Medicare covers mental health services, but the amount you pay and which providers you can see depend on which Medicare plan you have and the type of care you need.

Original Medicare (Part A and Part B) covers therapy, counseling, and psychiatric care when provided by a licensed mental health professional. You pay a copay for each visit — usually $20 for an office visit with a doctor or mental health specialist — after you meet your Part B deductible. Medicare Advantage plans (Part C) must cover at least the same mental health services as Original Medicare, though copays and deductibles may differ by plan.

The main limitation is that Original Medicare does not cover outpatient mental health services in a hospital setting the same way it covers other outpatient care. If you receive mental health treatment in a hospital outpatient department, you may pay more. Inpatient psychiatric hospital stays are covered under Part A, with the same hospital deductible and copay rules as any other hospital stay.

Key Takeaways

  • Original Medicare covers therapy and psychiatric visits at a $20 copay per visit after your Part B deductible, with no visit limit.
  • Medicare Advantage plans must cover the same mental health services but may have different copays, deductibles, or network restrictions.
  • Inpatient psychiatric hospital stays are covered under Part A with standard hospital cost-sharing, but outpatient hospital mental health services may cost more.
  • You can see any licensed mental health professional who accepts Medicare, including psychiatrists, psychologists, clinical social workers, and counselors.
  • Telehealth mental health visits are covered by Medicare and often have the same copay as in-person visits.

What Original Medicare Covers for Mental Health

Original Medicare Part B covers outpatient mental health services from licensed providers. This includes psychiatry (diagnosis and medication management), therapy and counseling from a licensed clinical social worker or licensed professional counselor, and psychological services from a psychologist. You pay 20 percent of the Medicare-approved amount after you meet your Part B deductible, which is $240 in 2024 — though this amount changes each year.

There is no limit on the number of mental health visits you can have in a year. You can see a mental health provider as often as medically necessary. The provider must accept Medicare assignment (meaning they accept Medicare's approved fee as full payment) for you to pay only the copay; if they do not, you may owe more.

Original Medicare also covers inpatient psychiatric hospital care under Part A. If you are admitted to a psychiatric hospital, you pay the hospital deductible (which is $1,632 per benefit period in 2024) for days 1 through 60, then $408 per day for days 61 through 90. After 90 days, you have 60 lifetime reserve days you can use, paying $816 per day. A benefit period begins when you enter the hospital and ends 60 days after you leave.

How Medicare Advantage Plans Handle Mental Health

Medicare Advantage plans (Part C) must cover all the mental health services that Original Medicare covers. However, they set their own copays, coinsurance amounts, and deductibles. One plan might charge $15 per therapy visit while another charges $30. Some plans may have no copay for mental health visits, while others require a deductible before coverage begins.

Medicare Advantage plans also control their provider networks. You may be required to see a mental health provider within the plan's network, or you may pay more to see an out-of-network provider. Before you choose a Medicare Advantage plan, check whether your current mental health provider is in the network, or whether the plan covers the type of care you need.

If you switch to a Medicare Advantage plan and your current mental health provider is not in the network, you have the right to request continued coverage for an ongoing course of treatment. This is called continuity of care, and plans must allow it for a limited time while you transition to an in-network provider.

Mental Health Services Covered by Medicare

Medicare covers a range of mental health services when ordered by a doctor or other may have access to provider. These include individual therapy or counseling, group therapy, psychiatric evaluation and management, medication management, and crisis intervention. The provider must be licensed and must bill Medicare under their own credentials — you cannot be billed for services provided by an unlicensed person under a licensed provider's supervision.

Substance use disorder treatment is also covered. This includes outpatient counseling and medication-assisted treatment (such as methadone or buprenorphine for opioid use disorder). Inpatient treatment for substance use is covered under Part A as a hospital stay.

Telehealth mental health visits have been covered by Medicare since 2020. You can have a video or phone visit with a mental health provider, and you pay the same copay as you would for an in-person visit. The provider must be licensed in your state, and you must be in a location where telehealth is permitted under state law.

Who Can Provide Mental Health Care Under Medicare

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

You do not need a referral to see a mental health provider. You can call a provider directly and schedule an appointment. However, some Medicare Advantage plans may require a referral from your primary care doctor before they will cover the visit. Check your plan documents or call your plan to find out.

If you are having a mental health crisis, you can go to an emergency room or call 988, the Suicide and Crisis Lifeline. Medicare covers emergency mental health services the same way it covers any other emergency care.

What Medicare Does Not Cover for Mental Health

Medicare does not cover mental health services provided by unlicensed counselors or life coaches, even if they work under the supervision of a licensed provider. It also does not cover services that are not medically necessary — for example, if a provider bills for sessions that were not actually provided, or for services that are not related to treating a mental health condition.

Medicare does not cover residential treatment facilities or halfway houses, even if they provide mental health services. If you need inpatient psychiatric care, it must be in a hospital. Some skilled nursing facilities offer mental health services, which may be covered under Part A if you are admitted after a hospital stay, but a facility cannot bill Medicare for mental health treatment alone.

Outpatient mental health services in a hospital outpatient department are subject to the Outpatient Prospective Payment System (OPPS), which means you may pay more than you would for the same service in a private office. If you have a choice between seeing a provider in a hospital setting and in a private practice, ask about the cost difference before your visit.

How to Find a Mental Health Provider Who Accepts Medicare

You can search for mental health providers on Medicare.gov using the "Care Provider Search" tool. Enter your location and the type of provider you are looking for (psychiatrist, psychologist, social worker, or counselor), and the tool will show you providers in your area who are enrolled in Medicare. You can also call your state's mental health association or your local community mental health center to ask for referrals.

When you call a provider's office, ask whether they accept Medicare assignment and whether they are currently taking new patients. Some providers have long wait lists. If you are in crisis or need care quickly, ask whether they have an opening sooner or whether they can refer you to another provider who does.

If you have a Medicare Advantage plan, use your plan's provider directory to find in-network mental health providers. The directory is available on your plan's website or in the materials you received when you enrolled. If you cannot find a provider you want to see, call your plan's customer service line and ask for help.

Frequently Asked Questions

Do I need a referral from my doctor to see a mental health provider?

No, you do not need a referral for Original Medicare. You can call a mental health provider directly and schedule an appointment. However, some Medicare Advantage plans require a referral from your primary care doctor before they will cover the visit. Check your plan documents or call your plan to find out what is required.

How much will I pay for a mental health visit?

With Original Medicare, you pay 20 percent of the Medicare-approved amount after you meet your Part B deductible ($240 in 2024). For most mental health visits, this comes to about $20 per visit. With a Medicare Advantage plan, you pay whatever copay your plan sets, which can range from $0 to $50 or more per visit. Check your plan documents or call your plan for the exact amount.

Are telehealth mental health visits covered by Medicare?

Yes, Medicare covers mental health visits by phone or video. You pay the same copay as you would for an in-person visit. The provider must be licensed in your state and enrolled in Medicare. Some providers may charge a small fee for the telehealth platform, but Medicare does not allow them to charge more for a telehealth visit than for an in-person visit.

What should I do if I am having a mental health crisis?

Call 988 (the Suicide and Crisis Lifeline) or go to your nearest emergency room. Medicare covers emergency mental health services. You can also call 911 if you are in when ready danger. These services are available 24 hours a day, 7 days a week, and are free to call.

Can I see a mental health provider who does not accept Medicare?

Yes, but you will likely pay more. If a provider does not accept Medicare assignment, you may owe the difference between what they charge and what Medicare approves. Ask the provider's office about their fees and whether they will bill Medicare before your visit so you know what to expect.