Starting October 2025, You’ll Need to Do This One Thing to Keep Using Telehealth Therapy

Key Takeaways

• Starting October 1, 2025, Medicare requires an in-person mental health visit at least once every 12 months to continue using telehealth for therapy and related services.

• Exceptions to this requirement exist, but you must meet specific conditions and document them properly to maintain telehealth access.

Why Medicare Is Changing Its Telehealth Rules

Medicare first expanded telehealth coverage for mental health services during the COVID-19 pandemic. This flexibility allowed you to receive therapy from home via video or phone, avoiding clinic visits while still getting the support you needed. Initially, this expansion was tied to the Public Health Emergency. But even after that emergency ended in 2023, Congress and the Centers for Medicare & Medicaid Services (CMS) extended many of these flexibilities until the end of 2024.

Now that we are in 2025, Medicare is finalizing its long-term policy on telehealth mental health coverage. And the clock is ticking: by October 1, 2025, if you’re still using telehealth for therapy or psychiatric services, you’ll need to meet the new face-to-face requirement to keep those sessions going without interruption.

What the New Requirement Says

To continue receiving mental health care through telehealth beyond October 1, 2025, you must:

• Have an in-person, face-to-face mental health visit with your provider at least once every 12 months.

• The visit must be with the same provider or a provider from the same practice.

• It must be documented in your medical record as having occurred within that 12-month timeframe.

You can still receive telehealth therapy if this condition is met. Medicare uses this rule to maintain quality and continuity of care.

Who This Affects

This rule applies to all Medicare beneficiaries who use telehealth for mental health care under Part B. This includes services such as:

• Individual or group psychotherapy

• Psychiatric diagnostic evaluation

• Medication management and psychiatric follow-ups

• Behavioral health integration

• Partial hospitalization and intensive outpatient services (when applicable through telehealth)

Whether you see a psychiatrist, psychologist, licensed clinical social worker, mental health counselor, or marriage and family therapist, this rule applies.

If you’ve been receiving care through audio-only (phone) sessions, you’re included too. Medicare continues to allow audio-only mental health visits, but the annual in-person visit is still required unless you qualify for an exemption.

What Counts as a Qualifying In-Person Visit

To satisfy the requirement:

• The visit must be in person, meaning you physically go to the clinic, hospital, or provider’s office.

• The provider must document it properly, indicating it was related to your mental health care and conducted within the past 12 months.

• If you switch to a different provider, the clock resets. You will need a new in-person visit with the new provider to resume telehealth services with them.

Are There Any Exceptions?

Yes, but they are limited and require documentation.

Medicare allows exceptions if you meet specific hardship conditions, such as:

• You have a severe physical or mental disability that makes it difficult to travel for an in-person visit.

• You live in a long-term care facility or are under home health care with mobility restrictions.

• You live in a rural or underserved area where access to in-person behavioral care is extremely limited.

If you qualify for one of these exceptions, your provider must document the reason in your medical record. It is not automatic. You still need to initiate the conversation and make sure the paperwork is complete.

What Happens If You Don’t Get the In-Person Visit?

If you fail to meet the 12-month in-person requirement, Medicare may stop covering your telehealth mental health visits. That means:

• You could be responsible for 100% of the cost of future virtual sessions.

• Your provider may cancel or reschedule telehealth appointments until the requirement is met.

• You risk interrupting a continuity of care that is essential to managing mental health conditions.

If you’ve had a face-to-face visit within the last 12 months, you’re already in compliance. But if your last in-person visit was before October 1, 2024, you must schedule a new one before October 1, 2025.

How to Prepare Now

You don’t have to wait until the last minute. You can act now to avoid any disruptions to your care. Here’s how:

• Check your last in-person mental health visit: Look at your calendar, patient portal, or call your provider’s office.

• Schedule your visit if needed: If you haven’t seen your provider in person within the past 12 months, book a visit now.

• Keep documentation: Ensure the visit is clearly documented in your chart and flagged as related to mental health care.

• Ask about exemptions early: If you believe you qualify for an exception, talk to your provider well in advance. Documentation is key.

Other Telehealth Services Aren’t Affected

This 12-month rule only applies to mental health services delivered via telehealth. If you use telehealth for:

• General medical consultations

• Follow-ups for chronic conditions

• Dermatology, cardiology, or other specialties

…this new rule does not apply. However, CMS may revise telehealth policies for other areas in the future, so it’s a good idea to stay informed.

Telehealth and Mental Health: A Lifeline for Many

Even though this requirement adds a step, Medicare is still committed to offering expanded mental health access through telehealth. In fact, 2025 continues to support:

• Permanent coverage for telehealth services provided in your home

• Ongoing access to audio-only therapy, when appropriate

• Inclusion of newly eligible providers like mental health counselors (MHCs) and marriage and family therapists (MFTs) as of 2024

Telehealth remains a valuable option for:

• Seniors with mobility issues

• Those with transportation barriers

• Individuals who prefer the comfort and privacy of home

This policy change doesn’t end those options. It simply adds a safeguard to ensure that remote care is backed by a trusted, in-person clinical relationship at least once a year.

What Mental Health Services Are Covered Under Medicare in 2025

Under Part B, Medicare covers a wide range of mental health services when provided by approved professionals:

• Psychiatric evaluations and diagnostic testing

• Psychotherapy (individual, group, or family)

• Medication management

• Crisis intervention services

• Substance use disorder treatment

• Care coordination

You pay 20% of the Medicare-approved amount for these services after meeting the annual Part B deductible of $257. If you have a Medigap plan, it may help cover these costs.

Under Part D, Medicare also covers many mental health medications. Starting in 2025, there is a $2,000 out-of-pocket maximum for prescription drugs. This can offer significant relief if you take psychiatric medications.

If you’re enrolled in a Medicare Advantage plan, you still receive these same mental health benefits, but you may have to follow plan-specific rules, like using in-network providers or obtaining prior authorization. Review your plan materials for exact details.

How Telehealth Fits into Broader Mental Health Access in 2025

In 2025, Medicare faces increasing demand for mental health services. Challenges include:

• A shortage of providers accepting Medicare

• Rural and underserved areas with few specialists

• Rising rates of depression, anxiety, and cognitive disorders in older adults

Telehealth helps address these challenges by expanding geographic access and reducing delays. It also allows you to connect with specialists outside your area without leaving home.

This makes the annual in-person visit more of a bridge than a barrier. Once you’ve had that visit, your virtual care can continue uninterrupted.

Staying Ahead of the October 2025 Deadline

Mark this date: October 1, 2025.

That’s when Medicare’s updated telehealth mental health rule officially takes effect. If you’ve already had your required in-person visit, you’re ready. If not, now is the time to:

• Contact your provider

• Review your visit history

• Schedule and complete the visit

This small step each year keeps the door open to continued access to therapy, psychiatric care, and mental wellness from the comfort of your home.

Take the Next Step to Protect Your Telehealth Access

Your mental health matters. And in 2025, Medicare is still supporting your right to care through telehealth. But to keep that access, it’s your responsibility to meet the annual in-person visit requirement or apply for an exemption if eligible.

Don’t risk losing your coverage for remote therapy sessions. Reach out to your provider now and schedule your visit. If you need help understanding your Medicare coverage or want personalized advice, speak with a licensed agent listed on this website who can walk you through your options.