Yes, Medicare covers mental health therapy, but the amount you pay and which therapists you can see depend on which Medicare plan you have and whether you meet certain conditions.

Medicare Part B (the medical insurance part) pays for outpatient mental health services including therapy with a psychiatrist, psychologist, clinical social worker, or licensed counselor. You typically pay 20% of the cost after you meet your annual deductible, and Medicare pays the other 80%. If you have a Medicare Advantage plan (Part C), your coverage works differently — you may have a copay per visit instead, and your plan sets its own rules about which therapists are in-network.

The key limitation is that Medicare only covers therapy that treats a diagnosed mental health condition. Therapy for general life coaching, stress management without a diagnosis, or relationship counseling for couples is not covered. Your therapist must also be enrolled in Medicare and accept Medicare payment.

Key Takeaways

  • Medicare Part B covers individual therapy with psychiatrists, psychologists, clinical social workers, and licensed professional counselors at 80% after your deductible is met.
  • You must have a diagnosis of a mental health condition — such as depression, anxiety, bipolar disorder, or PTSD — for the visits to be covered.
  • Medicare Advantage plans cover mental health therapy but often charge a copay per visit and may limit which therapists you can see.
  • Your therapist must be enrolled in Medicare and accept Medicare payment; not all mental health providers do.
  • Group therapy, psychiatric medication management visits, and crisis services are also covered under the same rules as individual therapy.

How Medicare Part B Covers Therapy

Under Medicare Part B, you pay a 20% coinsurance for mental health visits after you have paid your annual deductible (which is $240 in 2024, though this amount changes yearly). Medicare then pays the remaining 80%. This applies whether you see a therapist once a week or once a month — each visit counts the same way.

The therapist's credentials matter. Medicare covers visits with a psychiatrist (a medical doctor who specializes in mental health), a psychologist with a doctoral degree, a clinical social worker (LCSW), a licensed professional counselor (LPC), or a marriage and family therapist (LMFT) — but only if they are licensed in your state and enrolled in Medicare. A life coach, wellness counselor, or unlicensed practitioner is not covered, even if they call themselves a therapist.

You do not need a referral from your primary care doctor to see a mental health provider under Medicare Part B. You can contact a therapist directly, though it is often helpful to ask your doctor for recommendations of providers who accept Medicare.

What Diagnosis You Need

Medicare requires that your therapist document a diagnosed mental health condition in order for visits to be covered. Common diagnoses that Medicare covers include depression, anxiety disorders, post-traumatic stress disorder (PTSD), bipolar disorder, schizophrenia, obsessive-compulsive disorder (OCD), and adjustment disorders. Your therapist will assign a diagnosis code during your first visit, and this becomes part of your medical record.

The diagnosis does not have to be severe or long-standing. If you are experiencing symptoms of depression or anxiety for the first time, that is enough. However, therapy for general life stress, relationship conflict without a diagnosed condition, or personal growth is not covered. If you are seeking therapy for a specific life issue but do not have a diagnosed mental health condition, you would pay out of pocket.

Your therapist and Medicare may disagree about whether your symptoms meet the threshold for a diagnosis. If Medicare denies a claim, your therapist can appeal or provide additional documentation. You have the right to see what Medicare received and to dispute it.

Medicare Advantage Plans and Mental Health Coverage

If you have a Medicare Advantage plan (also called Part C), your mental health coverage works differently. Instead of the 20% coinsurance model, most Advantage plans charge a fixed copay — often $20 to $50 per therapy visit, though this varies by plan. Some plans cover a set number of visits per year (for example, 30 visits), while others do not limit visits as long as they are medically necessary.

Medicare Advantage plans also control which therapists you can see. You must use a therapist in your plan's network, or you will pay much more or the visit may not be covered at all. Before you start therapy, call your Advantage plan's member services line and ask: which mental health providers are in-network, how many visits per year are covered, what is your copay, and do you need prior authorization (approval from the plan before your first visit).

Some Medicare Advantage plans include additional mental health benefits that Original Medicare does not — for example, coverage for telehealth therapy, support groups, or psychiatric medication management. Ask your plan directly what is included.

Finding a Therapist Who Accepts Medicare

Not every therapist accepts Medicare, even if they are licensed and may have access to. Some therapists only work with private insurance or cash-pay clients. To find someone who accepts Medicare, start by calling your doctor's office and asking for referrals to mental health providers in your area who take Medicare. Your primary care doctor often has a list.

