Medicare Coverage for Mental Health Services

Keeping your mental health in check is just as important as your physical health. Mental health services can help you manage conditions such as anxiety and depression. Here’s what you need to know about how Medicare covers mental health services and your coverage options.

Does Medicare cover outpatient mental health services such as therapy and counseling?

Original Medicare Part B covers outpatient mental health services, including visits with healthcare providers who can diagnose and treat your condition. These services can take place in various settings, such as a doctor’s office, hospital outpatient department, or community mental health center². Medicare also covers remote mental health treatment via telehealth, also known as teletherapy. Covered outpatient mental health services include:

• Individual and group psychotherapy (talk therapy that helps with thoughts, feelings, and behaviors; Cognitive Behavioral Therapy, or CBT, is a common type)
• Family counseling (when the main purpose is to help with your treatment)
• Psychiatric evaluation and medication management
• Diagnostic tests
• Annual depression screening (at no cost if your provider accepts assignment)

For those who need more intensive support, Medicare also covers structured programs and inpatient care.

Intensive Outpatient Program (IOP) coverage

As of 2024, Medicare now covers in-person intensive outpatient program (IOP) services for mental health and substance use disorders. IOPs offer structured, intensive treatment that bridges the gap between regular outpatient therapy and partial hospitalization. Virtual IOPs are not covered.³

How much will you pay for outpatient mental health services?

For most outpatient mental health services, you’ll pay 20% of the Medicare-approved amount after meeting your Part B deductible ($257 in 2025). This applies to therapy sessions, psychiatric evaluations, and medication management visits.

Your annual depression screening is fully covered once per year if your doctor accepts Medicare assignment. This screening is typically offered as part of your yearly Medicare Annual Wellness Visit. It gives you and your provider a chance to discuss your mental well-being and identify any concerns early.

If your needs go beyond outpatient or intensive outpatient care, Medicare also helps with more comprehensive treatment options

Does Medicare cover partial hospitalization programs?

Yes, Medicare Part B covers partial hospitalization programs (PHPs), which provide intensive outpatient mental health treatment without requiring an overnight hospital stay. These structured programs can be an alternative to inpatient care or a step-down option after hospitalization.

For partial hospitalization programs, you’ll pay:

• A percentage of the Medicare-approved amount for each service
• The Part B deductible
• Coinsurance for each service
• A daily copayment if services are received through a hospital outpatient department

But what if you need round-the-clock care? That’s where inpatient mental health services come in

Does Medicare cover inpatient mental health services?

When mental health conditions require hospital care, Original Medicare Part A helps cover your inpatient treatment. This includes services you receive in a general hospital or a psychiatric hospital that specializes in mental health care.¹

Original Medicare Part A covers:

• Room and meals
• Nursing care
• Therapy and treatment
• Lab tests
• Medications during your inpatient stay
• Other services and supplies related to your care

How much will you pay for inpatient mental health services?

After meeting your Part A deductible ($1,676 in 2025), Medicare covers inpatient mental health care with the following cost structure (2025 allowances):

• Days 1-60: $0 coinsurance per benefit period
• Days 61-90: $419 coinsurance per day of each benefit period
• Days 91 and beyond (called lifetime reserve days): $838 coinsurance per day used (Medicare provides up to 60 of these extra days over your lifetime; once they’re used, they are not renewed)
• Beyond lifetime reserve days: You pay all costs

For care in a psychiatric hospital specifically, Medicare limits coverage to 190 days in your lifetime.

Which mental health professionals are covered by Medicare?

Medicare covers services provided by various mental health professionals, including:

• Psychiatrists (medical doctors who can prescribe medications),
• Clinical psychologists (professionals with doctoral degrees trained in psychology)
• Clinical social workers
• Mental health counselors
• Nurse practitioners and clinical nurse specialists
• Physician assistants

To ensure coverage, make sure your provider accepts Medicare assignment.

Are antidepressants and other mental health medications covered by Medicare?

Medicare Part D prescription drug plans typically cover medications used to treat mental health conditions, including antidepressants, antipsychotics, and anti-anxiety medications.⁴

Coverage varies by plan, so it’s important to check your plan’s formulary (list of covered drugs) to see which medications are covered and at what cost. Most Part D plans categorize drugs into tiers, with different copayment or coinsurance amounts for each tier.

