Yes, Medicare covers mental health treatment, but the coverage depends on the type of care and whether you have Original Medicare or a Medicare Advantage plan

Medicare Part B covers outpatient mental health services including therapy, counseling, and psychiatric visits. You pay 20% of the cost after you meet your annual deductible, and Medicare pays 80%. If you have a Medicare Advantage plan (Part C), your mental health coverage works differently — you'll have a copay or coinsurance amount set by your plan, which may be lower or higher than Original Medicare's 20%.

Inpatient mental health care — staying in a hospital or psychiatric facility — is covered under Medicare Part A if you're admitted as an inpatient. You pay a hospital deductible for the first 60 days, then coinsurance after that. The key word is "inpatient": you must be formally admitted to the hospital, not just visiting an emergency room or outpatient clinic.

Key Takeaways

  • Medicare Part B covers outpatient mental health visits with psychiatrists, psychologists, clinical social workers, and counselors at 80% after your deductible.
  • Medicare Part A covers inpatient psychiatric hospital stays, but only if you are formally admitted as an inpatient patient.
  • Medicare Advantage plans must cover mental health services but set their own copays and deductibles, which vary by plan.
  • Telehealth mental health visits are covered the same way as in-person visits under both Original Medicare and Medicare Advantage.
  • Some mental health providers do not accept Medicare, so you should confirm your provider is in-network before scheduling.

What Original Medicare Part B covers for mental health

Under Original Medicare Part B, you can see a psychiatrist, psychologist, clinical social worker, or licensed professional counselor for mental health treatment. Medicare pays 80% of the approved amount for each visit after you've paid your annual Part B deductible (which is $240 in 2024, though this amount changes yearly). You pay the remaining 20%, called coinsurance.

The number of visits is not limited by Medicare itself. However, your provider may need to request authorization from Medicare for ongoing treatment, especially if you're seeing a therapist for long-term care. This is called a "medical necessity review," and it's meant to confirm the treatment is medically necessary. Most routine mental health care is approved without delay.

If your provider charges more than Medicare's approved amount, you may owe the difference. This happens when a provider does not accept Medicare assignment. Always ask your provider whether they accept Medicare assignment before your first visit.

Inpatient psychiatric care under Medicare Part A

If you need to stay in a psychiatric hospital or psychiatric unit within a general hospital, Medicare Part A covers this as inpatient care. You pay the Part A deductible (which is $1,632 in 2024) for the first 60 days of your hospital stay. After 60 days, you pay coinsurance. After 90 days, you enter your "lifetime reserve days," which have a higher coinsurance amount and are limited in number.

The critical distinction is that you must be formally admitted as an inpatient. If you go to an emergency room, receive psychiatric evaluation, and are sent home the same day, that's outpatient care and is covered under Part B, not Part A. Partial hospitalization programs (day programs where you attend treatment during the day but go home at night) are also covered under Part B as outpatient services.

How Medicare Advantage plans handle mental health coverage

All Medicare Advantage plans (Part C) are required by law to cover mental health services at least as well as Original Medicare does. However, each plan sets its own copays, coinsurance amounts, and deductibles. One plan might charge $20 per therapy visit; another might charge $50. Some plans waive the deductible for mental health visits; others don't.

Medicare Advantage plans also control which providers are in-network. If your current therapist is not in your plan's network, you may have to pay more out of pocket or switch providers. Before you enroll in a Medicare Advantage plan, check whether your mental health provider is listed in that plan's provider directory. If you're already enrolled and your provider leaves the network, you have the right to request a continuity-of-care exception, which allows you to keep seeing that provider for a limited time while you transition to an in-network provider.

Telehealth mental health visits

Medicare covers mental health visits by video or phone the same way it covers in-person visits. You pay the same coinsurance (20% under Original Medicare) whether you see your therapist in their office or on a video call. This applies to both Original Medicare and Medicare Advantage plans.

During the COVID-19 pandemic, Medicare expanded telehealth access, and many of those expansions have remained in place. However, some telehealth rules do change, so if you're planning to use video or phone visits regularly, confirm with your provider that Medicare will cover it at the rate you expect.

Types of providers Medicare covers

Medicare covers mental health services from psychiatrists (medical doctors who specialize in mental health), psychologists (who hold a doctoral degree in psychology), clinical social workers (who hold a master's degree or higher and are licensed), and licensed professional counselors (who hold a master's degree or higher and are licensed). The provider must be licensed in your state and enrolled in Medicare.

Medicare does not cover services from unlicensed counselors, life coaches, or peer support specialists, even if they provide valuable support. If you see a provider who is not on this list, you'll pay the full cost yourself. Some therapists who are not Medicare-enrolled will provide you with a receipt so you can file a claim yourself, but Medicare will not reimburse you — you're responsible for the full amount.

What mental health services are not covered

Medicare does not cover routine checkups or preventive mental health visits with no diagnosed condition. If you want to see a therapist for general life coaching, stress management, or personal growth without a mental health diagnosis, Medicare won't pay for it. You would pay out of pocket.

Medicare also does not cover substance use disorder treatment in certain settings. Outpatient addiction counseling and medication-assisted treatment (like methadone or buprenorphine) are covered, but there are limits on inpatient detoxification and rehabilitation in some cases. If you need substance use treatment, ask your doctor or the treatment facility whether Medicare will cover it.

How to find a mental health provider who accepts Medicare

Use the Medicare Provider Search tool on Medicare.gov to find psychiatrists, psychologists, and counselors in your area who accept Medicare. You can search by provider type, location, and whether they accept new patients. The search results show whether each provider accepts Medicare assignment.

You can also call your state's mental health department or a local community mental health center to ask for referrals. Many community health centers offer sliding-scale fees and accept Medicare. If you have a Medicare Advantage plan, log into your plan's website or call the customer service number on your insurance card to search that plan's provider directory.

Before you schedule an appointment, call the provider's office and confirm three things: they accept Medicare, they accept new patients, and they accept Medicare assignment (so you won't owe more than your coinsurance). If the provider doesn't accept assignment, ask what their full charge is so you can decide whether to see them.

Frequently Asked Questions

Does Medicare cover therapy for depression or anxiety?

Yes. If you have a diagnosis of depression, anxiety, or another mental health condition, Medicare Part B covers therapy and counseling visits. You pay 20% coinsurance after your deductible. The number of visits is not limited by Medicare, though your provider may need to request authorization for ongoing treatment.

What if I can't afford the 20% coinsurance?

If cost is a barrier, ask your provider about sliding-scale fees or whether they offer reduced rates for patients with limited income. Some community mental health centers charge based on what you can afford. You can also ask your provider whether they accept Medicare assignment and whether they have financial information programs.

Does Medicare cover psychiatric medications?

Psychiatric medications are covered under Medicare Part D (prescription drug coverage) if you have a Part D plan. You pay a copay or coinsurance for each medication, depending on your plan. The medication must be on your plan's formulary (approved drug list). If it's not, you can ask your doctor to request an exception.

Can I see a therapist without a referral from my doctor?

Yes. Under Medicare Part B, you do not need a referral to see a mental health provider. You can call a therapist, psychologist, or psychiatrist directly and schedule an appointment. However, some Medicare Advantage plans may require a referral, so check your plan's rules.

What happens if my mental health provider retires or leaves Medicare?

If you're in Original Medicare, you can see any other Medicare-enrolled provider. If you're in a Medicare Advantage plan and your provider leaves the network, you can request a continuity-of-care exception, which typically allows you to keep seeing that provider for up to 90 days while you find a new in-network provider. Contact your plan to request this exception.