Medicare covers mental health therapy, but the amount and type depend on which Medicare plan you have and whether you see an in-network provider

Original Medicare (Parts A and B) covers outpatient mental health services at the same rate as physical health services — you pay 20 percent of the approved amount 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 some plans offer more. The catch is that coverage only applies to licensed mental health professionals: psychiatrists, psychologists, clinical social workers, and licensed professional counselors. Your plan's network and any prior authorization requirements determine whether you can see a specific therapist and how much you pay out of pocket.

Mental health therapy is not unlimited. Original Medicare covers an unlimited number of outpatient visits, but you must meet the Part B deductible ($240 in 2024, though this changes yearly) before coverage begins. After that, you pay 20 percent coinsurance for each visit. If you have a Medigap supplemental policy, it may cover some or all of that 20 percent. Medicare Advantage plans set their own limits — some cap visits at 30 or 60 per year, others have no annual limit — so you need to check your specific plan documents.

Key Takeaways

  • Original Medicare covers outpatient mental health therapy at 80 percent after you meet your Part B deductible, with no visit limit.
  • Medicare Advantage plans must cover mental health services but may impose visit caps or require prior authorization, so check your plan's rules before scheduling.
  • You pay less out of pocket if you see an in-network provider; out-of-network visits may not be covered at all under Medicare Advantage.
  • Inpatient psychiatric hospital stays are covered under Medicare Part A, but only for acute psychiatric conditions, not ongoing therapy.
  • Telehealth mental health visits are covered by Medicare and often have the same cost-sharing as in-person visits.

What Original Medicare covers for mental health treatment

Original Medicare Part B covers outpatient mental health visits with no annual limit. You pay 20 percent of the Medicare-approved amount after you meet your $240 Part B deductible. This means your first mental health visit of the year counts toward that deductible, and once you reach $240 in out-of-pocket costs for Part B services (not just mental health), Medicare begins paying its 80 percent share.

The provider must be enrolled in Medicare and licensed in one of these categories: psychiatrist (MD or DO), psychologist (PhD or PsyD), clinical social worker (LCSW), licensed professional counselor (LPC), or marriage and family therapist (LMFT) in states where Medicare recognizes that credential. If you see someone outside these categories — a life coach, unlicensed counselor, or peer support specialist — Medicare will not cover it, even if your state licenses them.

Original Medicare also covers inpatient psychiatric hospital stays under Part A. This applies to acute psychiatric crises requiring hospitalization, not ongoing therapy. You pay the Part A deductible (which varies by benefit period) and then coinsurance for days 61 and beyond. Psychiatric hospitals have a 190-day lifetime limit under Medicare, which resets only in rare circumstances.

How Medicare Advantage plans handle mental health coverage

Medicare Advantage plans (Part C) must cover all the mental health services that Original Medicare covers, but they can structure the benefit differently. Many plans require you to use in-network providers and may impose visit limits — common caps are 30, 52, or 60 visits per year, though some plans have no limit. You need to check your plan's Summary of Benefits and Coverage document or call the plan directly to learn your specific limits.

Most Medicare Advantage plans require prior authorization before you start therapy. This means the plan's medical review team must approve the treatment before you begin, or sometimes after a certain number of visits. If you start therapy without authorization and the plan denies it, you may be responsible for the full bill. Call your plan's mental health line before your first appointment to confirm authorization is in place.

Out-of-network mental health providers are usually not covered under Medicare Advantage, or covered at a much higher out-of-pocket cost. If your preferred therapist is not in your plan's network, you have two options: switch plans during the annual enrollment period (October 15 to December 7), or pay out of pocket and seek reimbursement if your plan allows it — though most do not.

What you pay for mental health visits

Under Original Medicare, you pay 20 percent coinsurance after your Part B deductible. If the Medicare-approved amount for a therapy visit is $100, you pay $20. If it is $150, you pay $30. The actual charge from the therapist may be higher, but Medicare only counts the approved amount toward your coinsurance.

If you have a Medigap supplemental policy (also called Medigap), it may cover some or all of your coinsurance. Medigap Plan G, for example, covers 100 percent of coinsurance after the Part B deductible. Medigap Plan N covers 100 percent of coinsurance but may charge a small copay per visit (up to $20). Check your Medigap policy documents to see what mental health coinsurance it covers.

