Key Takeaways

• In 2025, Medicare officially covers certain digital mental health tools, including some teletherapy apps and online platforms—but only when they meet strict criteria.

• Coverage is limited, and many digital tools still fall outside Medicare’s reimbursement rules, leaving you to cover those costs out of pocket.

Medicare’s Growing Interest in Digital Mental Health

Medicare is responding to the increasing demand for mental health support by expanding what it covers under digital health services. In 2025, more digital mental health tools are eligible for reimbursement, including some forms of remote therapy and behavioral health coaching. This change reflects Medicare’s broader push to modernize care delivery and meet beneficiaries where they are—especially at home.

These services fall under Medicare Part B, which generally covers outpatient services. However, the definition of what qualifies as a “digital mental health tool” is narrower than many expect. Not all mobile apps, AI-based therapies, or virtual wellness platforms qualify.

What’s Covered Under Medicare in 2025

To be eligible for Medicare reimbursement, a digital mental health tool or service must meet specific regulatory requirements:

• Be provided by a Medicare-approved provider – Only licensed professionals (such as psychologists, clinical social workers, or psychiatrists) can bill for services.

• Use an approved technology platform – Medicare requires the platform to be HIPAA-compliant and capable of secure, two-way audio and visual communication.

• Fit into an existing benefit category – The service must be medically necessary and fall within a covered mental health benefit, such as psychotherapy or psychiatric diagnostic evaluation.

• Originate from a U.S. location – International providers or apps operated outside the U.S. are not eligible for reimbursement.

This means that while some virtual therapy and digital behavioral coaching programs are now reimbursable, popular commercial apps or chatbots that offer mood tracking or cognitive-behavioral techniques without a human clinician do not qualify.

Telehealth Provisions Remain, But Not Indefinitely

Medicare continues to allow mental health services delivered via telehealth, including video sessions and some audio-only options. These rules were expanded during the COVID-19 public health emergency and have been extended through December 31, 2025.

Under current law:

• Telehealth mental health visits can take place in your home.

• Audio-only sessions are permitted if you’re unable to use video technology.

• Telehealth billing is allowed under Medicare Part B when the provider and service meet Medicare requirements.

However, unless Congress acts to extend or make these rules permanent, many of these flexibilities will expire at the end of 2025. You may want to confirm with your provider whether their digital services will remain covered beyond that date.

The Gap Between Innovation and Coverage

Despite Medicare’s willingness to cover some digital tools, there’s a significant gap between what technology can offer and what Medicare is willing to pay for.

Many innovative digital therapies are built on artificial intelligence, gamification, and self-guided learning—but Medicare generally does not cover tools without a licensed professional involved. If a digital platform is educational, self-paced, or peer-led without a direct provider-patient relationship, it’s not reimbursable.

This limits access for many seniors who may prefer or benefit from tools that support daily mood management, mindfulness training, or structured behavioral therapy in an app format. Without Medicare coverage, these tools often come with monthly fees that fall outside most beneficiaries’ budgets.

Provider Requirements and Licensing

For any digital mental health service to be covered, the professional providing it must:

• Be licensed in the state where you are physically located at the time of service.

• Enroll as a Medicare provider.

• Document medical necessity in your treatment plan.

This creates logistical hurdles, especially for providers trying to deliver services across state lines. It also complicates access in rural areas or for those with limited mobility. While digital tools were supposed to close access gaps, strict compliance rules mean the reality falls short.

How to Know What’s Covered

Medicare beneficiaries can verify coverage for digital mental health tools by:

• Asking your mental health provider whether they accept Medicare and deliver services via approved platforms.

• Checking with Medicare directly by calling 1-800-MEDICARE.

• Reviewing your Medicare Summary Notice (MSN) to ensure services are billed correctly.

• Using the official Medicare website’s tool to search for covered telehealth mental health services.

Keep in mind that even if a provider offers online services, not all digital mental health tools they use are necessarily reimbursable. The provider must code the service correctly and follow Medicare’s billing rules to ensure coverage.

Copayments and Deductibles Still Apply

Even when a digital mental health tool is covered under Medicare, you are still responsible for standard cost-sharing unless you have supplemental coverage. That means:

• Medicare Part B deductible ($257 in 2025) applies.

• Coinsurance of 20% applies after you meet the deductible.

• Supplemental insurance (such as Medigap) may cover some or all of your out-of-pocket costs.

Always ask your provider for an estimated cost before beginning digital services so you’re not surprised by unexpected charges.

Types of Services Most Likely to Be Covered

In 2025, the following digital mental health services are most likely to be covered under Medicare:

• Video-based psychotherapy sessions with a licensed clinical psychologist or social worker

• Telepsychiatry visits with a psychiatrist for medication management

• Behavioral health integration services involving collaboration between your primary care doctor and mental health provider

• Remote monitoring for patients diagnosed with a mental health condition, when used as part of an ongoing treatment plan

These services must be part of a broader care approach and usually require documentation of diagnosis, progress, and medical necessity.

What’s Still Not Covered in 2025

Despite the progress, many services and tools are still not reimbursed by Medicare:

• Standalone mental health apps without human oversight

• AI-based therapy chatbots without clinical supervision

• Digital journaling or mood-tracking platforms

• Online peer support communities

• Wellness and meditation apps

• Commercial cognitive training games

Unless these tools are delivered within a Medicare-approved clinical context, you’ll be paying for them out of pocket.

Coverage May Vary Under Medicare Advantage

If you’re enrolled in a Medicare Advantage plan, you may find slightly more flexibility. Some plans offer broader coverage of digital wellness or mental health tools as supplemental benefits. However, these benefits are not standard, vary widely by plan, and still must meet Medicare’s general rules.

Importantly, Medicare Advantage plans must provide at least the same level of coverage as Original Medicare—but they can choose to add extras at their discretion.

If you’re considering switching plans to gain access to broader mental health benefits, review the Annual Notice of Change (ANOC) each fall to see what digital mental health tools (if any) are included.

Staying Proactive About Your Mental Health in 2025

If you rely on mental health support, it’s important to:

• Talk to your provider about Medicare-approved digital options

• Confirm that any digital tool you’re offered is covered before using it

• Keep documentation of your sessions and services in case of claim issues

• Review your Medicare coverage annually to adjust based on your needs

The field of digital mental health is growing rapidly, but Medicare coverage continues to lag behind. Being proactive about understanding your benefits helps you avoid unnecessary costs.

Digital Support Is Advancing—But Medicare Isn’t Covering All of It Yet

You now have more access to mental health services from the comfort of home, thanks to Medicare’s expanded digital coverage—but that access is still limited. Many of the most innovative tools are not eligible for reimbursement, and cost-sharing applies even when services are covered.

To make the most of what’s available, speak with a licensed agent listed on this website. They can walk you through your mental health coverage options, help you understand your plan, and point out any overlooked benefits.