Does Medicare Cover EMDR Therapy?

Mental health is as much of a concern as physical health for many. And because of this, it is important to never overlook your mental health or that of a loved one. One therapy for various mental health disorders is called Eye Movement Desensitization and Reprocessing, or EMDR, therapy.

If this is a therapy you are considering, one of the questions you likely have is, “Does Medicare cover EMDR therapy?” In this article, we answer that question in clear, plain English. You will also find the average costs of EMDR therapy if you have to pay for it out of pocket.

Does Medicare Cover EMDR Therapy?

The short answer is yes; Medicare will cover the cost of EMDR therapy. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your EMDR therapy. Below we look at what these are so you know what to expect.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for EMDR therapy. Medicare provides coverage for your EMDR therapy if it is considered medically necessary. The operation must also be first ordered by your healthcare provider for Original Medicare to provide coverage.

Not much is known about Original Medicare’s coverage for EMDR therapy actually. Other than they will provide coverage for it. Original Medicare provides coverage for certain mental health therapy including EMDR therapy as long as the service is provided by a licensed psychiatrist, clinical psychologist, or other mental health professionals who accept Medicare assignment.

Original Medicare also provides the other mental health services that can help in overcoming grief such as:

Family counseling
Group psychotherapy
Individual psychotherapy
Lab tests
Psychiatric evaluation
Partial hospitalization
Medication management
Annual depression screenings

Coverage for mental health services is provided by Medicare Part A if it takes place in an inpatient setting. On the other hand, Medicare Part B provides coverage for mental health services that take place in an outpatient setting.

Medicare Part B also has a program called yearly wellness visits which includes depression screenings. Medicare Part B covers 100 percent of the costs of yearly wellness visits if your healthcare provider accepts Medicare assignment.

Part C and Part D Coverage for EMDR Therapy

Medicare Advantage plans (Medicare Part C) also provide coverage for EMDR therapy. These plans much provide coverage for all the same things that Original Medicare covers. They also offer additional coverage for some things that Original Medicare does not cover. What this coverage is and what your costs are for the coverage will vary by plan so be sure to check with your plan provider about these things.

Medicare Part C plans that include prescription drug plans will also provide coverage for medications that your healthcare provider will prescribe to you such as antidepressants.

Medicare Part D plans provide coverage for mental health medications such as antidepressants. Part D is a prescription drug plan, and just like Medicare Part C, Medicare Part D plans are provided by private insurance companies.

How Much Does EMDR Therapy Cost?

An EMDR therapy can cost from $100 to $300 per session if you pay out pocket. This cost will vary depending on the provider and where you live.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.