Medicare covers counseling for depression, but the amount you pay and which therapists you can see depend on which type of Medicare you have and whether you meet certain conditions.

Original Medicare (Part A and Part B) covers mental health treatment, including therapy for depression, at the same rate it covers other medical care — you pay 20 percent of the cost after you meet your Part B deductible. Medicare Advantage plans (Part C) must cover mental health services at least as well as Original Medicare does, but each plan sets its own rules about which therapists are in-network and how many visits you get per year.

The key difference is that Medicare requires a diagnosis from a doctor or psychiatrist before coverage begins. You cannot straightforward call a therapist and have Medicare pay; a medical provider must first document that you have depression or another mental health condition. After that, a wide range of licensed professionals can provide the therapy that Medicare will help pay for.

Key Takeaways

  • Original Medicare covers 80 percent of the cost of mental health counseling after you pay your Part B deductible, with no limit on the number of visits per year.
  • You need a diagnosis from a doctor, psychiatrist, or other medical provider before Medicare will cover therapy — the therapist alone cannot start the process.
  • Medicare covers therapy from psychiatrists, psychologists, licensed clinical social workers, licensed professional counselors, and marriage and family therapists, as long as they accept Medicare.
  • Medicare Advantage plans must cover mental health services but may limit which therapists you can see or how many visits per year, so check your plan's details before scheduling.

How to Start: Getting a Diagnosis First

Before any therapy visits are covered, you need a medical provider to diagnose depression or another mental health condition. This can be your primary care doctor, a psychiatrist, a nurse practitioner, or a physician assistant. During this visit, tell the provider about your symptoms — sadness, loss of interest in activities, sleep changes, fatigue, or thoughts of harming yourself. The provider documents the diagnosis in your medical record.

If you do not have a regular doctor, you can schedule an appointment with any doctor who accepts Medicare. You can search for doctors in your area on Medicare.gov by clicking "Care Providers" and entering your location. Some community health centers also accept Medicare and offer same-day or next-day appointments for new patients.

Once you have a diagnosis, your doctor can refer you to a therapist, or you can find one yourself. Either way, make sure the therapist accepts Medicare before you schedule — not all do, and if they do not, Medicare will not pay any part of the cost.

Which Therapists Medicare Covers

Medicare covers mental health counseling from several types of licensed professionals. These include psychiatrists (doctors who specialize in mental health), psychologists (who have a doctoral degree in psychology), licensed clinical social workers (LCSW), licensed professional counselors (LPC), and marriage and family therapists (LMFT). Each must be licensed in the state where they practice and must accept Medicare.

The type of therapist you see does not change what Medicare pays — you still pay 20 percent after your deductible with Original Medicare. Some therapists specialize in certain types of therapy, such as cognitive behavioral therapy (CBT) or interpersonal therapy, which research shows work well for depression. When you call to schedule, ask whether the therapist has experience treating depression and what type of therapy they use.

Psychiatrists can also prescribe medication, which many people use alongside therapy. If your therapist is not a psychiatrist and you need medication, your primary care doctor or a psychiatrist can prescribe it while your therapist provides the counseling.

Original Medicare Versus Medicare Advantage Coverage

With Original Medicare, you pay 20 percent of the approved amount for each therapy visit after you meet your Part B deductible (which is $240 in 2024, though this amount changes yearly). There is no yearly limit on how many therapy visits Medicare will cover — you can continue as long as your doctor says it is medically necessary. The therapist bills Medicare directly, and you receive a bill for your 20 percent share.

Medicare Advantage plans must cover mental health services at least as well as Original Medicare, but they can structure the benefit differently. Some plans charge a copay per visit instead of 20 percent coinsurance. Many plans limit the number of therapy visits per year — common limits are 30 or 52 visits, though some plans cover more. Some plans require you to see an in-network therapist or get a referral before starting therapy. Check your plan's summary of benefits or call the plan directly to learn your specific coverage.

If you are in a Medicare Advantage plan and your plan's therapist limit is too low, you have the right to switch to Original Medicare during the annual open enrollment period (October 15 to December 7 each year). You would then have access to any Medicare-accepting therapist and no visit limit.

What You Pay Out of Pocket

With Original Medicare, your out-of-pocket cost depends on the therapist's approved amount and whether they accept assignment. Most therapists who accept Medicare accept assignment, meaning they agree to charge only the amount Medicare approves. If the approved amount is $150 per visit and you have met your deductible, you pay $30 (20 percent) and Medicare pays $120.

The Part B deductible applies only once per year. After you pay $240 out of pocket toward the deductible in 2024, Medicare begins paying its share for the rest of that year. If you have already met your deductible earlier in the year for other medical care, you do not pay it again for therapy.

If you have a Medigap policy (supplemental insurance), it may cover some or all of your 20 percent coinsurance, which would lower your out-of-pocket cost further. Check your Medigap policy documents or call your Medigap insurer to confirm.

Finding a Therapist Who Accepts Medicare

The most direct way to find a Medicare-accepting therapist is to search on Medicare.gov. Go to the Care Providers section, select "Mental Health Professionals," enter your city or zip code, and filter by the type of provider you want (psychologist, social worker, counselor, or psychiatrist). The results show which providers accept Medicare in your area.

You can also call your doctor's office and ask for a referral to a therapist who accepts Medicare. Many primary care offices have a list of local mental health providers they work with. If you belong to a Medicare Advantage plan, call the plan's member services line — they can tell you which in-network therapists are available and whether you need a referral.

When you call a therapist's office to schedule, confirm that they accept Medicare and ask about their current availability. Many therapists have waiting lists, especially in rural areas. If the first therapist you contact is not available, ask if they can refer you to another provider who is accepting new patients.

Telehealth Therapy Options

Medicare covers therapy delivered by video (telehealth) from a therapist in your state, as long as the therapist accepts Medicare. This can be helpful if you live far from a therapist's office, have mobility challenges, or prefer to meet from home. The cost is the same as in-person therapy — you pay 20 percent after your deductible with Original Medicare.

Not all therapists offer telehealth, so ask when you call to schedule. Some therapists offer both in-person and video appointments and let you choose. If you use telehealth, you will need a private, quiet space for the appointment and a device with a camera and microphone (computer, tablet, or smartphone).

Frequently Asked Questions

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

Original Medicare does not require a referral — you can see any Medicare-accepting therapist directly. However, you do need a diagnosis from a medical provider first. Medicare Advantage plans vary; some require a referral and some do not. Check your plan's rules or call member services to confirm.

What if my therapist says I need more visits than my Medicare Advantage plan covers?

Ask your therapist to request an exception from your plan, explaining why additional visits are medically necessary. Some plans approve exceptions. If your plan denies the request and you believe the denial is wrong, you can file an appeal. If you are in a Medicare Advantage plan and feel the visit limit is too restrictive, you can switch to Original Medicare during open enrollment.

Does Medicare cover psychiatric medication for depression?

Yes. If a psychiatrist or your primary care doctor prescribes an antidepressant, Medicare Part D (prescription drug coverage) covers it. You pay a copay or coinsurance depending on which tier the medication is on in your plan's formulary. Some antidepressants are low-cost generics with small copays.

Can I see a therapist who does not accept Medicare?

Yes, but Medicare will not pay any part of the cost. You would pay the full fee out of pocket. Some therapists offer a sliding scale fee based on income if you cannot afford their full rate. Ask the therapist about this option before scheduling.

Is there a waiting period before Medicare covers therapy?

No. Once your doctor documents a diagnosis, therapy visits are covered when ready. However, many therapists have waiting lists, so there may be a delay in scheduling your first appointment, not a delay in coverage.