Key Takeaways

• Starting October 1, 2025, Medicare requires an in-person mental health visit every 12 months to continue receiving at-home telehealth services.

• Telehealth remains covered under Medicare, but compliance with the in-person requirement is critical to maintaining eligibility for continued services.

Understanding the 2025 In-Person Requirement for Mental Health Telehealth

Mental health care through telehealth has been a lifeline for many Medicare enrollees, particularly those who prefer or need to receive care from home. In 2025, this flexibility continues, but with a key change: to remain eligible for at-home mental health services delivered via telehealth, you must now have a face-to-face, in-person visit with your mental health provider at least once every 12 months.

This new rule aims to maintain care quality and clinical oversight, but it also introduces logistical challenges that you should plan for in advance.

What Stays the Same with Telehealth Coverage in 2025

Medicare continues to cover mental health services delivered through telehealth. These include:

• Psychiatric evaluations and diagnosis

• Individual and group psychotherapy

• Medication management

• Counseling from clinical psychologists, clinical social workers, and newly included professionals like licensed marriage and family therapists (LMFTs) and mental health counselors (MHCs)

• Services provided at home, rather than at an approved facility

There is no change to your Part B coinsurance requirement: you typically pay 20% of the Medicare-approved amount for outpatient mental health services after meeting the Part B deductible, which is $257 in 2025.

Telehealth continues to be an option for both audio-video and audio-only sessions, as long as the provider agrees and it’s clinically appropriate.

What Changes in 2025: The In-Person Visit Rule

Beginning October 1, 2025, Medicare requires that:

• You have a face-to-face, in-person mental health visit at least once every 12 months with the same provider or a practitioner in the same group.

• This applies only if you are receiving ongoing care via telehealth in your home.

If you fail to attend this in-person visit within the 12-month window, your eligibility for continued at-home telehealth services may be suspended until the in-person visit is completed.

This rule was set to begin in 2022 but was postponed multiple times due to the public health emergency. As of now, the October 2025 implementation date is active.

Who Must Follow This Rule

This requirement applies to:

• All Medicare beneficiaries receiving mental health care via telehealth in their home

• Enrollees using audio-video or audio-only telehealth sessions

It does not apply if you receive telehealth care from a medical facility like a hospital or rural health clinic, nor if the provider is physically in the same location as you during the session.

Additionally, this does not affect mental health care delivered in skilled nursing facilities or inpatient hospital settings under Part A.

Are There Any Exceptions?

Yes. Medicare provides limited exceptions in 2025:

• If you are physically or mentally unable to attend an in-person visit, your provider may document this limitation.

• Medicare permits exceptions for individuals who face severe travel hardship or lack access to transportation or support.

• The in-person requirement can also be deferred in the context of a national emergency or public health crisis, if declared by federal authorities.

However, these exceptions are narrow and must be clearly documented by the provider.

Why This Rule Exists

Medicare implemented this rule to promote:

• Stronger patient-provider relationships

• More accurate clinical assessments

• Higher care quality

• Prevention of overuse or fraud in telehealth billing

While telehealth remains a vital access point, Medicare’s oversight ensures that virtual care supplements, rather than replaces, hands-on clinical judgment and accountability.

What This Means for You

If you are currently seeing a mental health provider via telehealth, you should:

• Schedule your in-person visit well in advance to ensure you remain compliant.

• Confirm that your provider or their group offers in-person services and understands the new requirement.

• Document your visit date, and keep track of when your next one will be due.

Failing to meet the in-person requirement could result in:

• Loss of coverage for telehealth mental health visits

• Out-of-pocket charges if you continue telehealth care without meeting Medicare rules

Planning for Your 12-Month Visit

Medicare counts the 12-month window from the date of your last in-person visit. So, if your last face-to-face session was on October 15, 2024, you must complete your next one by October 15, 2025.

Planning tips:

• Set calendar reminders 1–2 months before your deadline.

• Ask your provider’s office to notify you when the next in-person visit is due.

• Arrange transportation or caregiver support early if you anticipate difficulty attending.

This proactive approach prevents interruptions in your mental health treatment.

What Counts as a Valid In-Person Visit

The visit must:

• Be face-to-face and conducted in person (not via video or phone)

• Be with your telehealth provider or another practitioner in their group

• Include assessment, care planning, or psychotherapy services

Routine check-ins or visits for unrelated medical issues typically do not satisfy this rule unless mental health care is also addressed.

Services That Remain Available Through Telehealth

Even with the in-person rule, you can still access a broad range of mental health services from home:

• Weekly or biweekly therapy sessions

• Monthly medication management

• Follow-up care after psychiatric hospitalization

• Support for depression, anxiety, PTSD, substance use disorders, and more

These remain covered under Medicare Part B, assuming you comply with all applicable visit requirements.

Role of New Mental Health Providers in 2025

As of 2024, Medicare expanded its mental health provider list. You can now access services through:

• Licensed Marriage and Family Therapists (LMFTs)

• Mental Health Counselors (MHCs), including licensed professional counselors (LPCs)

These professionals are also subject to the 12-month in-person visit requirement if providing ongoing care via telehealth. Be sure your selected provider is enrolled in Medicare and understands how to maintain your eligibility.

Additional Resources That Can Help You Stay Compliant

If you are unsure how to meet the new rule, consider the following options:

• Contact your provider’s billing office to ask how they are tracking the 12-month requirement

• Use Medicare’s official website to find information about covered providers near you

• Call 1-800-MEDICARE to confirm if your coverage may be affected

Care coordination services through Medicare Advantage plans or some Accountable Care Organizations (ACOs) may also offer reminders and transportation support, but this varies depending on your specific plan.

How This Affects Other Types of Mental Health Care

This rule specifically applies to telehealth mental health visits conducted at home. It does not change:

• Inpatient psychiatric care under Part A

• Emergency mental health services

• Telehealth visits from medical facilities

You can continue receiving these services under existing rules without the 12-month in-person requirement.

What to Do If You Miss the In-Person Visit Window

If you miss your 12-month in-person visit:

• Stop scheduling telehealth mental health sessions until the in-person requirement is met

• Reschedule an in-person appointment with your provider as soon as possible

• Contact Medicare or a licensed agent listed on this website for guidance on how to avoid claim denials or out-of-pocket costs

Coverage typically resumes once the face-to-face visit has been completed and documented.

Don’t Let a Missed Visit Disrupt Your Mental Health Care

Medicare’s in-person rule doesn’t mean telehealth is going away. It simply means you need to take one extra step each year to ensure uninterrupted care. If you rely on at-home visits for mental health treatment, build the required in-person session into your care routine now.

Reach out to your provider today to confirm your eligibility, and get your next face-to-face visit on the calendar. For help reviewing your Medicare options or understanding this change, contact a licensed agent listed on this website.