Medicare Mental Health Coverage: Therapy, Psychiatry, and Inpatient Care

Depression, anxiety, and other mental health conditions are common among Medicare beneficiaries -- yet mental health care is often underutilized due to stigma, cost concerns, or lack of awareness about coverage. Medicare covers a comprehensive range of mental health services. Here is what is available.

Medicare Part B covers outpatient mental health care at 80% after the Part B deductible -- the same cost-sharing as other medical services.

Covered outpatient services:

• Individual psychotherapy (with a psychiatrist, psychologist, licensed clinical social worker, or other qualified mental health professional)
• Group psychotherapy
• Family psychotherapy (when the purpose is to treat the patient's condition)
• Psychiatric evaluation and medication management
• Psychological testing
• Partial hospitalization programs (intensive outpatient mental health treatment)

Covered providers:

• Psychiatrists
• Psychologists
• Licensed clinical social workers (LCSWs)
• Licensed professional counselors (LPCs) -- covered since 2024
• Marriage and family therapists -- covered since 2024
• Nurse practitioners and physician assistants with mental health training

Cost: 20% coinsurance after the Part B deductible. Medigap Plan G covers this 20%.

Medicare covers preventive mental health screenings at no cost:

Depression screening: Annual screening in a primary care setting -- no cost-sharing. If screening is positive, your doctor can refer you to mental health treatment.

Alcohol misuse screening and counseling: Annual screening plus up to 4 brief counseling sessions per year for people who screen positive -- at no cost.

Medicare Part A covers inpatient psychiatric hospitalization -- but with an important limitation:

Psychiatric hospital benefit: Medicare covers up to 190 lifetime days in a freestanding psychiatric hospital. This is a lifetime limit -- once used, it cannot be renewed.

General hospital psychiatric unit: Inpatient psychiatric care in a general hospital (not a freestanding psychiatric hospital) is covered under the standard Part A benefit -- no 190-day lifetime limit applies.

Cost: Standard Part A cost-sharing (deductible per benefit period). Medigap Plan G covers the deductible.

Medicare covers substance use disorder treatment:

Outpatient treatment (Part B):

• Individual and group counseling
• Opioid use disorder treatment (including medication-assisted treatment with buprenorphine/Suboxone, methadone via opioid treatment programs)
• Alcohol use disorder treatment
• Intensive outpatient programs

Inpatient treatment (Part A): Covered when medically necessary, subject to standard Part A cost-sharing.

Opioid Treatment Programs (OTPs): Medicare covers a bundled payment for opioid use disorder treatment at certified OTPs -- including counseling, toxicology testing, and medications (methadone, buprenorphine).

Medicare significantly expanded telehealth coverage for mental health -- and many expansions have been made permanent:

• Individual and group psychotherapy via video
• Psychiatric evaluation and medication management via video
• Audio-only (phone) mental health visits for patients who cannot use video technology
• Initial in-person visit requirement for telehealth mental health (waived through end of 2024 PHE extensions)

Telehealth mental health services are particularly valuable for homebound beneficiaries, those in rural areas, and those with transportation challenges.

Use the Medicare Care Compare tool at medicare.gov/care-compare to find Medicare-enrolled mental health providers. You can also call 1-800-MEDICARE or contact your State Health Insurance Assistance Program (SHINE in Florida) for help finding providers.

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.