Key Takeaways

• As of 2024, Medicare now covers services provided by marriage and family therapists (MFTs), significantly expanding access to mental health care for couples and families.

• Understanding how to find Medicare-approved MFTs and knowing what services are included can help you take full advantage of this benefit.

What Changed in 2024 for Mental Health Coverage

Until recently, marriage and family therapists were not recognized as reimbursable providers under Medicare. This created a major access gap for beneficiaries seeking specialized therapy focused on relational dynamics. But beginning January 1, 2024, Medicare now covers mental health services provided by licensed marriage and family therapists (MFTs), along with mental health counselors (MHCs).

This update comes as part of a broader effort to expand mental health access within Medicare. With increased demand for emotional and psychological support, this change allows beneficiaries to receive targeted care for issues like relationship conflicts, family dysfunction, and caregiving stress—areas where MFTs have deep clinical expertise.

What Medicare Covers Under the New MFT Provision

Medicare now covers outpatient services from licensed MFTs and MHCs under Part B. Here are the services you can expect to be covered:

• Individual psychotherapy (for mental health conditions)

• Couples or family therapy when medically necessary

• Group therapy sessions led by MFTs

• Initial diagnostic evaluations

• Ongoing treatment planning

• Crisis intervention and stabilization

Services must be provided by a Medicare-enrolled MFT practicing independently or within a clinic or medical group. The therapy must also be deemed medically necessary by your healthcare provider. Therapy focused solely on personal growth or non-clinical concerns is not covered.

Who Qualifies for MFT Services Under Medicare

To use this new benefit, you must meet the following criteria:

• Be enrolled in Medicare Part B

• Have a mental health diagnosis or medical reason that supports therapy (such as anxiety, depression, adjustment disorders, etc.)

• Work with a licensed MFT who is enrolled in Medicare and accepts assignment

While Medicare now recognizes MFTs as eligible providers, it still requires that your services be for diagnosis or treatment—not general life coaching or personal development.

How to Find a Medicare-Enrolled MFT in Your Area

Finding a marriage and family therapist who accepts Medicare is a new experience for most people. Since MFTs were only added as covered providers in 2024, not all licensed therapists are enrolled in Medicare yet.

Here’s how to find one:

• Check the official Medicare Care Compare tool for behavioral health providers

• Contact your primary care provider for a referral

• Call local mental health clinics or group practices to ask if their MFTs accept Medicare

• Use provider directories from your Medicare Advantage plan, if applicable, keeping in mind that networks may vary

If you are already working with a therapist, ask if they are now Medicare-certified or plan to enroll. Many therapists are currently in the process of credentialing with Medicare due to this recent change.

Cost and Coverage Details You Should Know

When you receive marriage or family therapy through Medicare Part B, the following cost structure applies:

• Annual deductible: $257 for Part B services in 2025

• Coinsurance: 20% of the Medicare-approved amount after you meet the deductible

Some supplemental insurance plans (like Medigap) may cover that 20%, reducing your out-of-pocket costs.

If you’re enrolled in a Medicare Advantage plan, your costs may differ. These plans must cover the same services as Original Medicare, but they can set different copays, prior authorization rules, or network limitations. You’ll need to confirm the exact terms of your plan.

When Family or Couples Therapy Is Considered Medically Necessary

Medicare does not cover therapy just because you want to improve your relationship or communicate better. To qualify for covered marriage or family therapy, the treatment must address a clinical mental health need. Examples include:

• One or both individuals in the relationship have a diagnosable condition like depression or PTSD

• Family members are participating in therapy to support a person receiving treatment for a mental disorder

• Therapy is required to reduce psychological stress related to caregiving or chronic illness

In these cases, Medicare recognizes that the family dynamic directly affects your mental health and treatment outcomes.

Benefits of Seeing a Marriage and Family Therapist Under Medicare

MFTs are trained to address mental health conditions within the context of relationships, which sets them apart from individual therapists or psychologists. Their training includes systemic therapy, communication skills, conflict resolution, and family systems.

Here’s why this matters for you:

• You can now access therapy that involves your partner, children, or other family members, as long as it is clinically indicated.

• If you’re a caregiver or experiencing stress from family conflict, MFTs can help you build resilience and coping strategies.

• These therapists can work in tandem with your primary care provider or psychiatrist, improving coordination of care.

This is especially helpful for older adults experiencing issues like grief, caregiver burnout, or changes in family roles after retirement or illness.

Telehealth Therapy Remains an Option in 2025

Medicare continues to cover mental health services provided via telehealth. This includes therapy delivered by MFTs, as long as the provider is Medicare-enrolled and uses a secure video platform.

Here are the key facts:

• Telehealth is covered for patients in any location, including their home

• Audio-only visits are allowed for beneficiaries who cannot access video

• An in-person visit is required at least once every 12 months starting October 1, 2025, unless you qualify for an exception

This flexibility allows you to access care even if you live in a rural area or have mobility limitations.

What Medicare Doesn’t Cover in Family Therapy

Even with this expansion, there are still some limits. Medicare does not cover:

• Therapy solely for marital enrichment or self-help

• Services from MFTs who are not enrolled in Medicare

• Court-ordered therapy unless it meets medical necessity criteria

• Unlicensed counselors or providers in training

Also, missed appointments or late cancellations are generally not reimbursed by Medicare. Be sure to clarify the therapist’s office policies before starting sessions.

How This Change Impacts Caregivers and Spouses

If you’re supporting a loved one with dementia, chronic illness, or mental health issues, this new coverage can benefit both you and the person in your care. Medicare may now cover joint sessions where you participate alongside the primary patient to:

• Learn effective communication strategies

• Manage caregiver stress and prevent burnout

• Improve emotional support and understanding

You don’t have to meet the mental health criteria yourself to be included in the therapy session if your participation is deemed medically necessary for the primary patient’s treatment plan.

Timeline for Coverage Implementation

The inclusion of MFTs and MHCs in Medicare began last year on January 1, 2024. This is now in effect for all Medicare Part B enrollees, but the rollout is still ongoing as providers enroll and billing systems update.

Expect the following through 2025:

• Throughout 2024: Surge in new provider enrollments with Medicare

• Early 2025: Most mental health clinics and group practices continue integrating MFTs into Medicare-covered services

• October 1, 2025: Telehealth in-person visit requirement takes effect (annually)

If you previously had trouble finding a therapist who accepted Medicare, you may notice more options becoming available over time.

Why You Should Review Your Mental Health Benefits Now

Because this change is still relatively new, it’s easy to miss out. Many beneficiaries don’t realize marriage and family therapy is now a covered benefit. Reviewing your mental health coverage can help you:

• Determine whether you need a referral

• Confirm whether your therapist is enrolled in Medicare

• Compare your out-of-pocket costs under Original Medicare versus a Medicare Advantage plan

• Check if you need to meet prior authorization requirements

This is especially important if you’re already struggling with emotional health issues that affect your relationships or daily life.

Get Support for Emotional Health Through Medicare

Medicare’s expansion to include marriage and family therapy is a major step toward more holistic mental health care. It recognizes that your mental wellbeing often involves those closest to you. Whether you need help with relationship challenges, caregiving strain, or emotional recovery, you now have access to more personalized support.

To learn how this benefit applies to your situation or to compare costs between Original Medicare and Medicare Advantage, speak with a licensed agent listed on this website.