You can also search the Medicare.gov provider search tool at Medicare.gov/care-compare. Enter your location and search for "mental health providers" or "psychologists." The tool shows which providers are enrolled in Medicare in your area. Call the provider directly to confirm they are currently accepting new Medicare patients, because enrollment status can change.

If you have a Medicare Advantage plan, log into your plan's website or call member services to request a list of in-network mental health providers. This list is usually searchable by location and specialty.

What Happens at Your First Visit

At your first appointment, your therapist will ask about your symptoms, medical history, and what brought you in. They will likely assign a diagnosis code based on what you describe. They will also verify your Medicare information — bring your Medicare card. If you have a Medicare Advantage plan, they may ask for your plan member ID and may contact your plan to check your benefits and whether prior authorization is needed.

Your therapist will explain their fees and what Medicare will cover. If you have Original Medicare Part B, remind them that you will pay 20% coinsurance after your deductible. If you have an Advantage plan, confirm your copay. Some therapists ask you to sign a form acknowledging that you understand your cost-sharing responsibility.

After your first visit, your therapist will submit a claim to Medicare on your behalf. You should receive an Explanation of Benefits (EOB) in the mail within a few weeks showing what Medicare paid and what you owe. Review it to make sure the diagnosis and number of visits are correct.

Telehealth Therapy and Other Formats

Medicare covers therapy delivered by video (telehealth) under the same rules as in-person visits. You pay the same coinsurance or copay, and the therapist must be enrolled in Medicare. Telehealth therapy became much more common during the pandemic, and many therapists now offer it as an option. This can be helpful if you live in a rural area or have mobility challenges.

Group therapy is also covered by Medicare at the same coinsurance rate (20% after deductible). Some therapists offer group sessions for depression, anxiety, grief, or other conditions. Group therapy often costs less per person than individual therapy because the cost is split among participants.

Psychiatric medication management — visits with a psychiatrist to prescribe and monitor psychiatric medications — is covered the same way as therapy. If you see a psychiatrist for medication management and a separate therapist for talk therapy, both are covered.

What Is Not Covered

Medicare does not cover therapy for general life coaching, stress management classes, or wellness counseling unless there is a diagnosed mental health condition. Couples counseling or family therapy is covered only if one member of the couple or family has a diagnosed mental health condition that the therapy is treating. Therapy focused on improving communication or resolving conflict without a diagnosis is not covered.

Substance use disorder treatment (addiction counseling) is covered under different rules through Medicare Part D and specialized programs, not through regular mental health therapy coverage. If you need treatment for alcohol or drug use, ask your doctor about referrals to a substance use treatment program.

Inpatient psychiatric hospitalization is covered under Medicare Part A (hospital insurance), not Part B. If you need to be admitted to a psychiatric hospital, that is a separate benefit with different cost-sharing rules.

Frequently Asked Questions

Do I need my doctor's permission to see a therapist?

No. Medicare Part B does not require a referral from your primary care doctor. You can contact a mental health provider directly. However, telling your doctor that you are starting therapy is a good idea so they can coordinate your care, especially if you are also taking psychiatric medications.

What if my therapist is not enrolled in Medicare?

If your therapist is not enrolled in Medicare, Medicare will not pay for your visits. You can pay out of pocket and ask your therapist to provide a receipt and diagnosis code so you can file a claim yourself, but Medicare is unlikely to reimburse you. Always confirm that a therapist is enrolled in Medicare before your first visit.

How many therapy visits does Medicare cover per year?

Original Medicare Part B does not limit the number of therapy visits per year, as long as they are medically necessary and your therapist documents that you have a diagnosed condition. Medicare Advantage plans may set their own limits — some cover 30 visits per year, others do not limit visits. Check your plan's rules.

Will my therapist tell my doctor what we discuss?

Your therapist is bound by confidentiality laws and will not share details of your sessions with your doctor unless you give written permission or there is a safety concern (for example, if you are at risk of harming yourself). However, your therapist may send your doctor a brief note saying you are in treatment and what diagnosis you have, so your doctor can coordinate care.

What if Medicare denies my therapy claim?

If Medicare denies a claim, you will receive a notice explaining why. Common reasons include that the diagnosis was not clear, the therapist is not enrolled in Medicare, or the visit was deemed not medically necessary. You have the right to appeal. Your therapist can help by providing additional documentation. Contact Medicare at 1-800-MEDICARE to learn about the appeal process.