Medicare mental health coverage

Yes. Medicare covers outpatient mental health care, including therapy and psychiatry, under Part B. After you meet the yearly Part B deductible, you pay 20% of the Medicare-approved amount for most visits. A yearly depression screening is free when your provider accepts Medicare's payment rate (called "accepting assignment"). Medicare now also covers visits with licensed marriage and family therapists and mental health counselors, which makes it easier to find a therapist.

What does Medicare cover for mental health?

Under Part B (outpatient care), Medicare covers:

• A yearly depression screening, free with a provider who accepts assignment
• Individual and group therapy, and family counseling when its main purpose is to help with your treatment
• Psychiatric evaluations and medication management
• Diagnostic tests
• Safety planning if you're at risk of suicide or overdose
• Intensive outpatient and partial hospitalization programs
• Treatment for substance use disorders

Medicare Part A covers inpatient mental health care in a hospital, and Part D (drug plans) covers prescription medications such as antidepressants.

Which providers can I see with Medicare?

Medicare covers mental health visits with:

• Psychiatrists and other doctors
• Clinical psychologists and clinical social workers
• Nurse practitioners, clinical nurse specialists and physician assistants
• Marriage and family therapists and mental health counselors (added in 2024)

To pay the least, choose a provider who accepts assignment: they agree to Medicare's approved amount as full payment, so you only owe your 20% coinsurance. You can search for providers on Medicare.gov's care compare tool.

How much does therapy cost with Original Medicare?

You pay the yearly Part B deductible first, then 20% of the Medicare-approved amount for each visit. If you get care in a hospital outpatient clinic, there can be an extra hospital charge. A Medigap (Medicare Supplement) policy can cover some or all of your 20%.

How is Medicare Advantage different?

Medicare Advantage (Part C) plans, from private insurers like UnitedHealthcare, Humana or Aetna, must cover everything Original Medicare does, but they set their own rules:

• They usually have provider networks, so you may need to use in-network therapists and psychiatrists.
• Costs are usually copays instead of 20% coinsurance.
• Some services need prior authorization or a referral.

Check your plan's provider directory and Evidence of Coverage, or call the member number on your card.

Does Medicare cover TMS?

Generally yes, for treatment-resistant depression, when you meet the coverage criteria set by your regional Medicare contractor. These typically include a diagnosis of major depression and not enough improvement after several antidepressants. TMS is covered under Part B, so after the deductible you pay 20% of the Medicare-approved amount for each session (a Medigap policy can cover some or all of that). Medicare Advantage plans usually require prior authorization. Our TMS guide explains what a course of TMS involves.

Does Medicare cover Spravato?

Generally yes, for treatment-resistant depression, when you meet the coverage criteria. Because Spravato is given and monitored in a certified clinic, it's usually covered as a medical benefit under Part B rather than through a Part D drug plan. Medicare Advantage plans usually require prior authorization. The manufacturer's savings program isn't available with Medicare. Our Spravato guide covers how treatment works and what it costs.

Does Medicare cover telehealth therapy?

Medicare covers mental health visits by video and, in some cases, by phone, including from your home. Telehealth rules have changed several times in recent years, so check Medicare.gov or ask your provider about the current rules before your visit.