Find a Medicare Therapist

How Medicare Mental-Health Coverage Works

​​Medicare covers mental health care under several different parts, and understanding how they fit together can help you avoid surprises at billing time.

Part A covers inpatient psychiatric care—whether in a dedicated psychiatric hospital or as part of a general hospital stay. Costs follow the standard Part A rules for hospital coverage.

Part B covers most outpatient services, including therapy sessions, diagnostic testing, and medication management visits. After you meet the annual Part B deductible ($257 in 2025), you typically pay 20% of the Medicare-approved amount.

Part D adds coverage for prescription medications, including common mental health prescriptions such as antidepressants and mood stabilizers. Costs depend on your specific Part D plan’s copay or coinsurance schedule.

Medicare Advantage (Part C) combines hospital, outpatient, and drug coverage into one plan. These plans must cover everything that Parts A and B cover, but many add extra benefits like $0 copays for teletherapy. Costs vary depending on the plan you choose.

Tip: If you have a Medigap policy or Medicaid as a secondary payer, it can cover your 20% Part B coinsurance, significantly reducing your out-of-pocket costs.

Key Coverage Facts

• No annual cap: Medicare sets no limit on the number of medically necessary outpatient therapy sessions.
• More providers covered: Since January 1, 2024, Medicare directly reimburses licensed counselors and marriage and family therapists, alongside psychologists and clinical social workers.
• Telehealth extended: Medicare will continue covering telehealth through at least September 30, 2025, allowing patients to connect with Part B-eligible clinicians from home. Starting October 1, 2025, most telehealth sessions will again require you to be in a medical facility—unless new legislation extends current flexibilities.

Medicare Mental-Health Provider Types

If you’re a Medicare member, you have access to several types of licensed mental health professionals, each with a different role in your care.

A Medicare therapist or counselor—which may include LPCCs (licensed professional clinical counselors), LMFTs (licensed marriage and family therapists), or LCSWs (licensed clinical social workers)—provides weekly talk therapy. These providers help with issues like anxiety, depression, coping skills, and family dynamics.

A Medicare psychologist (PhD or PsyD) can also provide therapy but is especially valuable for psychological testing and specialized treatment approaches, such as trauma-focused therapy or evidence-based modalities like CBT and DBT.

A Medicare psychiatrist (MD or DO) focuses on the medical side of mental health care. Psychiatrists can diagnose complex conditions, prescribe medications, and manage cases where therapy alone isn’t enough.

Many people get the best results with a team approach—for example, seeing a counselor weekly for therapy, while checking in with a psychiatrist for medication management and consulting a psychologist for testing or advanced treatment strategies.

Real-Life Use Case: How Walter Found a Therapist That Accepts Medicare

Walter, a 68-year-old semi-retired truck driver in Columbus, noticed creeping anxiety and insomnia. Here’s how he moved from symptoms to treatment in 15 days:

1. Day 1 — Annual Wellness Visit
   Walter tells his primary-care doctor about his mood. The doctor adds a brief depression screening (free once per year).
   
   
2. Day 1 — Referral & Directory
   The doctor prints a list of therapists that take Medicare within 20 miles and reminds Walter that referral paperwork isn’t required—but can speed scheduling.
   
   
3. Day 2 — Phone Calls
   Walter calls three names. Two have openings next month; one, Susan Lee, LPCC, offers a telehealth slot in 13 days.
   
   
4. Day 13 — First Session
   After meeting his deductible earlier in the year, Walter pays 20 % of the Medicare-approved rate—$30.80 for a 45-minute visit.
   
   
5. Day 14 — Medication Check
   Susan suggests a low-dose SSRI. Walter schedules a 30-minute video consult with a Medicare psychiatrist through his Part D plan’s telehealth partner.

Step-by-Step: Booking Outpatient Therapy Under Medicare

1. Verify Your Coverage:
   Original Medicare: no networks—see any clinician who “accepts assignment.”
   Medicare Advantage: use the plan’s online directory to avoid out-of-network costs.
   
   
2. Run the Medicare.gov Care Finder (or your MA plan’s portal). Enter your ZIP code, select “mental health,” then filter for language, specialty, telehealth, or wheelchair access if needed.
   
   
3. Confirm the Clinician Accepts Medicare.
   Look for “Participating” (takes assignment) or “Non-participating” (can charge up to 15 % more). For the lowest cost, make sure to stick to participating whenever possible.
   
   
4. Check the Cost.
   Expect 20 % coinsurance after the deductible—or less if you have a Medigap policy, Medicaid, or a zero-dollar Advantage copay.
   
