Does Medicare Cover Counseling?

Counseling is something we turn into when we face life challenges and crises. Things that we cannot quickly solve or need help in solving.

However, not everyone who needs counseling has the financial means to afford it.

This is an issue that leads to a common question many people have which is, “Does Medicare cover Counseling?” In this article, we answer this question in clear, plain English. You will also find the average costs of various types of counseling and other helpful info.

The short answer is yes; Medicare will cover the cost of many types of counseling. 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 counseling. Below we look at what these are so you know what to expect.

Original Medicare (Medicare Part A and Part B) provides coverage for various types of counseling.

Mental Health Counseling

One type of counseling that Medicare covers is mental health counseling, such as psychiatric counseling. Medicare Part A provides coverage for mental health services that takes place in an inpatient setting. Part A will cover 190 days of inpatient care in a psychiatric hospital.

Medicare Part B provides coverage for many mental health services, like counseling, that take place in an outpatient setting. It also covers yearly depression screenings and follow-up appointments and referrals to other mental health specialists.

Marriage Counseling

Medicare Part B also provides coverage for marriage counseling. However, Medicare Part B will only cover marriage counseling if it treats a mental illness such as depression or anxiety.

Also, Medicare Part B only covers marriage counseling if the service is provided by Medicare-approved mental health professionals. This includes clinical psychologists and nurse practitioners. Medicare Part B covers 80 percent of the costs of marriage counseling.

Drug Rehab

Both Medicare Part A and Part B provide coverage for drug rehab counseling. Medicare Part A covers drug rehab if it takes place in an inpatient setting. If your inpatient stay lasts for more than 60 days, you will pay $352 per day. If it lasts for more than 90 days, you will pay $704 per “lifetime reserve day.”

Medicare Part B covers drug rehab if it is done in an outpatient setting. Coverage includes group or individual therapy. Medicare Part B may also cover Screening, Brief Intervention, and Referral to Treatment (SBIRT) for those who are at risk of developing a drug addiction.

Medicare Advantage plans (Medicare Part C) also provide coverage for various types of counseling. They cover everything Original Medicare covers as well as some additional benefits. However, exactly what it covers and how much the out-of-pocket costs are will vary depending on the specifics of your plan.

How Much Does Counseling Cost?

Psychological counseling usually costs somewhere between $60 to $120 per session. The cost will vary on a few factors including the type of mental healthcare provider who provides the service. Here is a list of the average rates of mental health providers:

Psychiatrists – $100 – $200 per session

Psychologist $70 – $150 per session
Counselor $20 – $80 per session
Psychotherapist $100 – $300 per session

Drug-addiction rehabilitation costs may differ depending on whether you have it as an inpatient or outpatient. Some drug rehabilitation programs are free. But many are not.

Outpatient drug rehabs range between $1,000 to $1,500. Meanwhile, inpatient drug rehabs may cost from $6,000 to $60,000 depending on if it is a 30-day, 60-day, or 90-day drug rehab.

Marriage counseling can cost from $35 to $200 per session, depending on if you will have the counseling online or in person. Online counseling tends to be cheaper than in-person counseling. It also varies on what type of counselor you go to.

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.