Your Medicare Coverage

Is my test, item, or service covered?

Mental health care (outpatient)

How often is it covered?

Medicare Part B (Medical Insurance) covers mental health services on an outpatient basis when provided by a doctor, clinical psychologist, clinical social worker, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant in a doctor or other health care provider's office or hospital outpatient department.

Medicare only covers these visits, often called counseling or therapy, when they’re provided by a health care provider who accepts Medicare payment.

Who's eligible?

All people with Medicare are covered.

Your costs in Original Medicare

  • 20% of the Medicare-approved amount for visits to a doctor or other health care provider. The Part B deductible applies.
  • 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. This amount will vary depending on the service provided, but will be between 20-40% of the Medicare-approved amount.
Note

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

Related resources

If you need immediate help for yourself or someone in a crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK or 1-800-SUICIDE (1-800-273-8255). TTY users should call 1-800-799-4TTY (1-800-799-4889).  

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