For Medicare Enrollees, Telehealth Is Still an Option for Mental Health—but Only Under These Rules

Key Takeaways

• Medicare continues to cover telehealth mental health services in 2025, but specific requirements apply, especially for ongoing care and types of providers.

• An annual in-person visit is now required starting October 1, 2025, unless you qualify for an exception.

Telehealth and Mental Health: Where Medicare Stands in 2025

Mental health remains a national concern, and access to timely care is critical. If you’re enrolled in Medicare, you still have the option to receive mental health services via telehealth in 2025. However, this coverage comes with rules you need to follow. Knowing what Medicare covers, who qualifies, and what restrictions apply can make the difference between seamless care and unnecessary delays.

Let’s break down what Medicare offers in terms of telehealth mental health services and what rules you need to keep in mind as the policies evolve.

The Basics of Medicare Telehealth Coverage

Medicare first began expanding telehealth access widely during the COVID-19 pandemic. Many of those temporary flexibilities have now been either modified or made permanent.

In 2025, Medicare covers telehealth services for mental health care under both Original Medicare and Medicare Advantage. This includes coverage for:

• Psychiatric diagnostic evaluations

• Individual and group psychotherapy

• Medication management

• Counseling services

• Care from psychiatrists, psychologists, clinical social workers, and now licensed mental health counselors and marriage and family therapists

Coverage applies whether you’re receiving care in a rural or urban area, at home or at another approved originating site.

Who Can Provide Telehealth Mental Health Services

Starting in 2024, Medicare expanded the list of providers eligible to offer telehealth mental health services. As of 2025, you can receive covered telehealth services from:

• Psychiatrists

• Clinical psychologists

• Clinical social workers

• Nurse practitioners (NPs)

• Physician assistants (PAs)

• Clinical nurse specialists

• Licensed marriage and family therapists (LMFTs)

• Licensed mental health counselors (LMHCs)

This broader list means more access, especially in underserved areas. However, the provider must accept Medicare assignment.

In-Person Visit Requirement: What Changes in October 2025

A key change is coming into effect starting October 1, 2025: Medicare now requires that you have an in-person visit with your mental health provider at least once every 12 months to continue receiving telehealth mental health services.

This applies to:

• Ongoing therapy

• Medication management

• Counseling sessions

There are exceptions:

• If you have a documented hardship (e.g., physical disability or remote location) that prevents in-person visits

• If you receive care through a Medicare Advantage plan with its own approved alternative system

Your provider must document the reason for any exception in your medical record.

Where You Can Receive Telehealth Services

In 2025, Medicare allows you to receive covered mental health telehealth services from your home. This is a permanent policy.

Previously, Medicare restricted telehealth services to specific geographic areas and facility types. Those limits no longer apply for mental health care.

You can receive telehealth services at:

• Your residence

• A family member’s home (if temporarily residing there)

• An assisted living facility or group home

• Any private location where you have secure, internet-connected access

Types of Communication Platforms Allowed

Medicare covers telehealth mental health care delivered via:

• Two-way, real-time audiovisual communication (e.g., Zoom, FaceTime, Skype for Business)

• Audio-only communication, if video is not available or practical for you

Audio-only telehealth remains an option in 2025, especially for:

• Rural or older patients who may not have access to video technology

• Services like talk therapy or counseling

However, your provider must still be able to deliver standard-of-care treatment over the phone. Documentation of why audio-only was used is required.

Copayments and Cost Sharing

Under Medicare Part B, outpatient mental health telehealth services are typically subject to:

• The annual Part B deductible, which is $257 in 2025

• 20% coinsurance of the Medicare-approved amount

If you have a Medigap policy or a Medicare Advantage plan, your out-of-pocket costs may be reduced. Always confirm the details with your plan.

Special Coverage for Substance Use Disorders

Mental health coverage under Medicare also includes services for substance use disorders (SUD), which can be delivered via telehealth.

Covered services include:

• Counseling and psychotherapy for SUD

• Medication-assisted treatment (MAT)

• Telehealth visits with addiction specialists

• Structured outpatient programs (if eligible)

These services follow the same telehealth rules, including the annual in-person requirement beginning in October 2025.

Coverage Under Medicare Advantage

Medicare Advantage plans are required to cover everything Original Medicare covers, including telehealth for mental health. However, they may impose:

• Prior authorizations

• Limited provider networks

• Different telehealth platforms

They may also offer additional services, such as care coordination or integrated mental and physical health programs. Be sure to review your plan’s Evidence of Coverage document to understand the specific benefits and restrictions.

When to Expect a Mid-Year Check-in

Beginning in 2025, Medicare Advantage plans are now required to send a Mid-Year Enrollee Notification of Unused Supplemental Benefits by July 31. If your plan includes supplemental mental health services and you haven’t used them, this notice will inform you.

This could be helpful in reminding you to:

• Book a therapy session

• Use a counseling benefit

• Explore mental wellness programs

This requirement is intended to boost awareness and encourage care utilization.

Limitations You Should Know

Despite improvements, there are still limitations in Medicare’s telehealth mental health coverage:

• No 24/7 coverage: Sessions must be scheduled. Crisis services may not be included.

• Not all providers offer telehealth: Even if Medicare allows it, your provider must have telehealth systems in place.

• Privacy matters: You must be in a secure location for services to qualify. Public or noisy settings may be disallowed.

• Annual visit enforcement: Missing your annual in-person visit (after October 2025) without a valid exception may suspend your telehealth eligibility.

Getting Started With Telehealth Mental Health Care

If you’re interested in receiving mental health care through telehealth under Medicare, here are the steps you should follow:

1. Confirm eligibility: Make sure you’re enrolled in Medicare Part B or a Medicare Advantage plan.

2. Find a provider: Look for a Medicare-assigned mental health provider who offers telehealth.

3. Choose your platform: Ask whether they use video, phone, or both.

4. Check costs: Ask about deductibles, coinsurance, and coverage for in-person visits.

5. Schedule your first appointment: Ensure documentation begins to meet the in-person requirement if your care continues beyond October 2025.

What’s Ahead for 2026 and Beyond

While 2025 offers stable access to telehealth mental health care, additional changes could follow in future years. Policymakers continue to evaluate:

• Expanding audio-only services

• Reducing the burden of in-person visit documentation

• Increasing provider availability

• Simplifying billing and coding for telehealth

Staying updated with Medicare rules is critical to maintaining access and continuity of care.

What These Rules Mean for You

Telehealth is no longer a temporary benefit. For Medicare enrollees in 2025, it’s a legitimate and effective way to receive mental health care. However, you need to stay informed about the rules surrounding provider qualifications, visit requirements, and technology options.

If you want clarity on how these telehealth benefits apply to your situation, talk to a licensed agent listed on this website. They can help you explore your plan options, understand Medicare-covered benefits, and ensure you continue receiving the support you need.