of practitioners, such as:

• Psychiatrists

• Clinical psychologists

• Clinical social workers

• Psychiatric nurse specialists

But that list left out a large portion of the behavioral health workforce. With LMFTs and MHCs now eligible to bill Medicare, you have more choice in selecting someone whose expertise, approach, and availability align with your personal needs.

Who Are LMFTs and MHCs?

You may not be familiar with these acronyms, so here’s a quick explanation:

• Licensed Marriage and Family Therapists (LMFTs) specialize in treating mental and emotional disorders within the context of relationships, particularly family dynamics and couples.

• Mental Health Counselors (MHCs) provide a wide range of therapeutic services for anxiety, depression, trauma, grief, and more. They are trained in talk therapy, behavioral therapy, and other evidence-based approaches.

Both provider types hold master’s-level education or higher and are licensed by the state where they practice. Until recently, you would have had to pay out of pocket to see these professionals. Medicare’s inclusion since 2024 means you can now access their services with standard Part B cost-sharing.

What This Means for Your Medicare Coverage

Outpatient Therapy Just Got Easier

If you’re enrolled in Medicare Part B, you’re now eligible to receive therapy services from LMFTs and MHCs, in addition to other mental health professionals. This broadens your choices and may reduce waiting times for appointments, especially in areas where psychiatrists and psychologists are hard to find.

Cost and Coverage Details

For covered outpatient mental health services under Part B in 2025:

• You first pay the annual Part B deductible, which is $257.

• After meeting the deductible, you pay 20% of the Medicare-approved amount for most services.

• If your therapist is part of a facility (like a hospital outpatient department), you may also have a copayment.

These standard costs apply whether you see an LMFT, MHC, or any other covered behavioral health provider under Part B.

Requirements for Providers to Bill Medicare

For an LMFT or MHC to be covered, they must:

• Be licensed to practice independently by the state

• Enroll in Medicare as a provider

• Deliver services that fall under Medicare’s covered mental health services (like individual or group therapy, assessments, and treatment planning)

Make sure to ask your provider if they’re enrolled in Medicare before you schedule a session.

What Types of Mental Health Services Are Covered

Medicare Part B covers a wide array of outpatient mental health services, many of which are now accessible through LMFTs and MHCs:

• Individual therapy (including cognitive behavioral therapy and talk therapy)

• Family or couples therapy (when medically necessary)

• Group therapy sessions

• Initial psychiatric evaluations

• Ongoing medication management (if coordinated with a physician)

• Partial hospitalization programs

• Substance use disorder counseling

You can also receive preventive depression screenings once per year at no cost, as long as your provider accepts assignment.

Telehealth Services Are Still Covered

In 2025, Medicare continues to cover mental health services provided via telehealth. That means you can have your therapy appointments from home using video (and sometimes audio-only) communication, as long as certain conditions are met:

• You must have had an in-person visit within the past 12 months with the provider or their group, starting from October 1, 2025.

• This in-person visit must repeat every 12 months to maintain eligibility, unless an exception applies.

Telehealth offers a valuable option if you live in a rural area, have mobility issues, or simply prefer to receive care from home.

Hospital-Based Mental Health Care Still Has Limits

Medicare Part A continues to cover inpatient psychiatric hospital care, but with some limits:

• You pay the Part A deductible of $1,676 per benefit period.

• You may have daily coinsurance starting from day 61 of your stay.

• You have a lifetime limit of 190 days in a Medicare-certified psychiatric facility.

However, if you are admitted to a general hospital for mental health care, the 190-day limit does not apply.

What About Medications for Mental Health?

Your prescriptions for mental health conditions are generally covered under Medicare Part D. In 2025:

• The maximum deductible under Part D is $590.

• Once your total out-of-pocket costs reach $2,000, you pay nothing further for covered drugs for the rest of the year.

• This applies across all Medicare drug plans.

Be sure to review your plan’s formulary to confirm that your mental health medications are covered. Some commonly prescribed psychiatric drugs fall under protected classes, meaning plans must include them on their formularies.

What to Watch Out for in 2025

Even with these improvements, you should be aware of potential challenges:

• Limited availability: Not all LMFTs and MHCs have enrolled in Medicare yet. If your preferred provider doesn’t participate, Medicare won’t pay for your care.

• Provider shortages: Many areas still experience a shortage of mental health professionals, especially in rural regions.

• Plan-specific rules: If you’re enrolled in a Medicare Advantage plan, you’ll need to follow that plan’s network and prior authorization rules.

Staying informed and asking questions before starting care can help avoid surprises.

When to Consider Mental Health Services

Mental health care isn’t just for crisis moments. You might consider talking to a licensed professional if you experience:

• Ongoing sadness, anxiety, or irritability

• Trouble sleeping, eating, or concentrating

• Difficulty managing grief or loss

• Relationship stress or conflict

• Loss of interest in daily activities

• Substance use that’s affecting your health

Thanks to the recent changes, you now have more covered options to explore therapy before symptoms worsen or interfere with your daily life.

How to Find a Medicare-Covered Therapist

To find a provider who accepts Medicare and offers therapy:

• Use Medicare’s Physician Compare tool to search for LMFTs, MHCs, or other mental health providers in your ZIP code.

• Call your local State Health Insurance Assistance Program (SHIP) for one-on-one help.

• Ask your primary care doctor for a referral.

• Check with your Medicare Advantage plan (if applicable) for a list of in-network mental health professionals.

If your preferred therapist isn’t listed, ask if they plan to enroll in Medicare or if they offer sliding scale options outside of Medicare.

What This Means for Your Mental Wellness in 2025

These Medicare updates have the potential to make a real difference in your access to care. With more therapists available, and the flexibility of in-person and telehealth sessions, you’re in a stronger position to manage your mental health consistently and affordably.

Remember, you don’t need a referral from a doctor to see most mental health specialists under Original Medicare. If you’ve been putting off therapy because of cost, limited availability, or confusion about coverage, this is the time that may change that.

Make Your Mental Health a Priority This Year

Medicare’s expansion to include LMFTs and MHCs is a meaningful step in closing the gap in behavioral health access. You now have a broader network of support when facing emotional or psychological challenges. Whether you’re looking to start therapy, continue treatment, or explore telehealth options, these changes open new doors.

To better understand your plan options or find a provider who fits your needs, get in touch with a licensed agent listed on this website who can walk you through your coverage and answer your questions.