Key Takeaways

• Medicare expanded its mental health provider network in 2024 to include licensed marriage and family therapists (LMFTs) and mental health counselors (MHCs), but access gaps remain in 2025 due to uneven provider participation.

• Even with broader eligibility, finding a provider who accepts Medicare and is available for appointments may still be difficult, especially in rural areas or underserved urban regions.

Expanded Coverage Became Law in 2024

The Consolidated Appropriations Act of 2023 included provisions to expand Medicare’s mental health provider eligibility starting January 1, 2024. For the first time, licensed marriage and family therapists (LMFTs) and mental health counselors (MHCs) were added to the list of qualified providers under Medicare Part B.

This expansion addressed a long-standing gap in Medicare mental health coverage. Previously, the program only reimbursed services from psychiatrists, psychologists, clinical social workers, and psychiatric nurse practitioners. The new rule widened the scope to include thousands more professionals, especially those with specialized skills in counseling, trauma care, and family therapy.

What’s Covered Under Medicare in 2025

As of 2025, Medicare covers a broad range of mental health services under Parts A, B, and D:

Part A: Inpatient Psychiatric Care

• Hospital stays in a psychiatric facility or general hospital

• Coverage up to 190 lifetime days in a dedicated psychiatric hospital

• Subject to the Part A deductible ($1,676 per benefit period in 2025) and coinsurance after day 60

Part B: Outpatient Mental Health Services

Medicare Part B pays for:

• One depression screening per year

• Individual and group therapy sessions

• Psychiatric evaluations and medication management

• Services provided by LMFTs, MHCs, psychologists, clinical social workers, and psychiatrists

• Intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs)

You pay 20% of the Medicare-approved amount after meeting the annual Part B deductible ($257 in 2025). Many enrollees with Medicare Supplement (Medigap) plans or Medicare Advantage plans may pay less depending on their plan design.

Part D: Prescription Drug Coverage

• Antidepressants, antipsychotics, anti-anxiety medications, and mood stabilizers

• 2025 includes a $2,000 out-of-pocket cap on prescription drugs

• Cost varies by drug tier, plan design, and pharmacy network

The 2024 Expansion Didn’t Solve Everything

While the 2024 expansion was a significant policy win, it didn’t automatically fix the persistent provider shortage. By mid-2025, many enrollees are still struggling to find providers who accept Medicare. There are several reasons for this lingering access issue.

1. Not All Providers Are Enrolled in Medicare

Just because LMFTs and MHCs are now eligible to bill Medicare doesn’t mean all of them have chosen to enroll. Joining Medicare as a provider involves a formal application process, credentialing, and adherence to Medicare billing and documentation standards.

In 2025, many mental health professionals—especially those in high-demand areas—still choose to operate on a private-pay basis or contract with commercial insurers instead. This leaves a smaller pool of available Medicare-accepting therapists, even though more are technically eligible.

2. Geographic Disparities Still Exist

Access remains uneven across the country. If you live in a large metropolitan area, you may have more provider options. But in rural communities or smaller towns, shortages are common. Even within cities, providers may be concentrated in wealthier areas, making access difficult for low-income seniors.

In these underserved regions, the 2024 policy change has yet to translate into measurable access improvements. Some enrollees are still placed on long waitlists or travel long distances for care.

3. Provider Availability Isn’t Keeping Up With Demand

The need for mental health support among older adults is rising. Isolation, chronic illness, bereavement, and financial stress all contribute to increased mental health concerns. At the same time, the COVID-19 pandemic intensified the demand for therapy, leaving many providers with full schedules.

In 2025, even Medicare-participating mental health professionals may be at capacity, particularly those accepting new patients. This creates a gap between what Medicare pays for and what you can actually access in real time.

What You Can Do to Get Help in 2025

Despite these challenges, there are still effective ways for you to receive the mental health support you need. The key is to be proactive and persistent.

Search for Medicare-Approved Providers

You can start your search with:

• Medicare.gov’s Provider Finder Tool

• Your state’s Department of Aging or Department of Health

• Local Area Agencies on Aging (AAAs)

• Licensed agent listed on this website

Use filters like specialty, distance, and languages spoken to narrow your search. Always call ahead to confirm availability and whether the provider is accepting new Medicare patients.

Ask Your Primary Care Doctor for Referrals

Your primary care physician can be a valuable resource. They may know which behavioral health providers in your area accept Medicare and can make referrals to facilitate faster appointments.

In some cases, you’ll need a referral for more intensive services like partial hospitalization programs or medication management with a psychiatrist.

Consider Telehealth Options

Medicare permanently expanded its telehealth coverage for mental health services. You can receive therapy via video or audio-only visits from home, provided your provider accepts Medicare and offers virtual sessions.

Starting October 1, 2025, you must meet with your provider in person at least once every 12 months to continue receiving telehealth services, unless you qualify for an exception (such as severe mobility or transportation limitations).

Use Integrated Behavioral Health Services

If you receive care through a clinic or medical group that uses a team-based approach, you may benefit from integrated behavioral health services. This model embeds mental health care into primary care settings, improving coordination and access.

Medicare covers collaborative care models when provided by qualified primary care teams working with behavioral health professionals. Ask your clinic if they offer this option.

How Medicare Advantage Plans Fit In

Many Medicare Advantage (Part C) plans include additional mental health benefits beyond Original Medicare. These can include:

• Lower out-of-pocket costs for therapy

• Expanded provider networks

• Access to wellness programs

• Case management or care coordination services

However, these benefits vary widely by plan and region. It’s important to review your plan’s Evidence of Coverage (EOC) each year to see what mental health services are included. If you’re unsure, a licensed agent listed on this website can walk you through your plan’s mental health offerings.

What to Watch for the Rest of 2025

As the year progresses, there are a few developments you’ll want to monitor if mental health access is important to you:

• Provider Enrollment Trends: More LMFTs and MHCs are expected to enroll in Medicare as billing systems and credentialing processes stabilize.

• New Plan Options: Medicare Advantage plans may expand supplemental mental health benefits during the fall Open Enrollment period (October 15 to December 7).

• Mid-Year Notifications: If you’re in a Medicare Advantage plan, you’ll receive a mid-year notice by July 31 listing any unused supplemental benefits, which may include therapy or counseling sessions.

• Telehealth Rule Updates: CMS may release new guidance on telehealth flexibility or extend in-person visit waivers for certain populations.

Staying informed can help you make better choices about your care and coverage as changes continue throughout 2025.

Don’t Wait to Seek Help

If you’re struggling with anxiety, depression, or any mental health concern, don’t delay care because you assume Medicare won’t cover it. Coverage has improved significantly, and while provider access is still catching up, help is available.

Early intervention can make a big difference. Mental health isn’t separate from your physical health. It’s all connected—and Medicare is finally starting to reflect that reality in its coverage.

Get the Support You Deserve With the Right Guidance

Medicare’s 2024 expansion marked a turning point, but gaps still exist in 2025. While LMFTs and MHCs are now part of the system, many aren’t participating yet. Finding care depends not only on your eligibility but also on local provider availability and network participation.

To ensure you’re getting the right support:

• Review your current Medicare plan’s mental health benefits

• Confirm provider participation before scheduling services

• Use telehealth options when possible

• Reach out for help understanding your choices

For personalized advice tailored to your situation, get in touch with a licensed agent listed on this website. They can help you explore coverage options, identify available providers, and answer your questions about Medicare mental health benefits.