What Medicare Covers for Mental Health Therapy and Counseling

Medicare covers mental health therapy sessions, but the amount you pay depends on which type of therapy you receive and whether you see a provider in the Medicare network

Medicare Part B covers outpatient mental health services including individual therapy, group therapy, and psychiatric evaluations. You pay 20 percent of the cost after you meet your annual deductible, and Medicare pays the remaining 80 percent. The provider must be enrolled in Medicare for this coverage to explore.

The main limitation is that Medicare does not cover therapy from unlicensed counselors or life coaches. Your therapist must be a psychiatrist, psychologist, licensed clinical social worker (LCSW), licensed professional counselor (LPC), or psychiatric nurse specialist. If you see someone outside these categories, Medicare will not pay for the session.

Key Takeaways

Medicare Part B covers individual and group therapy sessions with licensed mental health providers at 80 percent after you meet your deductible.
You must see a provider who is enrolled in Medicare; out-of-network providers may charge more and you may owe the full balance.
Therapy from unlicensed counselors, life coaches, or wellness practitioners is not covered by Medicare.
If you have a Medicare Advantage plan, coverage rules differ and you should check your plan documents or call the plan directly.
Inpatient psychiatric hospital stays are covered under Part A, but outpatient therapy is covered under Part B.

What Types of Mental Health Providers Medicare Covers

Medicare covers therapy from psychiatrists, psychologists, licensed clinical social workers, licensed professional counselors, and psychiatric nurse specialists. Each of these providers must hold the appropriate state license and be enrolled in Medicare. If a provider is not enrolled, Medicare will not pay, even if they are licensed.

Psychiatrists are medical doctors who can prescribe medication and provide therapy. Psychologists hold a doctoral degree in psychology and provide therapy and psychological testing. Licensed clinical social workers (LCSWs) have a master's degree and specialize in therapy and case management. Licensed professional counselors (LPCs) also hold a master's degree and provide counseling services. Psychiatric nurse specialists are registered nurses with additional training in mental health.

The provider's credentials matter more than their title. A person calling themselves a "therapist" or "counselor" without a specific license will not be covered. Before scheduling, ask the provider whether they accept Medicare and confirm their license type.

How Much You Pay for Each Session

You pay 20 percent of the Medicare-approved amount for each outpatient therapy session after you meet your Part B deductible. The deductible amount varies by year; you can find the current year's deductible on your Medicare card or by calling 1-800-MEDICARE. Once you reach the deductible, Medicare pays 80 percent of covered sessions for the rest of the calendar year.

The actual cost per session depends on the provider's location and specialty. A psychiatrist in an urban area may have a higher Medicare-approved amount than a psychologist in a rural area. The provider's office can tell you the exact Medicare-approved amount before your first visit.

If you see an out-of-network provider — one not enrolled in Medicare — you may owe the full bill. Some out-of-network providers charge more than the Medicare-approved amount, and you would be responsible for the difference. Always confirm that your provider is in-network before your first appointment.

Therapy Covered Under Medicare Part A Versus Part B

Medicare Part B covers outpatient mental health services — therapy you receive in a clinic, office, or hospital outpatient department. Part A covers inpatient psychiatric hospital stays when you are admitted for treatment and stay overnight.

If you are hospitalized for a psychiatric condition, Part A covers the hospital stay, meals, and room. Once you are discharged, any follow-up therapy is covered under Part B. The two parts work together: Part A handles the inpatient stay, and Part B handles the outpatient care that follows.

Therapy in a skilled nursing facility after a hospital stay may also be covered under Part A, depending on the circumstances of your admission and the type of care you need.

Medicare Advantage Plans and Mental Health Coverage

If you have a Medicare Advantage plan (Part C), your mental health coverage may differ from Original Medicare. Some Medicare Advantage plans cover more therapy sessions or charge lower copays than Original Medicare. Others may require you to use providers in their network or may limit the number of sessions per year.

You should review your plan's coverage documents or call the plan's customer service line to understand your specific benefits. The plan documents will list which providers are in-network, what your copay is per session, and whether there are limits on the number of sessions you can have each year.

If you are considering switching to a Medicare Advantage plan, mental health coverage is an important factor to compare, especially if you see a therapist regularly or plan to start therapy.

How to Find a Medicare-Enrolled Mental Health Provider

You can search for Medicare-enrolled mental health providers using the Medicare Provider Search tool on Medicare.gov. Enter your location and the type of provider you are looking for — psychiatrist, psychologist, LCSW, or LPC — and the tool will show you providers in your area who accept Medicare.

You can also call 1-800-MEDICARE and ask for a list of mental health providers in your area. The representative can tell you which providers are accepting new patients and whether they have evening or weekend appointments.

Your primary care doctor can also refer you to a mental health provider. Many primary care offices have relationships with local therapists and can recommend someone who accepts Medicare and has availability.

What Happens If You Cannot Afford Your Share of the Cost

If you have limited income, you may be able to reduce your out-of-pocket costs through Medicare Savings Programs or the Low-Income Subsidy program. These programs help pay your deductible, copays, and coinsurance. may be able to access depends on your income and resources, and the rules vary by state.

You can learn about these programs by calling 1-800-MEDICARE or contacting your state Medicaid office. Some community mental health centers also offer sliding-scale fees based on income, and they may accept Medicare as well.

If cost is a barrier to therapy, tell your provider or your doctor. They may be able to connect you with resources or lower-cost options in your area.

Frequently Asked Questions

Does Medicare cover therapy for depression or anxiety?

Yes. Medicare Part B covers outpatient therapy for depression, anxiety, and other mental health conditions when provided by a licensed mental health professional. You pay 20 percent of the cost after your deductible, and Medicare pays 80 percent.

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

Yes. Medicare does not require a referral to see a mental health provider. You can contact a Medicare-enrolled therapist directly and schedule an appointment. However, your doctor may be able to recommend someone or help coordinate your care.

Does Medicare cover online or telehealth therapy?

Yes. Medicare covers telehealth mental health services from enrolled providers. The coverage rules are the same as in-person therapy — you pay 20 percent after your deductible, and the provider must be licensed and enrolled in Medicare. Ask your provider whether they offer telehealth appointments.

What if my therapist is not enrolled in Medicare?

Medicare will not pay for therapy from a provider who is not enrolled in Medicare. You would pay the full cost out of pocket. Before scheduling, always confirm that your provider is enrolled in Medicare by checking the Medicare Provider Search tool or asking the provider directly.

Does Medicare cover couples therapy or family therapy?

Medicare covers group therapy and family therapy when provided by a licensed mental health professional and when the service is medically necessary. The coverage rules are the same as individual therapy. Ask your provider whether they offer these services and whether Medicare will cover them.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.