Key Takeaways

• In 2025, Medicare now covers services provided by licensed marriage and family therapists (LMFTs) and mental health counselors (MHCs) under Part B, significantly expanding your options for outpatient mental health care.

• You must ensure the provider is Medicare-approved, and you will typically pay 20% of the Medicare-approved amount after meeting your annual Part B deductible.

Why This Change Matters in 2025

Before 2024, Medicare did not reimburse services delivered by LMFTs or MHCs, despite these professionals being trained and licensed to offer therapy for individuals, couples, and families. This gap left many Medicare beneficiaries, especially in underserved or rural areas, with limited access to specialized mental health care.

Starting January 1, 2024, Medicare officially began covering LMFT and MHC services under Part B. As we move through 2025, this expansion is more important than ever, allowing you greater flexibility in choosing a provider that suits your specific needs.

Who Can Now Provide Therapy Under Medicare

Medicare Part B currently covers outpatient mental health services, and with the new expansion, you can now receive services from the following professionals:

• Psychiatrists

• Clinical psychologists

• Clinical social workers (CSWs)

• Nurse practitioners and physician assistants

• Licensed Marriage and Family Therapists (LMFTs)

• Licensed Mental Health Counselors (MHCs)

This means if you are dealing with anxiety, depression, grief, family conflict, or caregiving stress, you can seek therapy from providers whose training specifically focuses on these relational dynamics.

What Marriage and Family Therapists Do

LMFTs specialize in evaluating and treating mental and emotional disorders within the context of marriage, couples, and family systems. Their approach is holistic and often emphasizes improving communication and relationships as a core strategy to enhance mental well-being.

Examples of issues LMFTs commonly address include:

• Couples conflict

• Caregiver burnout

• Family trauma or dysfunction

• Grief and loss

• Parent-child relationship issues

What This Means for Your Coverage in 2025

If you have Medicare Part B, your outpatient mental health services now include therapy from LMFTs and MHCs. These services are covered under the same general structure as therapy from other behavioral health providers:

• Deductible: You first pay the Medicare Part B annual deductible, which is $257 in 2025.

• Coinsurance: After meeting the deductible, Medicare covers 80% of the approved amount. You are responsible for the remaining 20%.

• Provider Requirements: The LMFT or MHC must be Medicare-enrolled, meet all federal licensure and credentialing requirements, and bill under their National Provider Identifier (NPI).

Where You Can Receive These Services

You can receive covered mental health services from LMFTs and MHCs in a variety of outpatient settings, such as:

• Individual or group private practice offices

• Community mental health centers

• Hospital outpatient departments

• Federally qualified health centers (FQHCs)

• Rural health clinics (RHCs)

• Telehealth (with conditions)

In 2025, Medicare permanently covers mental health telehealth visits, but to continue using this benefit from home, you must have at least one in-person appointment every 12 months with the provider, unless you qualify for an exception.

Eligibility and Enrollment Reminders

To access LMFT or MHC services under Medicare, the following must apply:

• You are enrolled in Medicare Part B.

• The service is considered medically necessary.

• The provider is licensed and enrolled in Medicare.

• The service takes place in an eligible outpatient setting.

You do not need a referral from your primary care doctor, but you may need a documented diagnosis or treatment plan depending on the setting.

Services LMFTs and MHCs Can Provide Under Medicare

Covered services may include:

• Diagnostic assessments

• Individual therapy

• Couples or family therapy (when focused on a beneficiary’s mental health diagnosis)

• Group therapy

• Crisis intervention

• Psychoeducation for families

• Care planning coordination

While Medicare does not typically cover therapy solely for marital enrichment or family counseling without a diagnosed mental health condition, if the therapy relates directly to your treatment, it is covered.

Common Conditions Treated

You may find LMFTs and MHCs particularly helpful for managing conditions such as:

• Generalized Anxiety Disorder (GAD)

• Major Depressive Disorder (MDD)

• Adjustment disorders

• Post-Traumatic Stress Disorder (PTSD)

• Bipolar disorder (in coordination with psychiatric care)

• Bereavement-related disorders

• Caregiver stress and burnout

These professionals also help with coping strategies, behavioral management, and emotional regulation, especially for those who find traditional approaches less relational or accessible.

How to Find a Medicare-Approved LMFT or MHC

Here’s how you can locate a qualified provider:

• Medicare.gov Physician Compare Tool: Use the online tool to search for therapists in your ZIP code who accept Medicare.

• Ask Your Primary Care Doctor: Your doctor may refer you to a therapist who is already part of your care team’s network.

• Check with Your Medicare Advantage Plan: If you’re enrolled in a Medicare Advantage plan, contact the plan to confirm the therapist is in-network. Coverage rules may differ slightly.

• Call 1-800-MEDICARE: You can speak directly with a representative to get help finding an enrolled LMFT or MHC.

Important Differences From Previous Years

Here are the key changes as of 2025:

• Expanded Provider Types: LMFTs and MHCs were not Medicare-reimbursable providers prior to 2024.

• Greater Access in Rural Areas: These professionals often serve communities where other mental health providers are scarce.

• Enhanced Support for Caregivers and Families: Because LMFTs focus on family systems, this opens up better care options for people dealing with caregiving burdens or intergenerational mental health challenges.

Additional Coverage Tips

• If you’re enrolled in a Medicare Supplement (Medigap) plan, your 20% coinsurance may be partially or fully covered, depending on your policy.

• If you have Medicare Advantage, check for any prior authorization rules or provider network restrictions.

• Make sure your provider submits claims directly to Medicare using the correct billing codes.

• Keep track of all therapy sessions and related paperwork in case any coverage issues arise.

What Isn’t Covered by Medicare in This Context

Medicare still does not cover:

• Marriage counseling that is not medically necessary

• Therapy solely for relationship enhancement or self-improvement

• Services from unlicensed or non-enrolled therapists

• Group workshops, retreats, or coaching not tied to a mental health diagnosis

Why It’s Important to Act Now

If you’ve been delaying therapy due to cost or lack of access to a suitable provider, this new coverage expansion removes a significant barrier. Whether you are living alone, navigating family conflict, or supporting a loved one with chronic illness, this may be the right time to begin or resume therapy with a professional who understands your personal and relational context.

Also, since some LMFTs and MHCs are just starting to enroll in Medicare, appointment availability might be limited. The sooner you reach out, the better your chances of establishing ongoing care with a provider who fits your needs.

Take the Next Step Toward Personalized Mental Health Support

Medicare’s 2025 expansion to cover services from marriage and family therapists and mental health counselors gives you more options and flexibility in your mental health care journey. Now is the time to explore these services if you’ve struggled to find the right support in the past.

To find out how your plan fits this new benefit or to discuss coordination with Medicare Advantage or Medigap, connect with a licensed agent listed on this website for expert, personalized guidance.