Medicare covers mental health therapy and counseling in 2026, including outpatient psychotherapy, inpatient psychiatric care, telehealth sessions, and Intensive Outpatient Programs (IOP). Coverage falls under Part A for inpatient stays and Part B for outpatient services. Your out-of-pocket costs depend on which part applies, whether you have supplemental coverage, and which type of provider you see. This guide walks through every aspect of Medicare mental health coverage so you know exactly what to expect.
What Mental Health Services Medicare Covers in 2026
Medicare covers a broad range of mental health services across multiple settings. Here is a breakdown by category:
Outpatient Mental Health Services (Part B)
- Individual psychotherapy
- Group psychotherapy
- Family therapy when it is part of your treatment plan
- Psychiatric evaluation and diagnostic testing
- Medication management visits with a psychiatrist
- Depression screening (one per year, at no cost)
- Alcohol misuse counseling (four sessions per year, at no cost)
- Intensive Outpatient Programs (IOP) -- added as a covered benefit in 2024 and continuing in 2026
Inpatient Mental Health Services (Part A)
- Psychiatric hospitalization at a general hospital or a Medicare-certified distinct psychiatric unit
- Stays at a freestanding psychiatric hospital (subject to a 190-day lifetime limit)
Telehealth Mental Health Services
- Video therapy sessions with psychiatrists, psychologists, licensed clinical social workers, licensed mental health counselors, and marriage and family therapists
- Audio-only (phone) sessions when video is not available
- Sessions from your home, with no geographic restriction through at least December 31, 2027
Medicare Part B: Outpatient Therapy Costs in 2026
Part B handles most outpatient mental health care. The cost structure is the same as for other Part B medical services.
| Service | Medicare Pays | You Pay |
|---|
| Outpatient psychotherapy | 80% of approved amount | 20% after deductible |
| Psychiatric evaluation | 80% of approved amount | 20% after deductible |
| Depression screening (annual) | 100% | $0 |
| Alcohol misuse counseling | 100% | $0 |
| Group therapy session | 80% of approved amount | 20% after deductible |
| IOP services | 80% of approved amount | 20% after deductible |
2026 Part B deductible: $283. You pay this once per year before Medicare starts covering outpatient services. After you meet the deductible, Medicare pays 80% and you pay 20% of the Medicare-approved amount for each visit.
For reference, the 2026 Medicare-approved rates for common therapy procedure codes are approximately:
- 90837 (60-minute individual psychotherapy): $167.00
- 90834 (45-minute individual psychotherapy): $113.90
- 90791 (psychiatric diagnostic evaluation): $173.35
Your 20% share on a 60-minute session would be roughly $33 to $35. If you have a Medigap (Medicare Supplement) plan, it typically covers the 20% coinsurance, reducing your cost to near zero.
The $2,480 therapy threshold: Medicare uses a combined cap for outpatient therapy services. When your therapy expenses exceed $2,480 in a calendar year, your provider must add a KX modifier to claim codes to confirm continued medical necessity. This is not a hard coverage cutoff -- therapy continues as long as it remains medically necessary -- but the modifier requirement kicks in at that spending level.
Medicare Part A: Inpatient Psychiatric Care Costs in 2026
When you need hospital-level psychiatric care, Part A covers the stay. The cost structure depends on how many days you are admitted.
| Days in Hospital | Your Cost |
|---|
| Days 1 to 60 | $0 per day (after deductible) |
| Days 61 to 90 | $434 per day |
| Days 91 to 150 | $868 per day (lifetime reserve days) |
| After 150 days | All costs |
2026 Part A deductible: $1,736 per benefit period. This applies to each hospital admission after a 60-day break in care, not per year.
The 190-day psychiatric hospital limit: Medicare Part A limits inpatient care at freestanding psychiatric hospitals to 190 days over your lifetime. This limit does not apply to psychiatric units inside general hospitals or critical access hospitals. If you have used your 190 days at a freestanding facility, Medicare can still cover inpatient care at a general hospital psychiatric unit.
Who Can Provide Mental Health Services Under Medicare
Medicare expanded its list of covered mental health providers significantly in recent years. As of 2024 and continuing through 2026, the following professionals can bill Medicare for mental health services:
| Provider Type | Coverage Notes |
|---|
| Psychiatrists | Covered under Part B; can prescribe medication |
| Psychologists | Covered under Part B |
| Licensed Clinical Social Workers (LCSW) | Covered under Part B |
| Licensed Mental Health Counselors (LMHC) | Covered as of 2024; bills at 75% of psychologist rate |
| Marriage and Family Therapists (MFT) | Covered as of 2024; bills at 75% of psychologist rate |
| Nurse Practitioners and Physician Assistants | Covered under Part B with appropriate certification |
| Primary Care Physicians | Can provide some mental health services |
All providers must be enrolled in Medicare and the services must be deemed medically necessary.
Telehealth Mental Health Therapy in 2026
Medicare covers telehealth mental health sessions from home. This applies to both Original Medicare and Medicare Advantage plans. Key details:
- No geographic restriction: You do not need to be in a rural area. Any Medicare beneficiary can access telehealth mental health services from home.
- Video and audio options: Video sessions are the standard, but audio-only phone sessions remain covered for mental health specifically when video is not feasible.
- Same cost-sharing: You pay the same 20% coinsurance for telehealth sessions as you would for in-person visits.
- Coverage extended through 2027: Congress has extended telehealth flexibilities through December 31, 2027, giving you continued access regardless of location.
Intensive Outpatient Programs (IOP) Under Medicare in 2026
Medicare added IOP coverage as a benefit category in 2024. IOPs are structured programs for people who need more intensive support than weekly therapy but do not require a full inpatient hospital stay.
