Mental health care (outpatient)
Medicare Part B (Medical Insurance) covers a wide range of outpatient mental health services
Description
Outpatient mental health services involve diagnosing and treating people with mental health conditions, like depression and anxiety.
Coverage details
Medicare Part B (Medical Insurance) covers a wide range of outpatient mental health services, including:
- Safety planning interventions if you’re at risk of suicide or overdose.
- A follow-up phone call after you’re discharged from the emergency department for a behavioral health service or other crisis.
- FDA-cleared digital mental health treatment devices you get from your doctor or certain other qualified mental health providers.
- One depression screening per year. You must get the screening in a primary care doctor’s office or primary care clinic that can provide follow-up treatment and referrals.
- Individual and group psychotherapy with doctors (or with certain other Medicare-enrolled licensed professionals, as the state where you get the services allows).
- Family counseling, if the main purpose is to help with your treatment.
- Testing to find out if you’re getting the services you need and if your current treatment is helping you.
- Psychiatric evaluation.
- Medication management.
- Certain prescription drugs that aren’t usually “self administered” (drugs you would normally take on your own), like some injections.
- Diagnostic tests.
- Partial hospitalization.
- Intensive outpatient program services.
- Mental health services you get as part of substance use disorder treatment.
- A one-time “Welcome to Medicare” preventive visit. This visit includes a review of your possible risk factors for depression.
- A yearly “Wellness” visit. Talk to your doctor or other health care provider about changes in your mental health since your last visit.
Provider requirements
Part B covers mental health services and visits with these types of health professionals:
- Psychiatrists or other doctors
- Clinical psychologists
- Clinical social workers
- Clinical nurse specialists
- Nurse practitioners
- Physician assistants
- Marriage & family therapists
- Mental health counselors
Costs
- You pay nothing for your yearly depression screening if your health care provider accepts assignment .
- After you meet the Part B deductible , you pay 20% of the Medicare-approved amount for visits to your health care provider to diagnose or treat your condition.
- If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital.
Facility
You usually get these services outside of a hospital, in these types of settings:
- A doctor’s or other health care provider’s office
- A hospital outpatient department
- A community mental health center