Does Medicare Cover Therapy?

Does Medicare Cover Therapy?

Yes, Medicare covers therapy. Medicare Part B (Medical Insurance) covers outpatient mental health services, including individual therapy, group therapy, psychiatric evaluations, and medication management. Medicare has significantly expanded its mental health coverage in recent years, removing longstanding barriers to access and aligning mental health benefits more closely with medical benefits.

Under the Mental Health Parity and Addiction Equity Act, Medicare Advantage plans must cover mental health services at parity with medical benefits. Traditional Medicare (Parts A and B) also provides comprehensive mental health coverage, though the cost-sharing structure differs from commercial insurance.

If you are new to therapy, our therapy for beginners guide explains what to expect from the process.

How Medicare Covers Therapy: Parts A, B, and Advantage

Medicare covers mental health care through several components:

Medicare Part B (Outpatient)

Part B covers outpatient mental health services, which is where most therapy falls:

• Individual therapy — one-on-one sessions with a therapist (CPT codes 90834 and 90837)
• Group therapy — therapist-led sessions with multiple participants (CPT 90853)
• Family therapy — sessions involving family members (CPT 90847)
• Psychiatric diagnostic evaluation — initial assessment (CPT 90791)
• Medication management — follow-up sessions with a psychiatrist
• Annual depression screening — covered as a preventive service at no cost
• Annual alcohol screening and counseling — also covered at no cost

Medicare Part A (Inpatient)

Part A covers inpatient mental health treatment:

• Inpatient psychiatric hospitalization — up to 190 days lifetime in a psychiatric hospital
• Psychiatric care in a general hospital — no specific day limit when treated in a general hospital's psychiatric unit
• Partial hospitalization programs — intensive day programs as an alternative to inpatient care

Medicare Advantage (Part C)

Medicare Advantage plans must cover at least everything that Original Medicare covers, and many offer additional benefits:

• Lower copays — some Medicare Advantage plans offer $0 to $20 copays for therapy
• Expanded networks — broader provider networks than Original Medicare in some areas
• Additional benefits — some plans include supplemental behavioral health services, care management programs, or expanded telehealth options

Evidence-based approaches covered under Medicare include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), EMDR, and other established therapeutic modalities.

Medicare covers treatment for conditions including depression, anxiety, PTSD, bipolar disorder, OCD, grief, insomnia, substance use disorders, and suicidal ideation.

What You Pay for Therapy Under Medicare

Original Medicare (Part B) Costs

After you meet the Part B annual deductible, Medicare typically covers 80% of the approved amount for outpatient mental health services. You pay the remaining 20% coinsurance.

If you have a Medigap (Medicare Supplement) plan, it may cover part or all of the 20% coinsurance, further reducing your out-of-pocket cost. Some Medigap plans cover the Part B deductible as well.

Medicare Advantage Costs

Medicare Advantage plan costs vary by plan but are often lower than Original Medicare for therapy:

Medicare Advantage plans have an annual out-of-pocket maximum, which Original Medicare does not. This provides financial protection if you need extensive mental health treatment.

For detailed information on therapy costs, see our guide to paying for therapy.

How to Find Therapists Who Accept Medicare

Finding a therapist who accepts Medicare can require some effort, as not all mental health providers participate in the Medicare program.

1. Medicare.gov provider finder — Visit Medicare's provider directory to search for mental health providers who accept Medicare assignment in your area.

2. Medicare Advantage directory — If you have a Medicare Advantage plan, use your plan's provider directory (available on the plan's website or by calling member services) to find in-network therapists.

3. Call 1-800-MEDICARE — Medicare's helpline (1-800-633-4227) can assist you in finding providers and understanding your benefits.

4. Ask therapists about Medicare participation — When contacting a therapist, ask specifically whether they are a "participating Medicare provider" (accept Medicare assignment). Participating providers agree to accept Medicare's approved amount as full payment.

5. Community mental health centers — Federally qualified health centers and community mental health centers typically accept Medicare and may offer more available appointments.

6. State-specific resources — Your state's aging services department or area Agency on Aging can often help locate Medicare-accepting mental health providers.

Participating vs. Non-Participating Providers

Understanding this distinction is important for Medicare:

• Participating providers accept Medicare assignment, meaning they agree to accept Medicare's approved amount as full payment. You pay only the 20% coinsurance.
• Non-participating providers may charge up to 15% above Medicare's approved amount (the "limiting charge"). You pay the 20% coinsurance plus the extra amount.
• Opt-out providers have formally opted out of Medicare. If you see an opt-out provider, Medicare will not cover any of the cost, and you pay the full fee.

For guidance on selecting a therapist, see our guide on how to find a therapist.

Types of Providers Covered by Medicare

Medicare covers therapy from several types of licensed mental health professionals:

• Psychiatrists (MD/DO) — medical doctors who specialize in mental health, can prescribe medications
• Psychologists (PhD/PsyD) — doctoral-level therapists who provide therapy and psychological testing
• Clinical social workers (LCSW) — licensed professionals who provide therapy and connect patients with resources
• Licensed professional counselors (LPC/LCPC) — recently added to Medicare coverage, expanding access to therapists
• Licensed marriage and family therapists (LMFT) — also recently added to Medicare, covering family and couples therapy
• Psychiatric nurse practitioners — advanced practice nurses who provide therapy and medication management
• Clinical nurse specialists — specialized nurses in psychiatric or mental health care

The 2024 addition of LPCs and LMFTs to Medicare was a significant expansion that dramatically increased the number of therapists available to Medicare beneficiaries. Previously, Medicare only covered services from psychiatrists, psychologists, clinical social workers, and certain nurses.

