Does Medicare Cover Mental Health Care and Therapy?

Mental Health Is Medical Care in Medicare

Type of care	Where it is covered	Cost-sharing in Original Medicare
Therapy and psychiatric visits	Part B	Deductible, then 20%
Annual depression screening	Part B	No cost when the provider accepts assignment
Inpatient hospital stay	Part A	Deductible and daily coinsurance as the stay lengthens
Prescription medications	Part D	Depends on your plan’s tiers

Some people expect mental health benefits to be a separate category with tighter limits than physical health care. In Original Medicare, outpatient mental health care is paid for the same way as most other Part B services. You pay the Part B deductible, which is $283, and then 20% of the Medicare-approved amount for each service. Medicare pays the rest. If the care is delivered in a hospital outpatient department, Medicare notes you may owe an additional copayment or coinsurance to the hospital. Medicare’s published guidance does not set a fixed number of outpatient therapy visits. What it asks is that the care be medically reasonable and necessary, and some programs, such as hospital outpatient or partial hospitalization services, are provided under a written plan of care.

That is not to say that costs are small. Therapy sessions add up, and the 20% has no ceiling on its own. A Medicare Supplement plan can cover some or all of that share, depending on the plan, and Medicare Advantage plans usually replace the 20% with a copay per visit. We cover both ideas further down.

What Part B Covers on an Outpatient Basis

Medicare describes outpatient mental health coverage broadly. Services that can be covered include:

• Individual and group psychotherapy
• Psychiatric evaluation and diagnostic testing
• Medication management
• Crisis psychotherapy
• Partial hospitalization and intensive outpatient programs, which are structured day programs that offer more support than weekly therapy but do not require an overnight stay
• Treatment for substance use disorders, including counseling and certain medications
• Screening and brief counseling for alcohol misuse
• Smoking and tobacco cessation counseling

Prevention is part of the picture too. Medicare covers an annual depression screening in a primary care setting, and it is free to you when the provider accepts Medicare’s assignment, meaning the doctor agrees to take the Medicare-approved amount as full payment. Depression screening can also be part of your yearly wellness visit, which is separate from a physical exam. Medicare also covers cognitive assessment and care planning when memory or thinking problems are suspected, and behavioral health integration services that let a primary care practice coordinate mental health care with a psychiatric consultant.

In recent years Medicare has also added coverage for certain digital mental health treatment devices when a clinician prescribes them as part of an ongoing treatment plan. These are specific, FDA-cleared products rather than general wellness apps, and they come with conditions.

Who Can Provide Your Care

One of the practical hurdles is that Medicare pays only for care delivered by recognized types of providers. According to CMS, eligible mental health practitioners include psychiatrists and other physicians, clinical psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, physician assistants, and, more recently, marriage and family therapists and mental health counselors.

The addition of marriage and family therapists and mental health counselors widened the pool of people who can bill Medicare. It matters because many therapists in private practice are licensed counselors, not psychologists or social workers, and until recently they could not bill Medicare at all.

Even so, you will want to check each therapist before booking. A provider has to be enrolled in Medicare and accept Medicare payment for it to work. Some therapists do not take insurance, and some have formally opted out of Medicare, which means Medicare will not reimburse you at all for their services. Ask the office directly, “Do you bill Medicare, and do you accept assignment?” If you have Medicare Advantage, also ask whether the therapist is in your plan’s network. Our post on checking a plan’s network shows how to do that, and it applies equally to mental health providers, where narrow networks are a common complaint.

Therapy by Video and Phone

Telehealth has become a common way to receive therapy, and Medicare’s rules for it are more settled for mental health than for many other services. CMS states that Medicare covers telehealth for behavioral and mental health care on a permanent basis, including when you are at home. Providers are expected to be able to offer real-time audio and video, but they may use audio-only when a patient’s technology, abilities or preferences make video impractical.

For you, that means you can often see a therapist or psychiatrist from your living room, and you generally pay the same cost-sharing as an in-person visit. One rule to ask about: federal law calls for an in-person visit before the first at-home mental health telehealth service and at least once every 12 months afterward, with limited exceptions. According to CMS’s telehealth FAQ, that requirement is not being applied yet and is scheduled to start after December 31, 2027, with people who begin telehealth before then treated as established patients, so ask your provider how it applies to you. If you are in a rural area or have limited mobility, that can open up access. Rules for other kinds of telehealth have been temporary and extended in stages, so ask your provider to confirm that the specific service you want is covered by video or phone.

