Does Medicare cover therapy and counseling?

What therapy and counseling does Medicare cover?

Medicare Part B covers a wide range of outpatient mental health services. Medicare.gov describes outpatient mental health visits as the diagnosis and treatment of mental health conditions, like depression, anxiety and substance use disorder; these visits are often called counseling or psychotherapy and can be done individually, in group or family settings, and in crisis situations. Part B covers:

• Individual and group psychotherapy with doctors, or with certain other Medicare-enrolled licensed professionals, as the state where you get the services allows
• Family counseling, if the main purpose is to help with your treatment
• Psychiatric evaluation and medication management
• Testing to find out if you're getting the services you need and if your current treatment is helping you
• Diagnostic tests
• Safety planning interventions if you're at risk of suicide or overdose, and a follow-up phone call after you're discharged from the emergency department for a behavioral health service or other crisis
• Certain FDA-cleared or FDA-authorized digital mental health treatment devices, including devices that treat attention deficit/hyperactivity disorder, if you get them from your doctor or certain other qualified mental health providers and meet other conditions
• Mental health services you get as part of substance use disorder treatment, and medications used for substance use disorder
• Certain prescription drugs that aren't usually self-administered, like some injections

Which therapists and counselors does Medicare cover?

Medicare covers outpatient mental health services and visits with these types of providers:

• Psychiatrists or other doctors
• Clinical psychologists
• Clinical social workers
• Clinical nurse specialists
• Nurse practitioners
• Physician assistants
• Marriage and family therapists
• Mental health counselors

What do I pay for therapy with Medicare?

After you meet the Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount for visits to your health care provider to diagnose or treat your condition. If you get your services in a hospital outpatient clinic or hospital outpatient department, you may also have to pay the hospital a copayment or coinsurance.

You usually get these services outside a hospital: in a doctor's or other health care provider's office, a hospital outpatient department, a community mental health center, or through telehealth. What you owe depends on other insurance you have, how much your doctor charges, whether your doctor accepts assignment, the type of facility and where you get the service.

Can I get therapy through telehealth?

Yes. Medicare Part B covers certain telehealth services, and outpatient psychotherapy, depression screenings and cognitive assessments are among the examples Medicare.gov lists. Through December 31, 2027, Medicare covers telehealth services that you can get from anywhere in the U.S., including your home, and for most telehealth services you pay the same amount you would pay in person. See how Medicare covers telehealth.

What if I need more than a weekly therapy session?

Medicare Part B also covers two more intensive kinds of outpatient mental health care:

• Intensive outpatient program services, for people whose care plan states they need at least 9 hours of therapeutic services a week. You don't need to qualify for inpatient treatment to get them, and they can include group and individual therapy, mental health education and medication management.
• Partial hospitalization, a structured program that usually includes 4 to 8 hours of care a day as an alternative to inpatient psychiatric care, for people whose care plan states they need at least 20 hours of therapeutic services a week. Your provider must certify that you would otherwise need inpatient treatment.
• For both, you pay a percentage of the Medicare-approved amount for each service from a qualified mental health professional, and after the Part B deductible you also pay coinsurance for each day of services in a hospital outpatient setting or community mental health center.

Does Medicare Advantage or Medigap change therapy coverage?

Medicare Advantage Plans must cover all medically necessary services that Original Medicare covers, and plans may also offer extra benefits; rules and costs vary by plan. A Medicare Advantage Plan may require you to use providers in its network and to get approval (prior authorization) before it covers certain services. With Original Medicare, you can choose to buy a Medigap (Medicare Supplement Insurance) policy to help pay out-of-pocket costs like your 20% coinsurance. See how Medicare Advantage differs from Original Medicare.