Key Takeaways
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Medicare covers a wide range of outpatient and inpatient mental health services, including therapy, counseling, and psychiatric care.
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Even with expanded coverage in 2025, many Medicare beneficiaries still struggle to find counselors who accept Medicare due to low reimbursement rates, provider shortages, and administrative barriers.
Medicare Covers Therapy Services in 2025
As of 2025, Medicare offers significant support for mental health care. If you’re enrolled in Medicare, you can receive outpatient therapy, psychiatric evaluations, and medication management under Part B. Inpatient psychiatric care is covered under Part A. Recent improvements also include coverage for services from marriage and family therapists (MFTs) and mental health counselors (MHCs), which officially began in January 2024.
Covered Mental Health Services Include:
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Individual and group therapy
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Family counseling (when part of your treatment plan)
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Initial diagnostic evaluations
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Medication management and psychiatric monitoring
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Partial hospitalization and intensive outpatient programs
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Telehealth mental health visits (with an in-person visit every 12 months starting October 2025)
This expansion is part of Medicare’s broader strategy to address the growing mental health needs of older adults and people with disabilities.
Your Out-of-Pocket Costs for Therapy
Before seeking care, it’s important to understand how much you may need to pay. Under Medicare Part B in 2025:
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You must first meet the $257 annual deductible.
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After the deductible, Medicare pays 80% of the approved amount.
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You are responsible for the remaining 20% coinsurance.
Some Medicare Supplement plans may cover the coinsurance, but not all beneficiaries have them. If you have Medicare Advantage, your coinsurance or copayments vary depending on your plan. However, all plans must cover mental health services at least as well as Original Medicare.
The 2025 Provider Expansion Is Not Solving the Shortage
Although coverage has expanded, actually finding a mental health professional who accepts Medicare remains difficult. This is especially true in rural communities, low-income areas, and even suburban regions.
What’s Causing the Shortage?
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Low Medicare reimbursement rates: Many mental health providers feel the pay from Medicare is too low to be sustainable.
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Administrative burden: Billing Medicare involves paperwork, audits, and strict compliance standards that many private therapists prefer to avoid.
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Provider preference: Many therapists opt to work only with privately insured clients or take cash-only clients to reduce operational costs.
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Workforce shortage: There simply aren’t enough licensed mental health professionals to meet growing demand, especially those trained in geriatric mental health.
Where to Start When Searching for a Provider
If you’re looking for a Medicare-participating counselor, it’s important to take a structured approach.
1. Use Medicare’s Online Tool
Medicare.gov offers a tool called “Care Compare” where you can look up therapists, psychologists, and psychiatrists by ZIP code. Filter results to show only those who accept Medicare.
2. Call the Provider Directly
Even if a provider is listed online, call their office to confirm they currently accept Medicare. Some may have changed their billing policy or closed their panels to new Medicare patients.
3. Ask for Referrals
Speak to your primary care provider. They may have local mental health professionals in their network who accept Medicare or can recommend community mental health centers that do.
4. Explore Telehealth Options
Many Medicare-accepting therapists offer video or phone sessions. This can expand your options beyond your geographic region. Telehealth services remain covered permanently, although an in-person visit is required once every 12 months starting in October 2025.
New Providers Covered by Medicare Since 2024
A major improvement is that Medicare now pays for services from licensed mental health counselors and marriage and family therapists. These professionals often serve in underserved areas and previously were not reimbursed by Medicare.
This change went into effect on January 1, 2024, and continues in 2025. The inclusion of these provider types is helping slowly improve access, especially for those who couldn’t find psychologists or psychiatrists who accept Medicare.
Covered Providers Now Include:
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Psychiatrists
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Clinical psychologists
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Clinical social workers
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Nurse practitioners and physician assistants (specializing in psychiatry)
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Mental health counselors (MHCs)
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Marriage and family therapists (MFTs)
Even so, many of these providers are still reluctant to enroll due to the reimbursement and paperwork issues mentioned earlier.