   
5. Schedule Your First Visit.
   Ask about paperwork, telehealth setup, and cancellation policy.
   
   
6. Bridge the Gap While You Wait.
   Use free Part B services—yearly depression screening, alcohol-misuse counseling—or tap Advantage-plan perks like SilverSneakers Mindful Movement classes.

In-Network vs. Out-of-Network: What Changes Under Medicare?

Coverage Type

Who Can You See?

Typical Cost*

Original Medicare

Any provider nationwide who accepts assignment

20 % coinsurance after deductible

Medicare Advantage PPO

In-network → lowest copay; out-of-network → higher coinsurance

Plan-specific

Medicare Advantage HMO

In-network only (except emergencies)

Usually $0–$40 per visit

*Medigap or state Medicaid may remove your  remaining coinsurance.

Bottom line: with Original Medicare, your only “network” is the list of clinicians who accept Medicare. For Advantage plans, always cross-check the directory before booking for mental-health providers that accept Medicare.

Digital & Telehealth Options

Telehealth has become a major part of mental health care under Medicare, and members can continue to take advantage of flexible options through September 30, 2025.

If you prefer video therapy, you can meet with your enrolled clinician from virtually anywhere—including your own home. This is fully covered through the current extension period.

If video isn’t possible, audio-only therapy is also covered. Medicare made this option permanent for mental health visits, so even if you don’t have reliable internet or technology, you can still receive care by phone.

Starting October 1, 2025, unless new legislation passes, the rules for Original Medicare are scheduled to tighten. Routine video therapy at home will likely no longer be covered unless you are physically located in a medical facility within a rural area. Medicare Advantage plans may continue to allow home-based video care, depending on the carrier.

Tip: Many Medicare Advantage plans now advertise $0 copays for mental health telehealth visits. Always confirm by checking your Evidence of Coverage (EOC) so you know exactly what to expect.

Cost & Coverage 

Medicare covers a wide range of mental health services, but your out-of-pocket costs will depend on whether you have Original Medicare or a Medicare Advantage plan.

For a 45-minute individual therapy session (CPT 90834), Original Medicare members typically pay about 20% of the approved rate—roughly $30.80 after the Part B deductible ($257 in 2025). Many Medicare Advantage plans instead charge a flat copay, usually between $0 and $40 per session.

An initial psychiatric evaluation (CPT 90792) costs more because it’s a longer, more detailed appointment. Under Original Medicare, the 20% coinsurance works out to about $46.88. Medicare Advantage plans generally charge $0 to $50.

The good news is that annual depression screenings are always covered at $0—no copay, no deductible—under both Original Medicare and Advantage.

Starting in 2025, Medicare also added coverage for Intensive Outpatient Programs (IOPs). If you have Original Medicare, you’ll pay the standard Part B cost-share. Advantage plans vary, but many charge $0 to $50 per day for IOP participation.

Tip: If your first therapist doesn’t feel like the right fit, you can switch. Medicare allows you to change providers without penalty, and it’s often worth trying a different match to get the best results.

Advocating for Yourself When Wait Times Drag

• Call 1-800-MEDICARE. Ask for help finding open appointments.
  
  
• Ask the Provider to Opt In. Some clinicians who “don’t take Medicare” simply haven’t completed enrollment; your request can nudge them to do so.
  
  
• Use Federally Qualified Health Centers (FQHCs). These clinics must accept Medicare and often offer same-week slots.
  
  
• File a Complaint. CMS cares about network adequacy—especially for Advantage plans promising easy access.
  
  

Polite persistence can unlock a sooner visit with psychiatrists that take Medicare or a brand-new Medicare counselor.

Additional No-Cost or Low-Cost Resources

• 988 Suicide & Crisis Lifeline — call or text 988
  
  
• Senior Centers & Area Agencies on Aging — free support groups
  
  
• SAMHSA Treatment Locator — filter “payment accepted: Medicare”
  
  
• Medicare.gov Chat — live help finding providers
  
  

Frequently Asked Questions

Does Medicare cover therapy?
Yes. Part B (and all Advantage plans) cover outpatient therapy with enrolled professionals after the deductible; coinsurance or copay applies.

How do I find therapists that take Medicare near me?
Use the Medicare.gov Care Finder or your Advantage plan’s directory—filter for “accepts Medicare assignment.”

What’s the difference between a Medicare therapist and a Medicare psychologist?
“Therapist” is an umbrella term for licensed counselors and clinical social workers; “psychologist” means a PhD/PsyD who can also perform testing. Both can bill Part B.

Are psychiatrists that take Medicare accepting new patients?
Many are—but supply is tight. Search early, use telepsychiatry if offered, and ask primary care for referrals.

Will telehealth still be covered after 2025?
Through September 30, 2025, yes. After that, home-based teletherapy may require congressional action unless you’re in a rural medical facility.