Key Takeaways

• Medicare Part B covers a wide range of outpatient mental health services in 2025, including therapy, screenings, medication management, and treatment programs.

• Understanding coverage requirements, approved providers, and your cost-sharing responsibilities can help you access care without unexpected bills or delays.

Understanding Medicare Part B’s Mental Health Role

If you’re enrolled in Medicare, you might already know that Part B helps cover doctor visits, tests, and outpatient services. What many people don’t realize is how vital Part B has become for mental health support. In 2025, it covers a broad set of services to help you address conditions like depression, anxiety, bipolar disorder, PTSD, and more. However, it’s not automatic or unlimited—there are rules you need to follow, and knowing them can save you both time and money.

What Mental Health Services Does Medicare Part B Cover in 2025?

Medicare Part B now offers significantly expanded mental health services. These include:

• Psychiatric evaluations

• Individual and group therapy

• Family counseling related to mental health treatment

• Medication management by a psychiatrist or other qualified provider

• Screenings for depression and substance use disorders

• Partial Hospitalization Programs (PHP)

• Intensive Outpatient Programs (IOP)

• Services from new provider types added in 2024, such as Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs)

These services are aimed at helping you get treatment early, maintain stability, and prevent more severe issues that could lead to hospitalization.

What You Pay: Deductible, Coinsurance, and What’s Covered

In 2025, Medicare Part B continues to follow a cost-sharing model. Here’s what you need to know:

• Annual deductible: $257

• Coinsurance: You pay 20% of the Medicare-approved amount for most covered outpatient mental health services after meeting your deductible.

• Excess charges: If you see providers who don’t accept Medicare assignment, you may pay more.

Services like annual depression screenings are covered in full if your provider accepts assignment, and you don’t need to meet the deductible.

Who Can Provide Mental Health Services Under Medicare?

To get coverage, you must receive care from providers approved by Medicare. In 2025, these include:

• Psychiatrists

• Clinical psychologists

• Clinical social workers

• Psychiatric nurse practitioners

• Marriage and Family Therapists (MFTs)

• Mental Health Counselors (MHCs)

Each provider must be enrolled in Medicare and licensed in your state. You can verify this through Medicare’s provider search tools.

Therapy Options Covered Under Part B

Medicare Part B allows for different types of therapy to match your needs:

• Cognitive Behavioral Therapy (CBT)

• Dialectical Behavior Therapy (DBT)

• Interpersonal Therapy

• Solution-focused brief therapy

These can be delivered in-person or via telehealth. Many beneficiaries choose to start with individual therapy and add group or family therapy as needed.

Telehealth Mental Health Coverage Continues in 2025

One of the major shifts since 2020 has been the expansion of telehealth. For 2025, Medicare still covers mental health services via telehealth, including video and some audio-only visits.

However, there is one requirement: starting October 1, 2025, beneficiaries must have one in-person visit with their mental health provider every 12 months to maintain ongoing telehealth services. Exceptions exist for those with hardship conditions or in rural areas.

Treatment Programs: PHP and IOP

Medicare Part B covers two intensive outpatient services:

Partial Hospitalization Programs (PHP)

PHPs are structured day programs provided by hospitals or community mental health centers. They are ideal if you need more intensive treatment than standard therapy but don’t require overnight hospitalization. Medicare covers:

• Individual and group therapy

• Occupational therapy (if part of the mental health treatment)

• Activity therapies (if prescribed)

• Regular psychiatric evaluations and medication checks

To qualify, your doctor must certify that PHP is medically necessary and part of your treatment plan.

Intensive Outpatient Programs (IOP)

As of 2024, IOPs are also covered. They are less intensive than PHP but more structured than standard outpatient care. They typically include:

• 9–19 hours of therapy per week

• A combination of group and individual sessions

• Medication management

IOPs are valuable for stabilizing mental health conditions and preventing relapse.

Annual Screenings and Preventive Mental Health Services

Medicare now emphasizes early detection through preventive screenings, which are fully covered when done by a participating provider. These include:

• Annual depression screening: Done during a primary care visit, it helps identify early signs of depression.

• Alcohol misuse screening: Includes brief counseling if needed.

• Substance use disorder screening: Covered as part of behavioral health integration.

While these are preventive, they can lead to a referral for further mental health treatment if needed.

Medication Management and Psychiatric Care

Part B covers visits with psychiatrists or other eligible providers for:

• Evaluating symptoms

• Prescribing and managing medications

• Adjusting treatment plans

Medications themselves are typically covered under Part D, but the provider visits for monitoring them are billed to Part B.

Coordinating Care Through Behavioral Health Integration (BHI)

If you receive mental health care through your primary care physician, Medicare’s Behavioral Health Integration model can help coordinate it. This model includes:

• Ongoing assessment of mental health status

• Care planning and monitoring

• Communication between your primary doctor and mental health professionals

This is especially useful for those managing both chronic physical and mental conditions.

Inpatient vs. Outpatient: What Part B Does Not Cover

It’s important to know that Medicare Part B does not cover:

• Inpatient psychiatric hospital stays (this is covered under Part A)

• Emergency room visits for psychiatric crises (also covered under Part A or sometimes Part B, depending on the scenario)

• Prescription drugs (generally covered by Part D)

Also, Part B does not provide long-term custodial care in mental health facilities.

Coverage Limits and Duration of Therapy

Unlike private insurance plans that often place hard limits on the number of therapy visits, Medicare Part B does not set a fixed limit. Therapy is covered as long as it is:

• Medically necessary

• Documented in your treatment plan

• Reviewed periodically by your provider

This means you can continue with therapy for as long as your doctor certifies it as necessary. However, Medicare may review claims to confirm that the care is still justified.

How to Start Using Your Mental Health Benefits

Here’s a step-by-step process:

1. Talk to your primary care doctor: Discuss any mental health symptoms or concerns.

2. Get a referral (if needed): While you don’t need a referral for all services, your doctor can help direct you to an appropriate provider.

3. Choose a Medicare-approved provider: Use the Medicare website or contact your plan for help finding one.

4. Understand your costs: Ask your provider’s office to explain your out-of-pocket costs before starting treatment.

5. Attend regular sessions: Be consistent to get the most from your treatment plan.

How Part B Works with Other Coverage

If you have additional coverage like Medigap, Medicaid, or retiree insurance, it may reduce your costs:

• Medigap: May pay your Part B coinsurance.

• Medicaid: May help with premiums, deductibles, and copays.

• Employer or retiree insurance: May provide extra coverage for mental health or prescription drugs.

Understanding how your plans coordinate can prevent billing surprises.

Medicare’s Commitment to Expanding Mental Health in 2025

The addition of new providers in 2024 and the continued support for telehealth show Medicare’s commitment to mental health access. In 2025, these improvements remain in place, with plans to maintain flexibility while ensuring clinical accountability through in-person visit requirements.

This focus is especially crucial given the growing awareness of mental health needs in older adults, who may face isolation, loss, or chronic illness—all of which increase vulnerability.

Make Informed Use of Your Part B Mental Health Benefits

If you need mental health care, Medicare Part B offers strong support—but only if you know how to use it. From finding the right provider to managing your out-of-pocket costs, every step you take can make a difference in your outcomes.

For help selecting providers or understanding how your benefits apply, get in touch with a licensed agent listed on this website. They can help you make the most of your coverage in 2025.