Medicare covers counseling for mental health conditions, but the amount you pay and which therapists you can see depend on which Medicare plan you have and what type of counseling you need.

Original Medicare (Part A and Part B) covers outpatient mental health services at the same rate as physical health services — you pay 20% of the approved amount after you meet your Part B deductible. Medicare Advantage plans (Part C) set their own rules for mental health coverage, so your costs and covered providers vary by plan. The type of counseling matters too: Medicare covers therapy from licensed clinical social workers, psychologists, psychiatrists, and some other licensed counselors, but not all counseling types or providers may have access to.

You do not need a referral to see a mental health provider under Medicare, and you can change providers without permission. However, you will need to make sure your chosen therapist accepts Medicare and is in-network if you have a Medicare Advantage plan.

Key Takeaways

  • Original Medicare covers 80% of the cost for outpatient mental health services after you meet your Part B deductible, and you can see any Medicare-approved provider.
  • Medicare Advantage plans cover mental health services but set their own costs and provider networks, so you should check your plan documents before scheduling.
  • Medicare covers therapy from licensed clinical social workers, psychologists, psychiatrists, and licensed professional counselors, but the provider must be Medicare-approved.
  • Telehealth mental health visits are covered under the same rules as in-person visits, and many providers now offer this option.
  • You do not need a referral to see a mental health provider, but you should verify your provider accepts Medicare before your first appointment.

What Original Medicare Covers for Mental Health Services

If you have Original Medicare, Part B covers outpatient mental health services including individual therapy, group therapy, and psychiatric evaluations. You pay 20% of the Medicare-approved amount after you meet your annual Part B deductible (which is $240 in 2024, though this amount changes yearly). There is no limit on the number of sessions Medicare will cover, as long as your doctor or mental health provider says the treatment is medically necessary.

The provider must be Medicare-approved, which means they have enrolled with Medicare and agreed to accept Medicare's payment rates. You can find Medicare-approved providers by using the Medicare Provider Search tool on Medicare.gov or by calling 1-800-MEDICARE. If you see a provider who does not accept Medicare, you will pay the full cost yourself — Medicare will not reimburse you later.

Original Medicare also covers psychiatric services provided by a psychiatrist (a medical doctor who specializes in mental health). A psychiatrist can diagnose conditions, prescribe medication, and provide therapy. The coverage rules are the same: you pay 20% after your deductible.

How Medicare Advantage Plans Handle Mental Health Coverage

Medicare Advantage plans must cover at least the same mental health services that Original Medicare covers, but they can charge different amounts and have different rules about which providers you can see. Some plans charge a copay per visit (for example, $25 per therapy session), while others charge coinsurance (a percentage of the cost). Some plans have no copay for mental health visits. You need to check your specific plan's coverage details.

Most Medicare Advantage plans require you to use in-network providers, meaning therapists and psychiatrists who have a contract with your plan. If you see an out-of-network provider, you will typically pay more or the plan may not cover the visit at all. Before scheduling an appointment, call your plan or check your plan documents to confirm the provider is in-network and what your copay or coinsurance will be.

Some Medicare Advantage plans also limit the number of mental health visits per year, though this is less common. If your plan has a limit, you should know it before you start treatment so you can plan accordingly.

Types of Counseling and Therapists Medicare Covers

Medicare covers therapy from several types of licensed mental health professionals. A licensed clinical social worker (LCSW) holds a master's degree and is licensed by the state to provide therapy and counseling. A psychologist holds a doctoral degree (PhD or PsyD) and is licensed to diagnose and treat mental health conditions. A psychiatrist is a medical doctor (MD or DO) who specializes in mental health and can prescribe medication. A licensed professional counselor (LPC) or licensed mental health counselor (LMHC) is licensed by the state to provide counseling, though coverage rules vary slightly by state.

Medicare does not cover counseling from unlicensed counselors, life coaches, or spiritual advisors, even if they call themselves therapists. The provider must hold a state license in their field. If you are unsure whether a specific provider is covered, ask them directly whether they are Medicare-approved and what their Medicare provider number is.

Medicare covers both individual therapy (one-on-one sessions) and group therapy. Group therapy sessions are billed differently — you pay 20% of the approved amount per session, just as you would for individual therapy. Some therapists offer both formats, so you can ask which option works best for your situation.