Inpatient Mental Health Care Under Part A

If you need to be admitted to a hospital for mental health treatment, Part A pays, along with Part B for the doctors’ services. The costs follow the same structure as any hospital stay. You pay the Part A deductible per benefit period, which is $1,736. After 60 days, you pay a daily coinsurance of $434 for days 61 through 90. Beyond that, you can draw on up to 60 lifetime reserve days, at $868 per day. You also pay 20% of the doctors’ charges under Part B.

There is one limit that is specific to mental health. Medicare covers inpatient care in a freestanding psychiatric hospital for a maximum of 190 days in your lifetime. That lifetime limit does not apply to psychiatric units within a general hospital, which are covered like any other inpatient stay. For most people the 190 days is plenty, but if you expect to need long-term inpatient psychiatric care, it is worth discussing with your care team where that care will be delivered.

Medicare does not pay for custodial care, which is help with daily living rather than treatment, and it does not pay for private duty nursing or a private room unless it is medically necessary. If the concern is long-term care for a condition like advanced dementia, see our page on Medicare and long-term care.

Medications for Mental Health

Prescription drugs are handled differently. Part B does not generally cover the pills you take at home. Those come under Part D, or the drug coverage built into a Medicare Advantage plan. Medicare requires Part D plans to cover most medications in certain protected drug classes, which include antidepressants, antipsychotics and anticonvulsants. That is a meaningful safeguard, because switching a drug that is working can be disruptive.

It does not mean every drug is covered at the same price. Plans still use tiers, prior authorization and step therapy, and not every brand is on every list. Check that your specific medications are on your plan’s formulary, and look at the tier. Our post on formulary changes explains why that check is useful each fall. And the yearly cap on Part D out-of-pocket spending, described in our post on what the Part D cap means, limits what you can pay for covered drugs in a year.

How Medigap and Medicare Advantage Change the Picture

Medigap. A Medicare Supplement plan pays Part B coinsurance on approved services, which covers the 20% on therapy and psychiatric visits, depending on the plan letter. Our page on Plan G describes how the most popular plan handles this. With Original Medicare and Medigap, you can generally see any provider who accepts Medicare, which can help if you are searching for a therapist with a specific specialty.

Medicare Advantage. An Advantage plan must cover everything Original Medicare covers, including mental health services. You will usually pay a copay per visit, and there is an annual out-of-pocket maximum. In return, you use a network, and plans can require prior authorization for some services, especially inpatient and intensive programs. Some plans offer extras such as additional counseling or grief support. Whether the network includes enough therapists and psychiatrists accepting new patients matters more than a benefit list suggests, so call a few offices before you enroll.

When You Need Help Right Now

If you or someone you know is in crisis, call or text 988, the Suicide and Crisis Lifeline, or call 911 in an emergency. Both are available at any time. Medicare covers emergency care and crisis services, and you should never delay urgent care to sort out insurance first.

For family members and caregivers, supporting a person with depression or memory problems can feel overwhelming. Our guide to Medicare for caregivers explains how to help someone navigate coverage. A doctor or licensed therapist is the right source for medical guidance about treatment itself.

Frequently Asked Questions

Does Medicare cover therapy sessions?

Yes. Part B covers individual and group psychotherapy when it is medically necessary and delivered by an eligible provider. After your deductible, you generally pay 20% of the Medicare-approved amount in Original Medicare.

Is there a limit on how many therapy sessions Medicare covers?

Original Medicare does not set a fixed number of outpatient sessions. The care must be medically necessary and documented in a treatment plan. A Medicare Advantage plan may have its own authorization rules.

Does Medicare cover a psychiatrist?

Yes. Psychiatric evaluation and medication management are covered under Part B, with the same 20% cost-sharing. Medication itself is usually covered under Part D.

Does Medicare cover online therapy?

Yes. CMS states that mental health telehealth is covered on a permanent basis, including from your home, and audio-only may be allowed in some circumstances. Confirm with your provider that they bill Medicare for the visit.

Is there a lifetime limit on inpatient mental health care?

In a freestanding psychiatric hospital, Medicare covers a maximum of 190 days in your lifetime. The limit does not apply to psychiatric care in a general hospital.