Does Medicare Cover Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is a form of psychotherapy designed to help individuals identify and change unhelpful thinking patterns and behaviors. This therapeutic approach aims to improve emotional regulation, develop coping strategies, and address mental health conditions such as anxiety, depression, and phobias. Medicare provides coverage for Cognitive Behavioral Therapy as an effective mental health service.

Medicare Parts Covering Cognitive Behavioral Therapy

Medicare offers coverage for mental health services, including Cognitive Behavioral Therapy, primarily through Medicare Part B. Part B is medical insurance that covers outpatient mental health services when provided by qualified professionals. It includes individual and group psychotherapy sessions, psychiatric evaluations, and diagnostic tests.

Medicare Advantage Plans (Part C) provide an alternative way to receive Medicare benefits, encompassing at least the same coverage as Original Medicare Part A and Part B. These plans are offered by private companies approved by Medicare and often include additional benefits. While Medicare Advantage plans must cover CBT, their specific rules, networks, and costs may differ from Original Medicare.

Medicare Part A (hospital insurance) may also cover Cognitive Behavioral Therapy if it is part of an inpatient hospital stay for mental health treatment. This applies to care received in a general hospital or a psychiatric hospital. However, most CBT services are provided on an outpatient basis, falling under Part B or a Medicare Advantage plan.

Eligibility and Coverage Requirements for Cognitive Behavioral Therapy

For Medicare to cover Cognitive Behavioral Therapy, the service must be considered medically necessary by a healthcare professional. This means the therapy must be required to diagnose or treat a mental health condition.

CBT services must be rendered by qualified and Medicare-enrolled mental health professionals. These include psychiatrists, other doctors, clinical psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, and physician assistants. As of January 1, 2024, licensed marriage and family therapists and mental health counselors can also enroll in Medicare.

The therapy must be provided in an appropriate setting, such as a doctor’s office, a clinic, or a hospital outpatient department. Telehealth services for mental health, including CBT, are also covered by Medicare, allowing beneficiaries to receive care from their home via phone or video.

Costs of Cognitive Behavioral Therapy Under Medicare

Under Original Medicare Part B, beneficiaries are responsible for out-of-pocket costs for covered Cognitive Behavioral Therapy services. After meeting the annual Part B deductible ($257 in 2025), individuals typically pay 20% of the Medicare-approved amount. There is also a standard monthly premium for Part B ($185 for most people in 2025).

For those enrolled in Medicare Advantage Plans, the costs associated with CBT can vary. These plans may have different copayments, deductibles, or out-of-pocket maximums for mental health services. While Medicare Advantage plans must cover the same services as Original Medicare, their cost-sharing structures can differ significantly.

Medigap policies (Medicare Supplement Insurance) can help cover some of the out-of-pocket expenses associated with Original Medicare, such as deductibles, copayments, and coinsurance. While Medigap does not offer standalone mental health coverage, it can reduce the financial burden of costs that Original Medicare does not cover.

Finding a Covered Cognitive Behavioral Therapy Provider

Locating a Cognitive Behavioral Therapy provider who accepts Medicare is a practical step for beneficiaries. A primary care physician can often provide referrals or recommendations for mental health professionals within the Medicare network.

Beneficiaries can also utilize official Medicare resources to find covered providers. The “Find a Doctor” tool on Medicare.gov allows users to search for various types of Medicare providers, including mental health specialists, by location. It is important to verify that the provider accepts Medicare assignment, meaning they agree to accept the Medicare-approved amount as full payment.

For those with Medicare Advantage Plans, reviewing the plan’s specific provider directory is recommended. These private plans often have their own networks of approved healthcare professionals. Confirming that the therapist is in-network can help ensure the lowest out-of-pocket costs.