Medicare Advantage plans set their own copays or coinsurance. A plan might charge $30 per visit, $50 per visit, or a percentage of the approved amount. Some plans waive the copay for preventive mental health screening but charge for ongoing therapy. Your plan's Summary of Benefits and Coverage lists these amounts, or you can call the plan's customer service line.

Telehealth mental health visits and coverage

Medicare covers mental health visits by video or phone at the same rate as in-person visits. You pay the same coinsurance or copay whether you see your therapist in their office or on a video call. This applies to both Original Medicare and Medicare Advantage plans, though Medicare Advantage plans may have different rules about which telehealth providers are in-network.

The provider must be licensed and enrolled in Medicare, and the visit must take place in a state where the provider is licensed to practice. Some states restrict telehealth across state lines, so if your therapist is in a different state, confirm they can legally treat you in your state before booking.

Psychiatric medications and medication management

Mental health therapy and psychiatric medication management are separate benefits. Medication management visits with a psychiatrist or other prescriber are covered as office visits under Part B, with the same 20 percent coinsurance as therapy. The actual psychiatric medications are covered under Medicare Part D (prescription drug coverage) if you have it, or under Part B if you receive them in an outpatient hospital setting.

If you take psychiatric medications, make sure you have Part D coverage or a plan that includes drug coverage. Without it, you pay the full retail price for medications. Part D plans vary widely in which psychiatric drugs they cover and at what cost tier, so review your plan's formulary (drug list) or call the plan to confirm your medications are covered.

What Medicare does not cover for mental health

Medicare does not cover mental health services from unlicensed providers, even if they call themselves counselors or therapists. Peer support specialists, life coaches, and unlicensed practitioners are not covered. Some states license these roles, but Medicare does not recognize them.

Medicare also does not cover group therapy sessions in most cases, though some Medicare Advantage plans may cover them. Substance use disorder treatment is covered, but only through specific programs — outpatient visits with an addiction medicine specialist or licensed counselor are covered, but residential treatment centers and some specialized rehab programs have different rules.

Therapy for relationship issues, career counseling, or life coaching is not covered unless it is part of treatment for a diagnosed mental health condition. Medicare requires a diagnosis code (such as depression, anxiety, or bipolar disorder) to cover therapy. If you are seeking therapy for general wellness or personal growth without a diagnosed condition, Medicare will not pay.

How to find a Medicare-covered mental health provider

Start by calling your Medicare plan's customer service line and asking for the mental health provider directory. Original Medicare beneficiaries can search Medicare.gov's provider search tool or call 1-800-MEDICARE. Medicare Advantage members should use their plan's website or call the plan directly, because each plan maintains its own network.

When you contact a therapist's office, confirm three things: they accept Medicare, they are in-network for your specific plan (if you have Medicare Advantage), and whether prior authorization is needed. Many offices have staff who handle insurance verification and can tell you your out-of-pocket cost before your first visit.

If you cannot find a provider in your area, ask your primary care doctor for a referral. Primary care doctors often know which mental health providers accept Medicare and can sometimes expedite scheduling. Some areas have mental health crisis lines or community mental health centers that accept Medicare and can refer you to available providers.

Frequently Asked Questions

Does Medicare cover therapy for depression or anxiety?

Yes. Outpatient therapy for depression, anxiety, and other diagnosed mental health conditions is covered under Original Medicare at 80 percent after your Part B deductible, and under Medicare Advantage plans according to their specific benefits. You must see a licensed provider and have a diagnosis code in your medical record.

What if my therapist is out of network?

Original Medicare has no network, so any Medicare-enrolled provider is covered at the standard 80 percent rate. Medicare Advantage plans do have networks, and out-of-network mental health providers are usually not covered. If your preferred therapist is out of network, you can switch plans during open enrollment or pay out of pocket.

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

No. Medicare does not require a referral for mental health services. You can contact a therapist directly and schedule an appointment. However, your doctor's referral can help you find a provider faster and may be required by some Medicare Advantage plans for prior authorization.

How many therapy visits does Medicare cover per year?

Original Medicare covers unlimited outpatient mental health visits with no annual cap. Medicare Advantage plans vary — some have no limit, others cap visits at 30, 52, or 60 per year. Check your plan's Summary of Benefits and Coverage or call your plan to learn your specific limit.

Are virtual therapy visits covered the same as in-person visits?

Yes. Medicare covers telehealth mental health visits at the same rate as in-person visits. You pay the same coinsurance or copay whether you see your therapist on video, by phone, or in their office, as long as the provider is licensed and enrolled in Medicare.