Additional mental health coverage options

Medicare Advantage plans

Medicare Advantage (Part C) plans must cover everything Original Medicare covers, including mental health services. Some plans may offer additional benefits, such as:

• Lower copayments for mental health visits
• More extensive coverage for therapy sessions
• Additional telehealth options for mental health care
• Wellness programs that support mental health

Because Medicare Advantage plans are offered by private insurers, the mental health benefits and out-of-pocket costs can vary. Be sure to review your specific plan details to understand what’s included.

Medicare supplement insurance

While Medicare supplement plans don’t add extra mental health benefits, they can help cover your out-of-pocket costs for Medicare-approved mental health services, including:

• The Part A deductible and coinsurance for inpatient mental health care
• The Part B coinsurance (typically 20%) for outpatient mental health services
• The Part B deductible (only covered by Plan C and Plan F. These plans are only available to those eligible for Medicare before January 1, 2020.)

What mental health services are not covered by Medicare?

While Medicare provides substantial mental health coverage, there are some limitations to be aware of:⁵

For outpatient programs, Medicare does not cover:

• Transportation to mental health care facilities
• Meals
• Support groups that aren’t part of treatment
• Testing or training for job skills unrelated to mental health treatment

For inpatient programs, Medicare does not cover:

• Private rooms (unless medically necessary)
• Private duty nursing
• Phone or television in your room
• Personal care items such as toothpaste, razors, or slipper socks

Getting help for mental health

If you or someone you know is experiencing a mental health crisis, help is available 24/7 through the 988 Suicide and Crisis Lifeline. Call or text 988 to connect with trained counselors who can provide support and resources.⁶

Medicare mental health coverage FAQ

Q1. Do I need a referral to get mental health services with Medicare?

If you have Original Medicare, you don’t need a referral to see a mental health specialist, as long as the provider accepts Medicare assignment. That means they agree to be paid directly by Medicare and not to bill you more than the approved amount. While referrals aren’t required, checking in with your primary care doctor first may help coordinate your overall care.

If you’re enrolled in a Medicare Advantage plan, referral requirements vary. Some plans may require a referral from your primary doctor before you can see a specialist. Always review your plan’s specific rules to avoid unexpected costs.

Q2. Does Medicare cover therapy for anxiety and depression?

Yes, Medicare covers therapy for anxiety, depression, and other mental health conditions when provided by qualified professionals who accept Medicare. This includes individual and group therapy sessions.

Q3. How many counseling sessions does Medicare cover annually?

Medicare doesn’t set a specific limit on the number of therapy or counseling sessions covered per year. Coverage continues as long as your provider certifies that the services are medically necessary for your condition.

Q4. Does Medicare cover telehealth for mental health care?

Yes, Medicare covers telehealth services for mental health care, including therapy sessions and psychiatric evaluations. During the COVID-19 public health emergency, Medicare expanded telehealth coverage, and many of these options remain available.⁷

Find the right Medicare plan for your mental health

Understanding your mental health coverage options can help you get the care you need while managing Medicare costs. Whether you’re considering Original Medicare, a Medicare supplement insurance plan, or a Medicare Advantage plan, look for options that provide comprehensive mental health benefits tailored to your needs.

Sources

¹ Medicare.gov. Web page: Mental health care (inpatient). Retrieved Apr. 25, 2025, from www.medicare.gov/coverage/mental-health-care-inpatient

² Medicare.gov. Web page: Mental health care (outpatient). Retrieved Apr. 25, 2025, from www.medicare.gov/coverage/mental-health-care-outpatient

³ Center for Health Care Strategies. Web page: Expanded Medicare Coverage of Intensive Outpatient Services: Considerations for States. Retrieved Apr. 25, 2025, from www.chcs.org/resource/expanded-medicare-coverage-of-intensive-outpatient-services-considerations-for-states

⁴ Medicare.gov. Web page: Prescription drugs (outpatient). Retrieved Apr. 25, 2025, from www.medicare.gov/coverage/prescription-drugs-outpatient

⁵ Medicare.gov. Publication: Medicare and Your Mental Health Benefits. Retrieved Apr. 25, 2025, from www.medicare.gov/publications/10184-medicare-and-your-mental-health-benefits.pdf

⁶ 988 Suicide & Crisis Lifeline. Web page: Home. Retrieved Apr. 25, 2025, from www.988lifeline.org

⁷ Medicare.gov. Web page: Telehealth. Retrieved Apr. 25, 2025, from www.medicare.gov/coverage/telehealth

640310