Key Takeaways

• As of 2025, Medicare covers more types of mental health professionals, making it easier to begin therapy.

• While Medicare covers both inpatient and outpatient therapy, there are specific conditions and requirements you should understand to avoid delays or denials.

Why Mental Health Coverage Matters More Than Ever in 2025

Mental health care is no longer an optional add-on. In 2025, Medicare continues expanding its support for behavioral health, addressing rising demand for therapy among older adults and people with disabilities. Starting therapy under Medicare may still involve some paperwork and planning, but recent policy changes help simplify the process and remove many of the past roadblocks.

If you’re struggling with anxiety, depression, trauma, grief, or even just everyday stress, you might be surprised to learn just how much Medicare can help you access professional therapy this year.

What Types of Therapy Does Medicare Cover?

Medicare provides coverage for both inpatient and outpatient mental health services. Here’s what that means in practice:

Inpatient Coverage (Medicare Part A)

If you’re admitted to a general or psychiatric hospital for mental health treatment, Medicare Part A covers:

• Semi-private room and meals

• Nursing care

• Medications and therapy during your stay

However, there’s a 190-day lifetime limit for inpatient psychiatric hospital care that does not apply to general hospital stays. After those 190 days are used, Medicare won’t cover psychiatric stays in specialty facilities.

Outpatient Coverage (Medicare Part B)

This is where therapy usually begins. Part B covers outpatient mental health care such as:

• Individual and group therapy

• Psychiatric evaluations and testing

• Medication management

• Family counseling related to your treatment

• Partial hospitalization programs (PHPs)

• Intensive outpatient programs (IOPs)

• Preventive depression screenings

To be covered, the services must be considered medically necessary and provided by approved professionals.

Who Can Provide Covered Therapy in 2025?

As of January 1, 2024, Medicare began covering services from two new types of mental health providers:

• Licensed Marriage and Family Therapists (LMFTs)

• Licensed Mental Health Counselors (LMHCs)

This change continues into 2025, expanding access for those who previously struggled to find a provider who accepts Medicare. Other covered professionals include:

• Psychiatrists

• Psychologists (PhD or PsyD)

• Clinical Social Workers (LCSWs)

• Clinical Nurse Specialists

• Nurse Practitioners

• Physician Assistants

All providers must accept Medicare assignment, meaning they agree to Medicare’s approved payment structure.

How Much Will You Pay for Therapy in 2025?

If you have Original Medicare:

• Part B Deductible: $257 for 2025

• Coinsurance: After meeting the deductible, you typically pay 20% of the Medicare-approved amount

If you have a Medicare Supplement (Medigap) plan, it may cover part or all of these out-of-pocket costs. If you’re enrolled in a Medicare Advantage plan, you’ll need to check your plan’s cost-sharing details, but the coverage must be at least equal to Original Medicare.

What Are the Therapy Visit Limits Under Medicare?

There are no set limits on the number of covered outpatient therapy sessions per year, as long as they are considered medically necessary. However, Medicare may review the frequency and necessity of services after a certain threshold is reached. If your therapist or provider recommends long-term care, they must document your progress and treatment goals.

Medicare may also require a periodic reauthorization or recertification for extended therapy services, especially under partial hospitalization or intensive outpatient programs.

Do You Need a Referral to Start Therapy?

With Original Medicare, you usually do not need a referral to see a mental health professional. However, some Medicare Advantage plans do require prior authorization or referrals. Always check your specific plan’s rules to avoid unexpected delays.

Your primary care provider may still play a key role in documenting the need for therapy or coordinating your care.

What’s New in 2025 to Make Starting Therapy Easier?

The current year brings several updates that make it more practical to access therapy:

Expanded Provider Types

Medicare now recognizes LMFTs and LMHCs as billable providers, which means:

• More therapists accept Medicare

• Shorter wait times for appointments

• Greater access in rural and underserved areas

Permanent Telehealth Coverage for Mental Health

Therapy delivered through telehealth is now permanently covered under Medicare Part B for mental health services, including:

• Video visits from home

• Audio-only sessions (if video is unavailable or impractical)

However, starting October 1, 2025, beneficiaries must have an in-person visit with their provider every 12 months to continue telehealth therapy. Exceptions exist for those with transportation barriers or provider shortages.

Integration with Primary Care

Mental health services are increasingly being delivered within primary care settings. This helps:

• Reduce stigma

• Improve care coordination

• Make therapy a routine part of overall health management

Some Medicare-participating clinics now offer on-site behavioral health consultations during regular doctor visits.

What If You Need Medication Too?

Therapy often goes hand in hand with medication, especially for conditions like depression, bipolar disorder, or PTSD. Medicare provides:

• Part B: Coverage for medication management appointments

• Part D: Coverage for prescription drugs, including antidepressants, anti-anxiety medications, and mood stabilizers

As of 2025, the annual out-of-pocket limit for Part D drug costs is $2,000. Once your costs hit this cap, your plan covers 100% of drug expenses for the rest of the year.

What Is a Partial Hospitalization Program (PHP)?

If your condition requires structured therapy but not full-time hospitalization, a PHP may be recommended. These programs are covered under Medicare Part B and typically include:

• Intensive daily therapy (group and individual)

• Medication monitoring

• Skill-building and support sessions

To qualify, you must be under the care of a physician and the services must be part of a written treatment plan. You do not stay overnight, but attendance is usually required for several hours each day, 5 to 7 days per week.

What About Intensive Outpatient Programs (IOP)?

As of 2024, Medicare began covering intensive outpatient programs for mental health treatment. These continue in 2025 and offer:

• A structured schedule (typically 9–19 hours per week)

• Less intensity than PHPs but more than traditional outpatient therapy

• Services like cognitive behavioral therapy, relapse prevention, and psychiatric check-ins

This level of care is helpful for people stepping down from hospitalization or those needing more than weekly sessions.

How to Find a Therapist Who Accepts Medicare

To find a Medicare-approved therapist:

• Visit the official Medicare website’s provider search tool

• Call 1-800-MEDICARE and ask for mental health provider options near you

• Contact your local mental health clinic and ask if they bill Medicare

• Reach out to your primary care doctor for a referral to a Medicare-participating provider

Keep in mind that not all therapists accept Medicare, even if they are licensed. Confirm Medicare participation before starting services.

What to Expect at Your First Session

The initial therapy session typically includes:

• A mental health evaluation

• A discussion about symptoms and goals

• Review of your medical history

• Development of a treatment plan

Ongoing sessions focus on building coping skills, processing emotions, and tracking your progress. You and your therapist will decide on the frequency and type of sessions based on your needs.

Staying Committed to Your Mental Health

Consistency matters in therapy. Medicare supports regular, structured treatment, but you’ll need to actively participate in the process:

• Show up for appointments

• Follow treatment recommendations

• Communicate with your provider about what is and isn’t working

If you feel your needs aren’t being met, you can switch providers within the Medicare network.

Taking Advantage of Mental Health Support in 2025

Therapy is more accessible in 2025 than it has ever been under Medicare. Whether you’re just beginning your mental health journey or returning to care after a long break, this year’s updates offer real opportunities for support and healing.

If you’re unsure where to begin or want help finding a covered provider, get in touch with a licensed agent listed on this website. They can walk you through the steps, help you understand your options, and make sure you’re fully protected.