Mental Health Parity and Medicare

Medicare's mental health coverage has evolved significantly:

• Elimination of the therapy cap — Medicare previously imposed a higher coinsurance rate (50%) for outpatient mental health services. This discriminatory rate was phased out, and mental health services now have the same 20% coinsurance as other Part B services.
• Preventive screenings — Medicare covers annual depression and alcohol screenings at no cost to the beneficiary.
• No session limits — Medicare does not impose annual session limits on outpatient mental health treatment. You can receive as many sessions as are medically necessary.
• Medicare Advantage parity — Medicare Advantage plans must cover at least what Original Medicare covers and are subject to the Mental Health Parity Act.

Medicare continues to expand mental health access through policy changes, including expanding the types of providers covered and improving telehealth access.

Pre-Authorization Requirements

Original Medicare generally does not require prior authorization for outpatient therapy. You can schedule and begin therapy with a Medicare-accepting provider without pre-approval.

Situations where authorization or specific requirements may apply:

• Partial hospitalization — may require documentation showing it is an alternative to inpatient care
• Inpatient psychiatric care — covered under Part A with specific admission criteria
• Medicare Advantage plans — some plans may require prior authorization for certain mental health services; check your plan's Evidence of Coverage

For information about different levels of mental health treatment, see our levels of care guide.

Telehealth and Online Therapy Coverage

Medicare has significantly expanded telehealth coverage for mental health:

• Permanent telehealth coverage — Mental health telehealth was made permanent for Medicare beneficiaries, not limited to emergencies or rural areas
• Audio-only sessions — Medicare covers phone-based therapy sessions, important for beneficiaries without reliable internet or video capability
• Home-based sessions — you can receive telehealth therapy from your home, not just from a medical facility
• Same cost-sharing — telehealth sessions have the same 20% coinsurance as in-person visits
• In-person visit requirement — Medicare may require an in-person visit with your provider within the first six months of starting telehealth services and periodically thereafter

Telehealth is particularly valuable for Medicare beneficiaries who face mobility challenges, live in rural areas, or have transportation limitations. Ask potential providers whether they offer video or phone sessions.

Tips for Maximizing Your Medicare Mental Health Benefits

1. Choose participating providers — Therapists who accept Medicare assignment will not charge you more than the 20% coinsurance. This can save significant money compared to non-participating providers.

2. Get your annual depression screening — This preventive benefit is covered at no cost and can help identify mental health needs early.

3. Consider a Medicare Advantage plan — If you need regular therapy, a Medicare Advantage plan may offer lower per-session costs and an out-of-pocket maximum that Original Medicare lacks.

4. Use Medigap to cover coinsurance — If you have Original Medicare, a Medigap plan can cover your 20% coinsurance for therapy, potentially reducing your per-session cost to $0 after you meet the deductible.

5. Ask about LPCs and LMFTs — The recent addition of licensed professional counselors and marriage and family therapists to Medicare coverage means more providers are available. If you have had trouble finding a Medicare therapist, try again — the pool has expanded significantly.

6. Leverage telehealth — Virtual therapy can increase your options, especially if few Medicare-accepting therapists are available nearby.

7. Check for Extra Help programs — If you have limited income, you may qualify for Medicare Savings Programs or the Extra Help program, which can reduce your health care costs.

8. Keep records of your care — Document all therapy sessions, referrals, and communications with Medicare. This helps if you need to appeal a claim or verify your benefits.

For more strategies on paying for therapy, see our guide to paying for therapy.

FAQ

Does Medicare Part B cover therapy?

Yes. Medicare Part B covers outpatient mental health services, including individual therapy, group therapy, family therapy, psychiatric evaluations, and medication management. After you meet the annual Part B deductible, Medicare pays 80% of the approved amount, and you pay 20% coinsurance.

How much does therapy cost with Medicare?

With Original Medicare, you pay 20% of the Medicare-approved amount after meeting the Part B annual deductible ($257 in 2026). For a typical therapy session approved at $120 to $175, your cost would be roughly $24 to $35 per session. With a Medigap plan, your cost may be lower. Medicare Advantage plans may charge a flat copay of $0 to $40 per session.

Does Medicare limit the number of therapy sessions?

No. Medicare does not impose annual limits on outpatient mental health sessions. You can receive as many therapy sessions as are medically necessary. There is no cap on individual therapy, group therapy, or medication management visits.

Does Medicare cover therapy for anxiety and depression?

Yes. Medicare covers therapy for anxiety disorders, depression, and a wide range of other mental health conditions including PTSD, bipolar disorder, OCD, grief, and substance use disorders. Medicare also covers a free annual depression screening.

Do all therapists accept Medicare?

No. Not all therapists participate in Medicare, and some have formally opted out. When searching for a therapist, ask whether they are a "participating Medicare provider." Participating providers accept Medicare's approved amount as full payment. Community mental health centers and federally qualified health centers are good places to start, as they typically accept Medicare.

Does Medicare cover online therapy?

Yes. Medicare permanently covers telehealth therapy, including both video and audio-only (phone) sessions. You can receive telehealth therapy from your home. Medicare may require an in-person visit with your provider within the first six months and periodically thereafter. Telehealth sessions have the same 20% coinsurance as in-person visits.

Does Medicare cover couples therapy?

Medicare recently began covering services from licensed marriage and family therapists (LMFTs), which expanded access to couples and family therapy. Coverage applies when treatment is medically necessary for a diagnosed condition. Discuss your specific situation with a Medicare-participating LMFT.

Coverage rules and licensing requirements vary by state — see our state therapy guides.