Key Takeaways

• Medicare in 2025 includes a broader range of mental health services than many beneficiaries realize, covering inpatient, outpatient, therapy, medication, and telehealth options.

• New provider types, like mental health counselors and marriage and family therapists, are now eligible for reimbursement under Medicare Part B, significantly expanding access.

Understanding What “Covered” Means Under Medicare

When Medicare says a service is “covered,” it doesn’t always mean that everything related to that care is automatically paid for without question. In the case of mental health services, “covered” can include a surprisingly wide array of treatments, professionals, and settings. But there are still requirements you must meet, and limits you should understand.

In 2025, Medicare recognizes that mental health is as essential as physical health. To reflect this, coverage continues to expand with more provider types, telehealth flexibility, and integrated behavioral health options.

Covered Services Under Medicare Part A

Medicare Part A, which focuses on inpatient care, includes mental health coverage in hospital settings. Here’s what that looks like:

Inpatient Psychiatric Hospital Care

• Medicare Part A covers up to 190 lifetime days in a freestanding psychiatric hospital.

• This lifetime limit only applies to psychiatric hospitals, not general hospitals.

• If you’re admitted to a general hospital for mental health treatment, there is no lifetime limit, but regular Part A benefit periods apply.

What’s Included:

• Semi-private room

• Meals

• Nursing care

• Therapy sessions (group or individual, as appropriate)

• Medications administered during your stay

• Lab tests and other medically necessary services

Cost Considerations:

• In 2025, you pay a $1,676 deductible per benefit period.

• Days 1–60: $0 coinsurance

• Days 61–90: $419 per day

• Days 91–190 (lifetime reserve days): $838 per day

• After 190 days in a psychiatric hospital, you must pay full cost unless treatment continues in a general hospital setting.

Covered Services Under Medicare Part B

Medicare Part B is where most ongoing outpatient mental health services fall. This includes visits to psychiatrists, psychologists, and now, more types of professionals than ever before.

Who Can Provide Covered Services:

As of 2025, the following professionals are covered under Part B:

• Psychiatrists (MD or DO)

• Clinical psychologists (PhD or PsyD)

• Clinical social workers (LCSW)

• Nurse practitioners and physician assistants specializing in mental health

• Licensed mental health counselors (LMHCs)

• Licensed marriage and family therapists (LMFTs)

This expansion stems from Medicare’s response to workforce shortages and the need to improve mental health access.

What’s Included:

• Diagnostic evaluations

• Psychotherapy (individual, family, and group sessions)

• Medication management

• Partial hospitalization programs (PHPs)

• Intensive outpatient programs (IOPs)

• Behavioral health integration services (if part of your primary care)

• Substance use disorder counseling and treatment

• Depression screenings (once per year)

Costs Under Part B:

• $257 annual deductible in 2025

• After the deductible, you typically pay 20% coinsurance for most outpatient mental health services

• Some screenings and preventive services may be covered in full, with no coinsurance

Medicare Part D: Prescription Drug Coverage for Mental Health

Mental health treatment often includes prescription medications, especially for depression, anxiety, or bipolar disorder. These are covered under Medicare Part D, or through your Medicare Advantage plan if it includes drug coverage.

What’s Covered:

• Antidepressants

• Antipsychotics

• Anti-anxiety medications

• Mood stabilizers

In 2025, there is a $2,000 annual out-of-pocket maximum under Part D for all covered prescription drugs. This includes mental health medications and is a significant change from prior years.

You can also choose to spread your out-of-pocket costs across the year using the new Medicare Prescription Payment Plan, rather than paying large amounts upfront.

Telehealth for Mental Health in 2025

Since the pandemic, Medicare has permanently expanded coverage of telehealth mental health services. In 2025, these services remain in place, with some new conditions:

What’s Covered:

• Video (and in some cases, audio-only) psychotherapy sessions

• Medication management visits

• Psychiatric evaluations and follow-ups

• Consults with therapists, social workers, and now MHCs and MFTs

Important Requirements:

• Must have had an in-person visit within the past 12 months with the same provider

• Annual in-person follow-up required starting October 1, 2025

• Exceptions may apply for beneficiaries in rural or underserved areas

Telehealth services are covered under Part B, so standard deductible and coinsurance rules apply.

Medicare Advantage Plans and Mental Health Benefits

Medicare Advantage (Part C) plans are required to cover at least what Original Medicare does, including all standard mental health benefits. However, some plans may offer additional benefits, such as:

• Expanded telehealth availability

• Care coordination or case management

• Wellness and behavioral coaching

• Transportation to therapy appointments

These extra services vary widely by plan. Be sure to carefully review your Annual Notice of Change (ANOC) each fall to understand if your plan’s mental health coverage is changing for the following year.

Where Services Can Be Received

You are not limited to a single location for care. Medicare covers mental health services across a variety of settings, depending on the level of care you need:

• Doctor’s or therapist’s office

• Community mental health centers

• Outpatient hospital departments

• Partial hospitalization programs

• Telehealth (from home or other locations)

• Inpatient psychiatric or general hospitals

What Isn’t Covered

Even with expanded benefits, Medicare doesn’t cover everything. Some limitations still apply:

• Life coaching or general wellness counseling not deemed medically necessary

• Alternative therapies like acupuncture or massage (unless covered for another diagnosis)

• Unlicensed therapists or counselors not recognized by Medicare

• Services from providers who don’t accept Medicare assignment

• Custodial care or non-medical personal care in long-term facilities

You can still receive these services, but you’ll likely pay out of pocket unless you have supplemental coverage that includes them.

Taking the Next Step in 2025

If you’ve been putting off seeking mental health care because you thought Medicare wouldn’t cover it, 2025 may be the time to reevaluate. You now have access to a wide range of providers, treatment options, and service locations that are eligible for Medicare reimbursement.

To make the most of your coverage:

• Confirm that your provider accepts Medicare

• Ask if your treatment is considered medically necessary

• Understand your Part B and Part D cost-sharing responsibilities

• Check if you qualify for Extra Help with drug costs

• Review your Medicare Advantage plan’s evidence of coverage

Why This Matters More Than Ever

With an aging population and rising rates of depression, anxiety, grief, and isolation among older adults, mental health is no longer a peripheral concern. Medicare has made meaningful strides in recognizing this by offering broader, more accessible coverage in 2025.

Yet many beneficiaries still aren’t aware of what they can use. Understanding the full scope of what’s covered can lead to earlier intervention, better management of chronic conditions, and improved overall well-being.

If you need help evaluating your plan or accessing these services, get in touch with a licensed agent listed on this website for personalized guidance.