Telehealth Mental Health Visits and Coverage

Medicare covers mental health visits by video or phone under the same rules as in-person visits. You pay the same copay or coinsurance, and the provider must still be Medicare-approved. This means you can receive therapy from home, which many people find convenient, especially if you live far from a therapist's office or have difficulty traveling.

To use telehealth, you will need a device with video capability (a computer, tablet, or smartphone) and internet access. Your therapist will provide instructions on how to connect. Some therapists use find video platforms designed for healthcare, while others may use more common platforms — ask your provider what they use and whether it meets privacy standards.

Telehealth mental health services have been widely available since the COVID-19 pandemic, and most Medicare-approved therapists now offer this option. If you prefer telehealth, you can ask about it when you call to schedule your first appointment.

How to Find a Medicare-Approved Mental Health Provider

The easiest way to find a mental health provider who accepts Medicare is to use the Medicare Provider Search tool at Medicare.gov. Enter your location and select "Mental Health Professional" or the specific type of provider you want (psychologist, social worker, psychiatrist, or counselor). The search will show you providers in your area, their addresses, phone numbers, and whether they are accepting new patients.

You can also call 1-800-MEDICARE and ask for a list of mental health providers in your area. A representative can tell you which providers are accepting new Medicare patients and may be able to give you information about their specialties (for example, whether they treat depression, anxiety, or grief).

If you have a Medicare Advantage plan, you can also contact your plan directly to ask for a list of in-network mental health providers. Your plan's member handbook or website will have a provider directory, or you can call the customer service number on your insurance card.

What to Ask Your Doctor or Provider Before Starting Therapy

Before your first mental health appointment, confirm these details: Is the provider Medicare-approved? If you have Medicare Advantage, is the provider in-network? What will your copay or coinsurance be per visit? Does the provider offer telehealth if you prefer? How often does the provider recommend you come in, and does your plan have any limits on the number of visits?

You should also ask whether the provider has experience treating your specific condition. For example, if you are dealing with grief after a loss, ask whether the therapist has worked with people in similar situations. If you are managing anxiety or depression, ask about the types of therapy they use — some therapists specialize in cognitive behavioral therapy (CBT), while others use different approaches.

If cost is a concern, ask the provider whether they offer a sliding scale fee or whether they know of lower-cost options. Some community mental health centers offer services on a sliding fee scale based on income, and these services may also be covered by Medicare.

When to Seek Mental Health Care and What to Do If You Are in Crisis

You should consider reaching out to a mental health provider if you are experiencing persistent sadness, anxiety, difficulty sleeping, loss of interest in activities you normally enjoy, or thoughts of harming yourself. You do not need to wait for your symptoms to become severe — early treatment is often more effective than waiting.

If you are having thoughts of suicide or are in when ready danger, call 988 (the Suicide and Crisis Lifeline) or go to your nearest emergency room. You can also call 911. These services are free and available 24 hours a day. If someone else is in danger, call 911 when ready.

If you need mental health care urgently but it is not a life-threatening emergency, call your doctor or your mental health provider's office and ask about urgent or same-day appointments. Many providers keep some appointment slots open for urgent situations.

Frequently Asked Questions

Do I need a referral from my doctor to see a therapist on Medicare?

No, Medicare does not require a referral. You can contact a mental health provider directly and schedule an appointment. However, some Medicare Advantage plans may require a referral, so check your plan documents or call your plan to be sure.

What if my therapist is not Medicare-approved?

If your therapist does not accept Medicare, you will pay the full cost of each session yourself. Medicare will not reimburse you. Before scheduling, always ask whether the provider accepts Medicare and is in-network if you have a Medicare Advantage plan.

Does Medicare cover medication for mental health conditions?

Yes, if you have Part D prescription drug coverage, it covers psychiatric medications. You will pay your Part D copay or coinsurance for each prescription. If you do not have Part D, you can add it during the annual enrollment period or if you may have access to for a special enrollment period.

How much will I pay out of pocket for therapy?

With Original Medicare, you pay 20% of the approved amount after you meet your Part B deductible. With Medicare Advantage, you pay whatever copay or coinsurance your plan sets, which varies by plan. Call your plan or provider to find out your specific cost before your first visit.

Can I switch therapists if I do not feel like we are a good fit?

Yes, you can change providers at any time. You do not need permission from Medicare or your plan. If you want to switch, straightforward contact a new provider and schedule an appointment. You can ask your current provider to send your records to the new therapist.