Does Medicare cover therapy? Costs, who you can see and how to find a therapist

Does Medicare cover therapy?

Yes. Medicare Part B covers outpatient mental health care, including:

• individual and group psychotherapy
• family counseling, when the main goal is to help with your treatment
• psychiatric evaluations
• medication management
• diagnostic tests
• one depression screening a year

The yearly depression screening has to happen in a primary care office or clinic that can provide follow-up care and referrals. You pay nothing for it if the provider accepts assignment, which is explained below.

Part A covers inpatient mental health care in a hospital. Part D covers prescription drugs.

What therapy costs with Original Medicare

For 2026:

• The Part B deductible is $283 for the year. You pay the full Medicare-approved amount for covered services until you’ve met it.
• After that, you usually pay 20% of the Medicare-approved amount for each therapy visit.
• The standard Part B premium is $202.90 a month. People with higher incomes pay more.

Here’s an example with made-up numbers. Say the Medicare-approved amount for a session is $100 and you’ve already met your deductible. You’d pay $20, and Medicare would pay $80.

If you have a Medigap (Medicare Supplement) policy, it may pay some or all of that 20%. Medicare usually announces the next year’s premium and deductible each fall, so check medicare.gov for 2027 figures.

Who can provide therapy under Medicare

Medicare pays for psychotherapy from doctors and certain other licensed professionals, as state law allows. That includes:

• psychiatrists and other doctors
• clinical psychologists
• clinical social workers
• nurse practitioners
• physician assistants
• clinical nurse specialists
• marriage and family therapists, since January 1, 2024
• mental health counselors, since January 1, 2024

That last change came from a 2023 federal law. Before 2024, licensed professional counselors and marriage and family therapists couldn’t bill Medicare at all, which left many Medicare members with few choices. Counselors can now enroll, but not all of them have, so you still need to ask.

Ask whether the therapist accepts Medicare

This is the most important question to ask, because therapists fall into three groups.

Participating providers accept assignment. They take Medicare’s approved amount as full payment. You pay only your deductible and 20% coinsurance.

Non-participating providers accept Medicare but not always the approved amount. They can charge up to 15% more than the approved amount. This extra is called the limiting charge.

Opt-out providers have formally left Medicare. If you see one, you sign a private contract, you pay the full fee yourself, and you can’t send the claim to Medicare. Many private practice therapists have opted out, so ask before your first session. Medicare.gov has a lookup for providers who’ve opted out.

A simple way to ask:

“Are you enrolled in Medicare, and do you accept assignment?”

Telehealth therapy with Medicare

Medicare covers mental health care by telehealth, including sessions from your home. Many therapists see Medicare clients by telehealth, and some sessions can be audio-only when that’s what you can use.

A rule that would require an in-person visit before home telehealth mental health care, and then once a year, has been delayed several times. As of November 2026 it isn’t in effect. People who started home telehealth mental health care on or before January 30, 2026, are exempt from the first in-person visit. Ask your therapist whether anything has changed when you start.

The therapist has to be licensed in the state where you are during the session.

Mental health checks at your primary care visit

Two Medicare visits with your primary care provider include mental health:

• The yearly depression screening, covered at no cost when the provider accepts assignment, as long as it’s done in a primary care setting that can arrange follow-up care.
• The Annual Wellness Visit, available once you’ve had Part B for more than 12 months. It includes a review of risk factors for depression. The first one also asks about any past or current depression or other mood disorders. There’s no copay for the visit itself, though tests ordered during it can have costs.

If you’re not sure where to start, either visit is a reasonable first step. Your primary care provider can refer you to a therapist or psychiatric clinician who takes Medicare.

When you need more than weekly therapy

Medicare also covers more intensive outpatient care, for when weekly sessions aren’t enough but you don’t need a hospital stay.