To qualify for IOP coverage under Medicare:
- You must need at least 9 hours of treatment per week (some programs provide 20 or more hours)
- Services must be provided by a Medicare-certified facility
- A physician or other qualified provider must certify the medical necessity
- Part B applies, so the standard $283 deductible and 20% coinsurance apply
IOPs typically include individual therapy, group therapy, medication management, and psychoeducation sessions. They are particularly used for depression, anxiety, substance use disorders, and eating disorders.
Medicare Advantage and Mental Health Coverage
Medicare Advantage (Part C) plans must cover everything Original Medicare covers, including mental health services. Some plans offer additional benefits such as:
- More therapy sessions per year
- Lower copays for mental health visits
- Gym memberships or wellness programs that support mental health
- Additional telehealth benefits
The tradeoff: Medicare Advantage plans require you to use in-network providers. If your therapist or psychiatrist is not in-network, you may pay significantly more or the claim may not be covered at all. Always confirm your provider is in-network before starting treatment with a Medicare Advantage plan.
Medicare Supplement (Medigap) and Mental Health
Medigap plans help cover Original Medicare's cost-sharing. For mental health services:
- Medigap Plan G: Covers the Part B coinsurance (the 20% you owe after deductible), and covers the Part A deductible and coinsurance for inpatient stays.
- Medigap Plan N: Covers Part B coinsurance, but you may pay up to a $20 copay per visit.
- Other Medigap plans offer varying levels of cost-sharing assistance.
With a Medigap plan, your out-of-pocket per therapy visit can be reduced to near zero after paying the annual Part B deductible.
What Medicare Does Not Cover for Mental Health
There are gaps in Medicare mental health coverage worth knowing about:
- Custodial or long-term care: Medicare does not cover non-medical residential mental health care, long-term group home placement, or custodial supervision.
- Out-of-network providers (Medicare Advantage): If your plan requires network participation, seeing an out-of-network therapist may result in no coverage.
- Experimental treatments: Services not recognized as medically necessary by Medicare are not covered.
- Marriage counseling for relationship purposes only: Couples therapy is covered only if it is part of a medical treatment plan, not if the primary purpose is relationship improvement.
How to Find a Medicare-Covered Mental Health Provider
Finding a provider who accepts Medicare requires a few simple steps:
- Use the Medicare Care Compare tool at medicare.gov to search for psychiatrists, psychologists, and counselors in your area who accept Medicare.
- Call your plan (if Medicare Advantage) to get a list of in-network mental health providers before scheduling an appointment.
- Ask your primary care doctor for a referral. Many PCP offices maintain referral lists for Medicare-enrolled mental health specialists.
- Check telehealth platforms such as those connected to federally qualified health centers, many of which accept Medicare for mental health visits.
How to Check Your Full Medicare Benefits
Your mental health coverage is one piece of a larger benefits picture. Use the free screener at benefitsusa.org/screener to check what additional programs you may qualify for, including Medicare Savings Programs that can reduce your Part B premiums and cost-sharing, Medicaid dual enrollment, and other assistance.
Frequently Asked Questions
Does Medicare cover therapy with a regular psychotherapist?
Yes. Medicare Part B covers individual and group psychotherapy with licensed psychologists, licensed clinical social workers, licensed mental health counselors, and marriage and family therapists. You pay 20% of the Medicare-approved amount after the annual Part B deductible of $283.
Is there a limit on how many therapy sessions Medicare covers per year?
Medicare does not set a fixed session limit. Therapy is covered as long as it is medically necessary and your provider documents the ongoing need. However, when cumulative therapy costs reach $2,480 in a year, your provider must add a KX modifier to claims to confirm continued medical necessity.
Does Medicare cover mental health medication management?
Yes. Visits with a psychiatrist or other qualified prescriber for medication evaluation and management are covered under Part B. Psychiatric medications are covered under Part D (prescription drug coverage), not Part B.
Can I get therapy by phone or video through Medicare?
Yes. Medicare covers both video and audio-only (phone) mental health sessions. Telehealth mental health services are covered from your home with no geographic restriction through at least December 31, 2027.
Does Medicare cover substance use treatment?
Yes. Medicare covers medically necessary substance use disorder treatment including detoxification, counseling, and medication-assisted treatment (such as buprenorphine). Part A covers inpatient detox; Part B covers outpatient counseling and IOP services for substance use.
What is the 190-day limit for psychiatric hospitals?
Medicare Part A limits coverage at freestanding psychiatric hospitals to 190 days in your lifetime. This limit does not apply to psychiatric units located inside general hospitals. If you reach the 190-day limit at a freestanding facility, Medicare can still cover care at a general hospital's psychiatric unit.
Does Medicare Advantage cover the same mental health services as Original Medicare?
Medicare Advantage plans must cover at least the same mental health services as Original Medicare. Many plans offer additional benefits such as lower copays or extra therapy sessions. The key difference is that you must use in-network providers, or your costs may be significantly higher.
How do I find a therapist who accepts Medicare?
Use the Care Compare tool at medicare.gov to search for mental health providers by location. If you have Medicare Advantage, contact your plan for a list of in-network providers before booking an appointment.
Are mental health services covered under Medicare the same cost as other medical services?
Yes. Following the phased implementation of the Medicare mental health parity rule completed in 2014, outpatient mental health services carry the same 20% coinsurance as other medical services under Part B. There is no separate or higher cost-sharing rate for mental health.
Can I use Medicare for an Intensive Outpatient Program (IOP)?
Yes. Medicare covers IOP services under Part B as of 2024. You must attend at least 9 hours of treatment per week and the program must be Medicare-certified. Standard Part B cost-sharing applies: 20% after the $283 annual deductible.
