Key Takeaways

• As of January 1, 2024, Medicare now covers services provided by licensed marriage and family therapists (LMFTs) and mental health counselors (MHCs), expanding access to outpatient mental health care.

• Telehealth mental health visits are now a permanent benefit under Medicare, giving you more flexibility to receive care from home, with some in-person requirements starting in late 2025.

How Medicare’s Mental Health Coverage Expanded in 2024

If you’re enrolled in Medicare, major changes that took effect in 2024 may directly impact the kind of mental health care you can receive—and how you receive it. For the first time, Medicare recognizes services from licensed marriage and family therapists and mental health counselors, adding thousands of qualified professionals to the pool of approved providers.

This expansion marks one of the most significant updates to Medicare’s mental health benefits in decades. With demand for mental health services on the rise, this move aims to close critical gaps in access and improve your chances of getting timely support.

Who Can Now Provide You Care Under Medicare

Prior to 2024, Medicare only covered mental health services from psychiatrists, psychologists, clinical social workers, and certain advanced practice nurses. However, many mental health counselors and marriage and family therapists—who make up a large portion of the behavioral health workforce—were excluded.

That changed with the implementation of the Mental Health Access Improvement Act, part of the 2023 Consolidated Appropriations Act. Starting January 1, 2024:

• Licensed mental health counselors (MHCs), including licensed professional counselors (LPCs), are recognized providers under Medicare Part B.

• Licensed marriage and family therapists (LMFTs) are also covered.

You can now book appointments with these professionals and have them reimbursed by Medicare, as long as the provider participates in the program and accepts Medicare assignment.

What These Professionals Can Treat

Both MHCs and LMFTs can help manage a wide range of conditions covered by Medicare, including:

• Depression

• Anxiety disorders

• Trauma-related conditions (such as PTSD)

• Substance use disorders

• Grief and loss

• Family and relationship conflicts

These providers often specialize in therapy techniques such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and solution-focused brief therapy. Depending on your needs, they may offer individual, group, or family sessions.

How Costs Work for Outpatient Mental Health Care

Under Medicare Part B, you are responsible for:

• The annual deductible, which is $257 in 2025

• 20% of the Medicare-approved amount for services after the deductible

This coinsurance applies to outpatient visits with psychologists, psychiatrists, clinical social workers, and now MHCs and LMFTs.

Medicare pays the remaining 80% of the approved amount. If you have a Medicare Supplement plan or other secondary insurance, it may cover some or all of the remaining cost.

Where You Can Receive Mental Health Services

Medicare allows you to receive outpatient mental health services in the following settings:

• Your doctor or therapist’s private office

• Outpatient hospital departments

• Community mental health centers

• Federally qualified health centers (FQHCs)

• Rural health clinics

Telehealth visits are also included, making access more flexible—especially if you’re in an underserved area.

Permanent Telehealth Coverage with New Rules

Due to the pandemic, Medicare began covering mental health visits via telehealth. This policy became permanent in 2024, but it comes with some conditions you should know:

• You can receive mental health telehealth services from your home or any eligible location.

• Video or audio-only visits are permitted if your provider agrees.

• Starting October 1, 2025, you must see your provider in person at least once every 12 months to continue receiving telehealth services for mental health, unless you qualify for an exception.

These updates aim to strike a balance between convenience and continuity of care, allowing you to benefit from remote visits while ensuring strong therapeutic relationships.

Hospital-Based Mental Health Care Still Covered

If you need more intensive support, Medicare Part A still covers inpatient psychiatric hospitalization. This includes stays in psychiatric hospitals or general hospitals with psychiatric units.

Here’s how Part A coverage works in 2025:

• You pay the $1,676 deductible for each benefit period.

• Days 1–60: $0 coinsurance

• Days 61–90: $419 per day

• Beyond 90 days: $838 per lifetime reserve day (up to 60 total lifetime days)

Medicare limits coverage in a freestanding psychiatric hospital to 190 lifetime days, but there is no such limit in a general hospital.