• Intensive outpatient programs (IOP) have been covered since January 1, 2024. They’re offered by hospital outpatient departments, community mental health centers, federally qualified health centers and rural health clinics. When the coverage started, CMS warned that not every program would be enrolled with Medicare right away, so ask the program directly.
• Partial hospitalization programs are a step more intensive, with treatment most of the day, several days a week.

If you or someone you’re with is in crisis, call or text 988, the Suicide and Crisis Lifeline, at any time.

Medigap and therapy

If you have Original Medicare with a Medigap policy, the policy may pay some or all of the 20% coinsurance for therapy. Which part depends on your Medigap plan letter.

One example is Medigap Plan N. It can charge a copay of up to $20 for some office visits. CMS’s guidance for Plan N says telehealth visits don’t count as office visits for that copay. Check your policy, or call the insurer that sold it, to see what you’d pay for a therapy session.

If you have a Medicare Advantage plan

A Medicare Advantage plan, sometimes called Part C, is sold by a private insurer and replaces Original Medicare for most of your care. It has to cover everything Original Medicare covers, but the rules for getting it can differ.

• Networks. Most plans have a network, and many pay little or nothing out of network.
• Copays. Many plans charge a flat copay for therapy instead of 20%.
• Approvals. Some plans need approval or a referral for some services.
• A behavioral health company may manage the benefit, so check the back of your card for a separate number.

Your plan’s Evidence of Coverage lists your outpatient mental health copay and any approval rules. Check your plan’s directory, or call, to confirm a therapist is in network.

Our insurer guides cover several Medicare Advantage plans in our states, including UnitedHealthcare, Aetna and Cigna’s former plans, now HealthSpring.

Open enrollment ends December 7

Medicare’s open enrollment for 2027 runs from October 15 to December 7, 2026. During that window you can switch between Original Medicare and Medicare Advantage, change Advantage plans, or change drug plans. Changes start January 1, 2027.

If therapy matters to you, check before you switch:

• Is my current therapist in the new plan’s network?
• What’s the copay for an outpatient mental health visit?
• Does the plan need approval or a referral for therapy?
• Are telehealth sessions covered the same way as office visits?

What Medicare usually doesn’t cover

• Couples counseling for relationship problems on their own. Family or couples sessions are covered only when the main goal is helping with your treatment.
• Life coaching and other services that aren’t treatment for a condition.
• Care from opt-out providers, as explained above.

How to find a therapist who takes Medicare

1. Use Medicare’s Care Compare at medicare.gov to search for psychiatrists, clinical psychologists and other professionals near you. If you have Medicare Advantage, use your plan’s directory instead.
2. Then search LunahUP by city, with telehealth included. No profile lists Medicare yet, so ask each practice: “Are you enrolled in Medicare, and do you accept assignment?”
3. Ask your primary care doctor. They may know therapists who take Medicare, and some primary care practices offer behavioral health care in the same office.

If Medicare denies a claim

With Original Medicare, your Medicare Summary Notice explains any denied claim and how to appeal. With Medicare Advantage, your plan’s Evidence of Coverage explains the appeal steps. Your therapist’s office can often help.

Questions to ask

Ask the therapist:

• “Are you enrolled in Medicare, and do you accept assignment?”
• “Do you see Medicare clients by telehealth?”
• “If I have Medicare Advantage, are you in my plan’s network?”

Ask your Medicare Advantage plan:

• “What’s my copay for outpatient therapy?”
• “Do I need a referral or approval?”
• “Is [therapist’s name] in network?”
• “Does another company manage my behavioral health benefits?”

The short version

• Medicare Part B covers outpatient therapy for a mental health condition.
• In 2026 you pay the $283 deductible, then usually 20% of the approved amount per visit.
• Since 2024, Medicare pays licensed marriage and family therapists and mental health counselors.
• Ask whether a therapist accepts assignment. Opt-out therapists can’t bill Medicare.
• Telehealth from home is covered. The in-person visit rule has been delayed and isn’t in effect as of November 2026.
• Medicare Advantage plans have networks and their own copays.
• Open enrollment for 2027 ends December 7, 2026.