Key Takeaways

• Medicare now covers a broader range of therapy services in 2025, including sessions with marriage and family therapists and mental health counselors.

• Getting started with Medicare-covered therapy involves knowing your coverage type, understanding provider eligibility, and meeting basic requirements.

Why Medicare Now Plays a Bigger Role in Your Mental Health

In 2025, your Medicare benefits go beyond hospital stays and routine check-ups. You now have access to expanded mental health care, including therapy sessions that can address anxiety, depression, grief, trauma, and more. For many, this coverage can be a lifeline—but only if you know how to use it.

Recent policy changes have widened access to outpatient therapy, made telehealth options permanent, and added more types of licensed providers to the Medicare-approved list. Yet many Medicare beneficiaries are still unaware that these options exist, or unsure how to begin.

This article breaks it down clearly, so you can take advantage of the help you’re entitled to.

What Counts as a Covered Therapy Session Under Medicare

Medicare covers a variety of mental health therapy services, primarily through Part B (Medical Insurance). These include:

• Individual and group therapy

• Psychiatric evaluations and diagnostic interviews

• Medication management

• Cognitive behavioral therapy (CBT) and other evidence-based therapies

• Telehealth therapy visits

Starting in 2024, Medicare also began covering therapy sessions provided by:

• Licensed Marriage and Family Therapists (LMFTs)

• Licensed Mental Health Counselors (MHCs)

This change is particularly significant in 2025 because it greatly expands the network of available therapists.

Do You Need a Diagnosis to Qualify?

Yes. Medicare typically requires that therapy services be “medically necessary.” This means you must have a diagnosed mental health condition such as:

• Major depressive disorder

• Anxiety disorders

• Post-traumatic stress disorder (PTSD)

• Substance use disorders

• Bipolar disorder

• Schizophrenia

The diagnosis is made by a physician, psychiatrist, clinical psychologist, or other qualified provider. Preventive screenings for depression or substance use, however, do not require a prior diagnosis and are also covered.

What You Pay for Medicare-Covered Therapy in 2025

Under Medicare Part B in 2025, you pay:

• The annual Part B deductible: $257

• Then 20% of the Medicare-approved amount for outpatient therapy sessions

If you have a Medicare Supplement (Medigap) plan, it may cover some or all of that 20%. If you’re enrolled in a Medicare Advantage plan, your costs and coverage rules may differ, depending on your plan’s structure.

The $2,000 annual out-of-pocket cap under Medicare Part D applies to prescription drugs, including psychiatric medications, which can be prescribed as part of therapy.

How to Start: Step-by-Step Process

1. Confirm Your Coverage Type

• If you have Original Medicare, therapy is usually billed under Part B.

• If you have Medicare Advantage (Part C), your plan will handle mental health services. You must follow their rules on referrals and provider networks.

2. Get a Referral (If Needed)

Original Medicare does not require a referral to see a mental health provider. But Medicare Advantage plans may require one, especially if the provider is outside the network.

Check with your plan or call the number on your card to be sure.

3. Find a Medicare-Approved Therapist

In 2025, the list of approved providers includes:

• Psychiatrists

• Clinical psychologists

• Clinical social workers

• Nurse practitioners with mental health specialties

• Licensed mental health counselors (MHCs)

• Marriage and family therapists (LMFTs)

Your provider must accept Medicare assignment, meaning they agree to be paid directly by Medicare and not bill you more than the approved amount.

4. Schedule and Attend Your First Appointment

You can choose:

• In-person visits, usually at a clinic, therapist’s office, or hospital outpatient center

• Telehealth therapy, now permanently covered under Medicare if it’s audio-visual and provided by an approved provider

Just note: Starting October 1, 2025, Medicare requires at least one in-person visit every 12 months for telehealth therapy users, unless an exemption applies.

Where You Can Receive Services

Medicare pays for outpatient mental health services delivered in:

• Doctor’s or therapist’s offices

• Hospital outpatient departments

• Community mental health centers

• Your home (for telehealth)

• Rural health clinics and federally qualified health centers

For inpatient mental health care, Medicare Part A covers up to 190 lifetime days in a psychiatric hospital. However, most routine therapy is handled on an outpatient basis through Part B.

What About Preventive Mental Health Services?

Medicare recognizes the importance of early detection. Preventive mental health services in 2025 include:

• Annual depression screening

• Substance use assessment

• Alcohol misuse counseling (up to four sessions per year)

• Welcome to Medicare and Annual Wellness Visits, which can assess mental health risks and refer you to therapy

These services are often covered at no cost to you, if the provider accepts Medicare assignment and the visit meets preventive criteria.

Prescription Medication and Therapy Together

For many conditions, therapy and medication go hand in hand. Medicare Part D covers outpatient prescription drugs, including psychiatric medications such as:

• Antidepressants

• Anti-anxiety medications

• Mood stabilizers

• Antipsychotics

If your therapy provider prescribes medication, it must be filled through a Part D plan or Medicare Advantage plan with drug coverage. In 2025, your drug costs will be capped at $2,000 annually.

What to Do if You Can’t Find a Provider

Unfortunately, not every therapist accepts Medicare, and this remains a barrier to access in some areas. If you’re having trouble:

• Search the Medicare.gov provider directory

• Call your local State Health Insurance Assistance Program (SHIP) for help

• Ask your primary care provider to help refer you to a Medicare-participating therapist

• Explore telehealth options to widen your reach, especially in rural or underserved areas

Does Medicare Cover Grief or Relationship Counseling?

Yes, if it’s considered medically necessary. While grief and relationship issues aren’t diagnoses themselves, therapy for these concerns may be covered if they contribute to or stem from a mental health condition such as depression or anxiety.

You can also receive couples or family counseling when it’s part of a treatment plan for a covered individual with a mental health diagnosis.

How Often Can You Receive Therapy?

There is no hard limit on the number of therapy sessions per year. Medicare will cover ongoing therapy as long as:

• The therapy is considered medically necessary

• The provider documents progress and treatment plans

• The therapy is provided by an approved provider

Your plan may review therapy frequency periodically. Long-term therapy is possible, but it’s often subject to medical necessity evaluations.

What If You Need Crisis Services?

Medicare also covers partial hospitalization programs (PHP) and intensive outpatient programs (IOP) for people in crisis or those requiring more structured therapy than standard outpatient care.

These programs include multiple therapy sessions per week, medication management, and structured group counseling. You will typically need:

• A referral from a physician or mental health provider

• A diagnosis and treatment plan

• Confirmation that the facility is Medicare-approved

Costs are similar to outpatient therapy under Part B: 20% coinsurance after the deductible.

Don’t Delay Starting Therapy if You Need It

Many people delay therapy because of confusion around costs, fear of stigma, or not knowing where to begin. But Medicare in 2025 has made it much easier to start and continue mental health care.

You deserve access to care that supports your emotional and mental wellbeing. Whether you’re dealing with long-term depression or recent life changes, help is within reach if you take the first step.

Get Personalized Help Finding the Right Path

Mental health care under Medicare in 2025 is broader and more accessible than ever. From therapy and medication to preventive care and crisis programs, your benefits can support your emotional health—but only if you use them.

If you’re unsure about your coverage, costs, or how to find a therapist who accepts Medicare, speak with a licensed agent listed on this website. They can help you understand your options and connect you with the right care.