Short answer: Medicare Part B covers medically necessary outpatient counseling and psychotherapy for mental health and substance use conditions. Covered providers include psychiatrists, psychologists, clinical social workers, mental health counselors, marriage and family therapists, and other eligible professionals.
Original Medicare coverage
Part B covers individual, group, and family psychotherapy when it is used to diagnose or treat a covered mental health condition. Coverage can also include crisis services, medication management, partial hospitalization, and intensive outpatient services when the applicable requirements are met. Part A covers covered mental health care during a formal inpatient hospital admission.
Medicare also covers one yearly depression screening without cost sharing when it is furnished in an appropriate primary care setting by a provider who accepts assignment. Ongoing treatment after a screening is billed under the ordinary mental health benefit.
Eligibility and limits
The service must be reasonable and medically necessary, and the professional must be enrolled in Medicare and legally authorized to provide the service. The type and frequency of counseling should be supported by the treatment plan and documentation. Relationship coaching, general personal development, and services from a provider who cannot bill Medicare may not be covered.
Costs
After the Part B deductible, you generally pay 20 percent of the Medicare-approved amount for covered outpatient counseling. A hospital outpatient department may charge an additional copayment or coinsurance. The yearly depression screening has no cost when the requirements are met and the provider accepts assignment.
Medicare Advantage
Medicare Advantage plans must cover Medicare-covered mental health services. Plans may use provider networks, referrals, and prior authorization for some levels of care. Emergency and crisis protections apply under plan and federal rules.
What to do next
- Confirm that the counselor is enrolled in Medicare or in your plan’s network.
- Ask whether the visit will be billed as individual, group, or family psychotherapy.
- Check authorization before intensive outpatient or partial hospitalization care.
- Call or text 988 for a mental health crisis, or call 911 for an immediate emergency.
Coverage is determined from the claim, the patient’s eligibility, provider status, and applicable Medicare rules. A provider’s recommendation does not guarantee payment. Before a planned service, ask the provider what will be billed and ask Medicare or the plan whether any coverage review is required.
Sources
Last reviewed: August 2026. Medicare rules and plan benefits can change.