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.
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 to diagnose your condition or to monitor or change your prescriptions. The Part B deductible applies.
- If you get treatment in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount of the hospital. This amount will vary depending on the service provided, but will be between 20-40% of the Medicare-approved amount.
- 35% of the Medicare-approved amount for outpatient treatment of your condition (like individual or group psychotherapy, often called counseling or therapy) in a doctor or other health provider's office or hospital outpatient department.
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.
- Substance Abuse & Mental Health Services Administration
- National Institute of Mental Health
- Find hospitals
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).