Which Outpatient Mental Health Care Services Does Medicare Cover?

Published by: Medicare Made Clear

Medicare covers the following outpatient mental health care services:1

 

  • Annual depression screening
  • Individual or group psychotherapy
  • Family counseling, when the goal is to help with treatment
  • Psychiatric evaluation and diagnostic tests
  • Outpatient treatment programs
  • Medication management and certain medications that are not self-administered, like some injections
  • For treatment of drug or alcohol abuse
  • Partial hospitalization

 

 

Which Mental Health Care Providers Will Medicare Cover?

 

Medicare only covers mental health care services that are provided by qualified health care professionals who accept Medicare assignment. Qualified health care professionals include the following:

 

  • Psychiatrist or other doctor
  • Clinical psychologist
  • Clinical social worker
  • Clinical nurse specialist
  • Nurse practitioner
  • Physician assistant

 

 

Where Can Medicare-Covered Mental Health Care Services Be Provided?

 

Covered outpatient mental health care services may be provided in the following settings:

 

  • A primary care doctor’s office or primary care clinic
  • Other approved health care providers offices
  • A hospital outpatient department
  • A community mental health center

 

 

How Much Does Medicare Pay For Mental Health Care Services?

 

An annual depression screening is free if the doctor accepts Medicare assignment. Otherwise, Medicare Part B pays 80 percent of the Medicare-approved amount for most covered mental health care services. You are responsible for the remaining 20 percent, and the Part B deductible applies.

 

Medicare Advantage plans (Part C) also help pay for mental health care services and may cover additional mental health services or items. Check with your plan provider to get coverage and cost details.

 

 

1 https://www.medicare.gov/coverage/mental-health-care-outpatient

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