Medicare Mental Health Coverage: Therapy, Doctors, Hospital Limits
Written by My65 Playbook Editorial Team
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If you have a Medicare Advantage plan, your costs differ from these; check your plan's Evidence of Coverage for your copays instead.
Medicare covers mental health care under Part B for counseling and psychiatrist visits, and under Part A for hospital stays. In 2026, you pay 20% of the Medicare-approved amount (20 cents per approved dollar) after the $283 Part B deductible. Psychiatric hospital stays have a 190-day lifetime limit.
Key takeaways
- Part B covers therapy, psychiatric visits and a yearly depression screening.
- After the 2026 Part B deductible of $283, you pay 20% coinsurance: 20 cents of each approved dollar.
- Since January 1, 2024, licensed counselors and marriage and family therapists can bill Medicare.
- Part A covers inpatient care, but a psychiatric hospital stay is limited to 190 days in your lifetime.
- With a Medicare Advantage plan, costs and networks vary by location and carrier.
What mental health care does Part B cover?
- Individual and group therapy
- Family counselingWhen the goal is to help your treatment
- Psychiatric evaluation
- Medication management
- Yearly depression screening$0 when the provider accepts assignment
Part B (medical insurance) covers mental health care you get outside a hospital. It also covers some care in a hospital outpatient clinic. You can read more about what Medicare Part B covers.
Covered services include:
- One-on-one and group therapy (talk therapy, also called psychotherapy)
- Family counseling, when the goal is to help your treatment
- A psychiatric evaluation to diagnose a condition
- Medication management, where a provider checks how your drugs are working
- Tests to diagnose a condition, when they are medically needed
- A yearly depression screening in a primary care office
Medicare also reviews your risk of depression at your first preventive visit. The Welcome to Medicare visit and preventive coverage article explains how that visit works.
Which therapists and counselors can you see?
Medicare pays several kinds of licensed providers for mental health care. These include psychiatrists and other doctors, clinical psychologists and clinical social workers. Nurse practitioners, physician assistants and clinical nurse specialists also qualify.
Since January 1, 2024, marriage and family therapists and mental health counselors can bill Medicare too. Before that date, Medicare did not pay them directly.
The provider must accept Medicare. Ask whether they "accept assignment." That means they agree to take the Medicare-approved amount as full payment. You then pay your share and nothing above it.
How much do you pay for therapy visits?
First, you pay the Part B deductible. The 2026 Part B deductible is $283 a year; it is set annually. After that, you pay 20% of the Medicare-approved amount for each visit. That is 20 cents for every dollar Medicare approves.
The yearly depression screening costs you $0 if your provider accepts assignment. If you get therapy in a hospital outpatient clinic, the hospital may also charge a copayment.
You also pay the monthly Part B premium. The 2026 standard Part B premium is $202.90 a month; it is set each year, and higher-income enrollees pay more.
Medigap (extra insurance from private companies that helps pay Original Medicare's share) can help pay your 20%. What a policy pays depends on the plan letter you choose.
What is the 190-day psychiatric hospital limit?
Part A (hospital insurance) covers inpatient mental health care. You can get it in a general hospital or in a psychiatric hospital that treats only mental health conditions.
In a psychiatric hospital, Part A covers up to 190 days in your lifetime. Once you use those days, Part A will not pay for more care there. The limit does not apply to a psychiatric unit inside a general hospital.
| Psychiatric hospital | Psychiatric unit in a general hospital | |
|---|---|---|
| 190-day lifetime cap | Yes | No |
| 2026 Part A deductible | $1,736 per benefit period | $1,736 per benefit period |
| Doctor visits during the stay | Part B, 20% coinsurance | Part B, 20% coinsurance |
| Kinds of care | Mental health only | Many kinds of care |
The costs per stay are the same in both settings. The difference is the lifetime cap, which applies only to a psychiatric hospital.
What does a hospital stay cost under Part A?
In 2026, the Part A deductible is $1,736 for each benefit period; it is set annually. A benefit period starts the day you are admitted. It ends when you have been out of a hospital or skilled nursing facility for 60 days in a row.
After the deductible, Part A pays for the first 60 days of each benefit period. From day 61, you pay a daily coinsurance amount. You can confirm the 2026 daily amounts at Medicare.gov or 1-800-MEDICARE.
Doctors who treat you in the hospital bill Part B. You pay 20% of those approved amounts, or 20 cents per approved dollar.
Is there care between therapy and the hospital?
Yes. Partial hospitalization is a structured day program at a hospital outpatient clinic or community mental health center. You get treatment during the day and sleep at home. It is for people who would otherwise need a hospital stay.