What Partial Hospitalization Programs (PHPs) Offer

You may not need full inpatient admission to get structured mental health treatment. Medicare covers Partial Hospitalization Programs (PHPs) as a type of outpatient care, typically provided by hospitals or community mental health centers.

PHPs include several hours of treatment each day for multiple days a week. Services may include:

• Individual and group therapy

• Medication management

• Psychiatric evaluations

Medicare Part B covers these services, and you pay:

• 20% of the Medicare-approved amount for each service

• A separate cost for each day of program participation

Coverage for Intensive Outpatient Programs (IOPs)

A new benefit added in 2024 is coverage for Intensive Outpatient Programs (IOPs). These are a step below PHPs but more intensive than standard therapy visits.

IOPs provide structured therapy several times per week. They’re useful for individuals who need more than once-a-week therapy but do not meet criteria for inpatient or PHP levels of care.

Medicare covers IOPs under Part B. As with other outpatient services, you pay 20% coinsurance after meeting the deductible.

Preventive Mental Health Screenings

Medicare encourages early detection of mental health conditions through preventive screenings. These services are typically covered in full when you meet the eligibility criteria:

• Annual depression screening: During a primary care visit with the ability to follow up.

• Alcohol misuse screening and counseling: For those who screen positive.

• Substance use assessment: If medically necessary.

These services are designed to identify problems early and connect you with the right care, potentially preventing conditions from worsening.

Prescription Drug Coverage for Mental Health Conditions

Medicare Part D covers most medications used to treat mental health conditions, including:

• Antidepressants

• Antipsychotics

• Anti-anxiety medications

• Mood stabilizers

In 2025, a new $2,000 annual cap on out-of-pocket prescription drug costs now applies, helping you better manage the cost of long-term treatments. You’ll also have the option to spread your drug costs over 12 months through Medicare’s new Prescription Payment Plan.

Keep in mind that each plan has its own formulary, or list of covered drugs. It’s important to check that your medications are included and to review tier levels and prior authorization rules.

How Medicare Advantage Plans Compare

If you’re enrolled in a Medicare Advantage plan, you still receive all the mental health benefits provided under Original Medicare. However, your plan may:

• Use a network of providers

• Require referrals or prior authorizations

• Offer extra mental health support services

While Medicare Advantage plans cannot reduce your basic benefits, they may package them differently. Always review your plan’s Evidence of Coverage for exact rules and availability.

Addressing the Ongoing Provider Shortage

Even with these improvements, not all mental health providers accept Medicare. There remains a shortage of Medicare-participating professionals, especially in rural areas and for specialized services.

Here are some steps you can take to improve access:

• Use Medicare’s online Physician Compare tool to search for providers

• Call local clinics and community health centers directly

• Ask your primary care doctor for a referral

You may also consider telehealth appointments to access therapists outside your immediate region.

Why These Changes Matter More Than Ever

The inclusion of LMFTs and MHCs in 2024 has increased the number of available Medicare-eligible therapists by tens of thousands. This expansion came in response to widespread recognition that older adults face high rates of untreated depression, isolation, and anxiety—and often have fewer resources to seek care.

By opening Medicare’s doors to more types of licensed professionals, these changes help make mental health care more accessible, especially for those living on fixed incomes or in underserved areas.

Make the Most of Your Medicare Mental Health Benefits

If you haven’t reviewed your coverage recently, now is a good time to:

• Confirm your provider accepts Medicare and is a covered mental health professional

• Understand your out-of-pocket costs for outpatient services and prescriptions

• Explore whether you might benefit from therapy, IOP, PHP, or preventive screenings

Even if you’ve never used Medicare for mental health before, these recent changes give you more flexibility and access than ever before. Mental health is part of overall health—and you deserve comprehensive support.

Get Support Tailored to You

Medicare has taken big steps forward, but how the benefits apply to your personal situation depends on your coverage, your providers, and your health needs.

To make informed choices, consider speaking with a licensed agent listed on this website. They can help you:

• Understand what your plan does and does not cover

• Identify therapists who accept Medicare

• Compare out-of-pocket costs and network restrictions

• Make plan changes during Open Enrollment if needed

Don’t wait until a crisis to get the help you need. Reach out today for guidance.