Key Takeaways

• Starting in 2024, Medicare covers services from licensed marriage and family therapists (LMFTs) and mental health counselors (MHCs), expanding your access to therapy under Part B.

• Despite this progress, provider shortages and confusing directories continue to make it difficult to find professionals who actually accept Medicare.

Medicare Expands Mental Health Provider Access

In 2024, Medicare began covering services provided by licensed marriage and family therapists (LMFTs) and mental health counselors (MHCs). This marked a significant step forward in mental health care for older adults and people with disabilities.

Before 2024, Medicare beneficiaries could only access therapy from a limited pool of professionals, such as psychologists, psychiatrists, and clinical social workers. The inclusion of LMFTs and MHCs now broadens your options considerably, especially if you’re seeking relationship counseling or specialized support in areas like trauma or substance use.

These providers are now eligible to:

• Bill Medicare Part B for covered outpatient services

• Participate in Medicare Advantage plans

• Work in various settings, including private practice, clinics, and community health centers

Who Is Eligible for These Services?

You’re eligible to receive mental health services under Medicare Part B if:

• You are enrolled in Medicare Part B

• The services are deemed medically necessary

• The provider accepts Medicare assignment

Medicare Part B pays 80% of the approved cost after you meet the annual deductible, which is $257 in 2025. You are responsible for the remaining 20% coinsurance, unless you have supplemental coverage that helps with those costs.

Inpatient mental health care is covered under Medicare Part A, but outpatient therapy, psychiatric evaluations, medication management, and telehealth visits fall under Part B.

Where You Can Receive Mental Health Services

Medicare allows you to receive outpatient mental health services in several types of settings, including:

• A provider’s private office or clinic

• Hospital outpatient departments

• Federally Qualified Health Centers (FQHCs)

• Rural health clinics (RHCs)

• Community mental health centers (CMHCs)

• Through telehealth from your home or another location

Telehealth coverage is particularly important for beneficiaries in rural or underserved areas, and Medicare permanently covers video or audio-only mental health visits. However, starting October 1, 2025, Medicare requires an in-person visit every 12 months if you’re using telehealth for mental health care, unless you meet certain exceptions.

Why Finding a Provider Is Still Difficult

Despite the expansion of covered professionals, you may still struggle to find a Medicare-accepting mental health provider. Here’s why:

1. Limited Participation in Medicare

Many LMFTs and MHCs are only beginning to enroll in Medicare. Since the law took effect in 2024, it takes time for providers to go through the credentialing process. This means that in many areas, especially rural or low-income communities, there still aren’t enough providers who accept Medicare patients.

2. Outdated or Incomplete Provider Directories

Online directories and Medicare’s official provider search tools are not always up to date. Providers who are newly enrolled may not appear for months. Others may be listed but not currently accepting new patients. This leads to frustrating dead ends when you call office after office and hear the same message: “Sorry, we’re not taking new Medicare patients right now.”

3. Reimbursement and Administrative Burdens

Some providers are hesitant to join Medicare due to lower reimbursement rates and more paperwork compared to private insurance or cash-paying clients. While Medicare coverage now extends to LMFTs and MHCs, the incentive to participate isn’t always strong without policy improvements or support systems.

4. Stigma and Cultural Barriers

Even when providers are available, mental health stigma still prevents many beneficiaries from seeking care. For some, navigating mental health terms, diagnoses, and billing requirements may be overwhelming. Language barriers, cultural mismatches, or lack of familiarity with how Medicare works can also contribute to underuse.

How to Search for a Medicare Mental Health Provider

While the process can be challenging, there are steps you can take to improve your chances of finding a qualified provider:

• Use the Medicare.gov Care Compare tool: While not perfect, it lets you filter for psychologists, psychiatrists, and clinical social workers who accept Medicare.

• Contact your local State Health Insurance Assistance Program (SHIP): SHIP counselors provide free, unbiased help with Medicare-related issues, including finding a provider.

• Call community health centers or behavioral health clinics: These often serve Medicare beneficiaries and may have in-house MHCs or LMFTs.

• Ask your primary care provider for a referral: Physicians are often connected to mental health networks and may know who accepts Medicare.

• Use telehealth platforms partnered with Medicare: Some providers offer virtual services and may be more accessible than local options.

What Services Are Covered Under Medicare Part B?

You can receive a wide range of mental health services under Medicare Part B, including:

• Individual and group therapy

• Family counseling when it directly affects your treatment

• Psychiatric evaluations and diagnostic testing

• Medication management

• Partial hospitalization programs (PHPs)

• Intensive outpatient programs (IOPs)

• Telehealth mental health services

• Annual depression and cognitive screenings

These services are only covered when provided by eligible professionals, such as psychologists, psychiatrists, clinical social workers, LMFTs, and MHCs.

Understanding Your Costs in 2025

Mental health care under Medicare Part B follows the same cost structure as other Part B services:

• Deductible: $257 annually

• Coinsurance: 20% of the Medicare-approved amount

• Premium: $185 monthly standard premium

If you’re enrolled in a Medicare Advantage plan, your costs may differ slightly depending on the plan structure. Just remember that all Medicare Advantage plans must cover at least what Original Medicare covers.

Prescription medications for mental health conditions are typically covered under Part D, which includes a $2,000 annual out-of-pocket cap for 2025. This can ease the financial burden of ongoing psychiatric medications like antidepressants, antipsychotics, or mood stabilizers.

What’s Changed Since 2024?

Several key developments have improved access to mental health care:

• LMFTs and MHCs are now recognized as Medicare providers.

• Telehealth for mental health is permanently covered, including video and audio-only visits.

• The out-of-pocket cap for Part D significantly lowers your drug expenses for mental health treatments.

• In-person visit requirement for telehealth starts October 1, 2025, unless you’re exempt based on hardship, disability, or location.

These changes are aimed at expanding both access and affordability. Still, implementation is ongoing, and practical challenges remain for beneficiaries trying to use these expanded services.

What to Watch for in the Coming Years

Medicare’s mental health landscape will likely continue evolving. Here are some trends to follow:

• Growth in Medicare-participating MHCs and LMFTs: As more providers enroll and complete training on billing Medicare, access may improve.

• Policy changes to boost participation: Some advocacy groups are calling for higher reimbursement rates and reduced administrative barriers.

• Better directory tools: Efforts are underway to improve provider lookup accuracy.

• Increased mental health screening requirements: Preventive services and screenings may expand further under Medicare’s wellness initiatives.

Making the Most of Your Coverage

To ensure you’re getting the care you need:

• Review your Medicare Summary Notice or Explanation of Benefits regularly.

• Keep track of your Part D prescription costs.

• Advocate for yourself when contacting providers; ask directly if they accept Medicare assignment.

• Keep a written list of denied appointments or long wait times in case you need to appeal or escalate a concern.

• Ask if your provider offers sliding-scale fees or payment plans for services not covered or partially reimbursed.

Don’t Let the System Discourage You from Getting Help

Medicare’s expansion of covered mental health professionals is an important and overdue change. But that doesn’t automatically make care easy to access. The slow rollout of provider participation, outdated directories, and persistent stigma continue to create barriers.

Still, these services are available. And if you’re willing to be proactive and persistent, you can find a provider who meets your needs.

If you’re unsure where to begin or need help exploring your coverage, speak with a licensed agent listed on this website. They can walk you through your options and help you identify plans or resources that fit your situation.