Since January 1, 2024, Part B also covers intensive outpatient program services. These programs give more care than weekly therapy, but fewer hours than partial hospitalization. A doctor must certify that you need this level of care.
For both, you pay coinsurance for each day of services after the Part B deductible. The amount depends on the program and setting.
Can you get counseling by video at home?
- Telehealth from any U.S. location, including homeNow – December 31, 202720% coinsurance; Part B deductible applies
Yes, for now. Through December 31, 2027, you can get Medicare telehealth services anywhere in the U.S., including your home. You pay 20% of the Medicare-approved amount, and the Part B deductible applies.
Video visits can help if you live far from a therapist or do not drive. Ask your provider whether they offer telehealth visits and bill Medicare for them.
How are mental health drugs covered?
Medicare drug coverage (Part D) helps pay for drugs such as antidepressants. You get it through a stand-alone drug plan or a Medicare Advantage plan with drug coverage. Plans must cover all or nearly all drugs in certain groups, including antidepressants and antipsychotics.
In 2026, a plan's drug deductible can be no more than $615, and some plans charge less or none. Your out-of-pocket costs for covered drugs are capped at $2,100 in 2026. After you reach the cap, the plan pays 100% of covered drugs for the rest of the year.
If you join the Medicare Prescription Payment Plan, you pay $0 at the pharmacy counter and get monthly bills instead. It does not lower your costs; it spreads them over the rest of the year.
How does Medicare Advantage handle mental health?
Medicare Advantage plans (Part C, private plans that take the place of Original Medicare) must cover the same mental health services. But each plan sets its own copays and network. Plan details vary by location and carrier.
Before you book, check that the therapist or psychiatrist is in your plan's network. Some plans also need a referral or approval first. Your plan's Evidence of Coverage (the yearly booklet of plan rules) lists these steps.
What does Medicare not pay for?
Original Medicare does not pay for meals or rides to mental health appointments. It also does not pay for support groups that are not group therapy. Job skills training that is not part of your treatment is not covered either.
How can you check your mental health bills?
- Open each Medicare Summary Notice when it arrives
- Match each therapy date to your calendar
- Circle any visit you did not get
- Report suspected fraud to 1-800-MEDICARE
Original Medicare mails a Medicare Summary Notice every few months. It lists each service billed in your name. Look for therapy sessions or visits you did not get. Reading your Medicare Summary Notice shows how to spot errors and appeal.
Guard your Medicare Number like a credit card. If you suspect fraud, report it to 1-800-MEDICARE.
Have questions? Call 1-877-443-3251 to talk it through with a licensed insurance agent. You never pay the agent; the plans they represent do, and the decision stays yours.
We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Medicare has neither reviewed nor endorsed this information.
What to do this week
- Write down the kind of help you want, such as talk therapy, medication checks or a day program.
- Call two local therapists or counselors and ask, "Do you accept Medicare assignment?"
- Ask your primary care provider for your yearly depression screening at your next visit.
- If you have a Medicare Advantage plan, look up the provider in your plan's directory and ask whether a referral is needed.
- List every mental health drug you take, with doses, and check each one in your Part D plan's drug list.
- Put your next Medicare Summary Notice by the phone and compare each therapy date to your calendar.
A real example
Medicare Disclaimer
We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Medicare has neither reviewed nor endorsed this information.
Frequently asked questions
Does Medicare pay for therapy with a counselor?
Yes. Since January 1, 2024, Part B pays licensed mental health counselors and marriage and family therapists, along with psychologists, clinical social workers and psychiatrists. In 2026 you pay 20% of the Medicare-approved amount after the $283 Part B deductible.
How many therapy sessions does Medicare cover each year?
Medicare sets no yearly cap on outpatient therapy sessions. The care must be medically needed, and you pay 20% of the Medicare-approved amount for each visit after the Part B deductible.
What is the 190-day limit?
Part A covers up to 190 days of care in a psychiatric hospital over your whole lifetime. The limit does not apply to a psychiatric unit inside a general hospital.
Is the yearly depression screening covered?
Yes. Part B covers one depression screening a year in a primary care setting. You pay $0 if your provider accepts assignment.
Can I see my therapist by video?
Yes. Through December 31, 2027, you can get Medicare telehealth services anywhere in the U.S., including at home. You pay 20% of the Medicare-approved amount, and the Part B deductible applies.
Are antidepressants covered by Medicare?
Medicare drug plans (Part D) must cover all or nearly all antidepressants. In 2026, your out-of-pocket costs for covered drugs are capped at $2,100 for the year.
