How Does Medicare Cover Psychotherapy?

Mental well-being is a fundamental aspect of overall health, especially for Medicare beneficiaries. Psychotherapy, often referred to as talk therapy, addresses emotional difficulties and promotes mental health. Medicare, the federal health insurance program, provides coverage for various psychotherapy services, helping eligible individuals access needed mental health support.

Understanding Medicare Psychotherapy Coverage

Medicare covers psychotherapy under different parts of the program, depending on the care setting. Outpatient mental health services, including most psychotherapy, fall under Medicare Part B (Medical Insurance). Part B covers visits with qualified professionals such as psychiatrists, psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, physician assistants, licensed marriage and family therapists, and mental health counselors. These services are typically provided in a doctor’s office, clinic, or hospital outpatient department.

For inpatient care, Medicare Part A (Hospital Insurance) covers mental health services. This can occur in a general hospital or a psychiatric hospital. Part A covers services like a semi-private room, meals, nursing care, and therapy during an inpatient stay. There is a lifetime limit of 190 days for care in a freestanding psychiatric hospital.

Medicare Advantage Plans (Part C) are offered by private companies approved by Medicare and must cover at least all services Original Medicare (Parts A and B) covers. These plans may also offer additional benefits, different cost-sharing structures, or network rules for mental health services. Medicare Part D provides prescription drug coverage and covers medications prescribed as part of mental health treatment, such as antidepressants and antipsychotics, but does not cover psychotherapy itself.

Covered Mental Health Services

Medicare covers a wide range of medically necessary psychotherapy services designed to diagnose and treat mental health conditions. Common forms of therapy include individual psychotherapy, where a patient meets one-on-one with a mental health professional. Group therapy sessions are also covered, offering a setting for shared experiences and support among multiple participants.

Family counseling is covered if its primary purpose is to help with the patient’s treatment and is medically necessary. Diagnostic evaluations are also included as initial assessments to determine a diagnosis and create a treatment plan. These services address various conditions, such as depression, anxiety, trauma, and substance use disorders. All covered services must be provided by a Medicare-approved provider to ensure eligibility.

Patient Costs for Psychotherapy

Medicare beneficiaries have financial responsibilities for psychotherapy services. For most outpatient mental health services covered under Part B, patients are responsible for a deductible and a coinsurance. In 2025, the Part B deductible is $257. After meeting this deductible, beneficiaries pay 20% of the Medicare-approved amount for their services.

This 20% coinsurance applies to various services, including therapy sessions, psychiatric evaluations, and medication management visits. An annual depression screening is fully covered without a coinsurance or deductible if the healthcare provider accepts Medicare assignment. Medicare Advantage Plans may have different cost-sharing structures, such as varying copayments or coinsurance amounts, and and often include out-of-pocket maximums that can limit a beneficiary’s annual spending.

Accessing Psychotherapy Services

Accessing covered psychotherapy services involves a few practical steps. It is important to choose a provider who accepts Medicare assignment to ensure coverage and manage out-of-pocket costs. Providers who accept assignment agree to accept Medicare’s approved amount as full payment for services.

Beneficiaries can find Medicare-approved providers by using Medicare’s online Physician Compare tool or by calling 1-800-MEDICARE. Referrals from a primary care physician may be helpful, depending on the specific Medicare plan. All services must be medically necessary, meaning the provider must document that the psychotherapy is appropriate for the patient’s condition and meets accepted standards of medical practice. This documentation should include the diagnosis, symptoms, treatment plan, and progress to support the ongoing need for therapy.