Key Takeaways

• Medicare now covers more mental health services in 2025, including visits to marriage and family therapists (MFTs) and mental health counselors (MHCs).

• Despite expanded coverage, many beneficiaries struggle to find providers who accept Medicare due to low reimbursement rates and workforce shortages.

Mental Health Matters More Than Ever

The importance of mental health care has never been clearer. In 2025, Medicare offers broader coverage for mental health services than ever before. If you’re a Medicare beneficiary, you’re entitled to both inpatient and outpatient mental health care, therapy, evaluations, preventive screenings, and prescription drug support.

However, this growing awareness and expansion of benefits are met with a stark challenge: access. Even with Medicare covering more providers and services, you might face serious difficulties finding a professional who will see you.

What Medicare Covers for Mental Health in 2025

Inpatient Services Under Part A

Medicare Part A covers hospital stays for mental health care, including:

• Semi-private rooms, meals, and nursing care

• Psychiatric evaluation and medication management

• Inpatient psychiatric hospital care (up to 190 days lifetime in a freestanding psychiatric hospital)

• General hospital mental health care without a lifetime day limit

You must pay the inpatient hospital deductible, which is $1,676 per benefit period in 2025. Daily coinsurance applies beyond 60 days.

Outpatient Services Under Part B

Medicare Part B covers a wide range of outpatient mental health services, such as:

• Individual and group therapy sessions

• Psychiatric diagnostic evaluations

• Medication management

• Intensive outpatient programs (IOPs)

• Partial hospitalization programs (PHPs)

• Family counseling (if it helps your treatment)

New in 2025, Part B also pays for therapy delivered by licensed marriage and family therapists (LMFTs) and mental health counselors (MHCs). This expansion means thousands of additional professionals are now eligible to provide care under Medicare.

After meeting the $257 deductible, you are typically responsible for 20% of the Medicare-approved amount for outpatient mental health services.

Preventive Screenings

You are entitled to one depression screening per year under Part B, conducted in a primary care setting. You also get access to annual wellness visits where cognitive assessments can be made.

Prescription Drug Coverage Under Part D

Medicare Part D covers a broad range of mental health medications, including antidepressants, antipsychotics, mood stabilizers, and anti-anxiety drugs. As of 2025, there is a $2,000 cap on your out-of-pocket spending for covered prescription drugs, which improves affordability compared to previous years.

Expanded Provider Eligibility: A Win on Paper

Until recently, Medicare excluded many mental health professionals from its coverage. In 2024, legislation changed that. As of January 1, 2024, LMFTs and MHCs are recognized as Medicare providers. This change adds over 200,000 professionals to the eligible workforce, on paper.

In practice, however, not all newly eligible therapists enroll in Medicare or accept Medicare beneficiaries.

Why Finding a Medicare Therapist Can Be So Difficult

Low Reimbursement Rates

One major reason for the lack of participating mental health professionals is reimbursement. Medicare pays significantly less than private insurance or cash pay, especially for mental health services.

As a result, many therapists choose not to enroll as Medicare providers. Some limit the number of Medicare clients they see, while others opt out entirely. This reduces your pool of accessible therapists despite your eligibility.

Administrative Burdens

Another factor is the complexity of Medicare’s billing and documentation requirements. Some therapists, particularly solo practitioners, find the paperwork too time-consuming or costly to manage.

Geographic Disparities

Where you live also matters. Rural areas and underserved urban communities often face shortages of mental health providers in general. Adding the Medicare filter narrows your options even further.

Even in cities, demand for mental health services outpaces availability. Waitlists are common, and Medicare beneficiaries may wait longer for an opening than others.

Telehealth Is Expanding, But Not a Universal Fix

Since 2020, telehealth has played a larger role in delivering mental health care. In 2025, Medicare continues to cover mental health services provided via telehealth, including sessions conducted from your home.

Eligible services include:

• Therapy by video or audio call

• Medication management

• Psychiatric evaluations

However, one catch applies: as of October 1, 2025, Medicare requires at least one in-person visit every 12 months to continue receiving telehealth mental health services. Some exceptions apply, such as documented hardship or provider shortages.

This requirement may be a barrier if you live far from providers or have mobility challenges. It also limits the appeal for therapists who prefer providing care exclusively online.

What You Can Do to Access Care

Use the Medicare Provider Locator

Start with the official Medicare.gov “Find & Compare” tool to search for mental health providers who accept Medicare in your area. You can filter results by provider type, specialty, and location.

Ask for Referrals

Talk to your primary care provider. They may know local mental health professionals who accept Medicare or have a care coordination team that can help you schedule services.

Contact Your State SHIP

State Health Insurance Assistance Programs (SHIPs) offer free counseling to Medicare beneficiaries. They can help you:

• Understand what services you’re entitled to

• Navigate provider directories

• Appeal denied claims

• Explore options for supplementing your care

Explore Federally Qualified Health Centers (FQHCs)

FQHCs offer behavioral health services and are more likely to accept Medicare patients. These centers also provide sliding-scale payments based on income, which can help manage costs even if certain services fall outside of Medicare coverage.

Consider Medicare Advantage Plans (with Caution)

Some Medicare Advantage plans offer broader mental health networks or additional benefits like therapy hotlines, wellness coaching, or expanded telehealth. However, provider networks can be limited, and benefits vary. Make sure to carefully review any plan’s network and coverage.

Remember: do not make decisions based on marketing claims. If you’re considering changes, consult a licensed agent listed on this website.

Gaps Still Remain in 2025

Even with expanded coverage and new provider eligibility rules, access remains a real concern for Medicare mental health care in 2025. Here’s what hasn’t changed:

• Provider acceptance is still voluntary. Just because someone is eligible to bill Medicare doesn’t mean they will.

• No national directories guarantee availability. Finding a therapist may still take multiple calls.

• Medicare’s mental health provider directory is incomplete. It may not reflect real-time availability.

• Cultural competency and language barriers persist. Matching with a provider who understands your background remains challenging.

What to Watch for Moving Forward

The Centers for Medicare & Medicaid Services (CMS) continues to evaluate access issues and payment structures. There is growing pressure to:

• Increase reimbursement rates for mental health services

• Reduce administrative hurdles

• Expand telehealth access permanently without in-person requirements

• Improve provider data accuracy on Medicare directories

Whether these improvements arrive in 2026 or later remains to be seen, but the need is clear.

Don’t Let the System Stop You from Getting Help

Mental health deserves the same priority as physical health. If you’re on Medicare and need support, you’re not alone—and you do have rights. While finding a provider may be frustrating, persistence pays off.

Use the tools available to you. Seek referrals, consider telehealth, and reach out to assistance programs. And if you’re overwhelmed, you don’t have to figure it out on your own.

You can speak with a licensed agent listed on this website to understand your Medicare mental health benefits more clearly and explore care options available in your area.