Understanding Medicare’s 12-Month In-Person Visit Requirement
In 2025, Medicare continues to cover mental health telehealth visits. However, to maintain eligibility for telehealth services, you must:
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Have an in-person, face-to-face appointment every 12 months with the provider furnishing your telehealth therapy.
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This requirement begins October 1, 2025, and applies to most outpatient mental health telehealth services.
Exceptions apply in cases where in-person visits are not feasible due to hardship, travel barriers, or mobility issues. But these exceptions must be documented.
Inpatient Psychiatric Coverage Has a Lifetime Limit
Medicare Part A covers inpatient psychiatric hospitalization, but there is a 190-day lifetime limit on care in a freestanding psychiatric hospital. This cap does not apply to psychiatric care provided in a general hospital.
What’s Included:
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Room and board
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Nursing care
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Medications and psychiatric services
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Lab tests
Your cost-sharing in 2025 includes:
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$1,676 deductible per benefit period
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Daily coinsurance for longer stays ($419/day for days 61-90, $838/day for lifetime reserve days)
It’s essential to be aware of this limit if you’ve had previous psychiatric hospital stays in a freestanding psychiatric facility.
Watch Out for Non-Participating Providers
Even if a provider is licensed and qualified, not all accept Medicare. Here’s what you need to know:
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Participating providers accept Medicare’s approved amount as full payment.
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Non-participating providers may accept Medicare but can charge up to 15% more than the approved amount.
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Opt-out providers do not bill Medicare at all. If you see one, you pay the full cost.
Make sure to ask upfront before scheduling your first appointment. Otherwise, you may face unexpected costs.
Medicare Advantage Mental Health Coverage in 2025
All Medicare Advantage plans must include the same core mental health benefits offered by Original Medicare. However, plans may:
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Require prior authorization before therapy begins
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Use network restrictions that limit your choice of therapists
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Offer additional services such as wellness programs or case management
If you’re enrolled in a Medicare Advantage plan, call your plan’s customer service to ask for a list of in-network mental health professionals. And always confirm directly with the provider that they are still accepting your plan.
What to Do If You Can’t Find a Provider
Unfortunately, many beneficiaries are left without access, even when they meet all Medicare requirements. If you’re having trouble:
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Call Medicare at 1-800-MEDICARE to ask for local resources.
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Contact your State Health Insurance Assistance Program (SHIP) for free counseling.
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Use community-based services, like county mental health departments or clinics funded by federal grants.
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Ask your doctor to help advocate on your behalf or refer you to a Medicare-accepting provider.
Telehealth Is Helping, But Gaps Remain
Telehealth options have helped alleviate some of the access issues, particularly in rural areas. However, some beneficiaries struggle with:
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Poor internet connectivity
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Lack of devices or tech knowledge
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Discomfort discussing mental health over video or phone
And with the 12-month in-person requirement reinstated in October 2025, access may shrink again unless flexibility is expanded.
Better Access Starts With Better Information
One of the biggest barriers is lack of awareness. You may not know which services are covered, or which providers to contact. A licensed agent listed on this website can help you:
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Understand your Medicare mental health benefits
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Identify covered services in your area
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Explore your plan’s mental health network and requirements
Don’t give up if the first few calls lead nowhere. Persistence and the right guidance can make a difference in getting the care you need.
Mental Health Support Is There, But You May Have to Work for It
Medicare in 2025 covers more mental health services than ever before. But that doesn’t mean the care is easy to access. From reimbursement barriers to provider shortages, there are many reasons why you may find it difficult to schedule a therapy session.
Still, you have options. Whether it’s searching online, calling Medicare, speaking with your doctor, or exploring telehealth, the support system does exist. For more help understanding your coverage or finding a participating provider, speak with a licensed agent listed on this website who can walk you through your choices.
