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does Medicare cover psychological therapy

Does Medicare Cover Psychological Therapy?

Mental health is just as important as our physical health. It’s something not to be ignored or take lightly. 

There may come a time when we need to seek help to deal with mental health issues we’re facing. And a common treatment option involves psychological therapy. It can be helpful in treating addiction, Depression, phobias, mental health conditions including bipolar disorder and schizophrenia as well as other mental issues.  

If you need some help for a mental health problem, a common question you may have is, “Does Medicare cover Psychological Therapy?” In this article, we answer the question in clear, plain English. You will also find the average costs of psychological therapy and other helpful info. 

Does Medicare Cover Psychological Therapy? 

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

Original Medicare (Medicare Part A and Part B) provides coverage for psychological therapy costs.  

When a person first enrolls in Medicare, they will receive a “Welcome to Medicare” preventive visit. This includes a visit to a doctor who will review your risks of suffering from depression. In addition to that, Medicare also covers yearly wellness visits. Yearly wellness visits include discussion with your healthcare provider regarding your mental health changes since your last visit.  

If you need psychological therapy, Medicare Part B provides coverage for both individual and group sessions. But the service has to be provided by a doctor or certain state-licensed professionals. State-licensed professionals may include: 

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

Medicare Part B also pays for one depression screening each year. The depression screening must occur in a primary care doctor’s office or similar to make sure that there is follow-up care if needed.  

Medicare Part B covers 80% of the cost of the Medicare-approved amount for psychological therapy as well as the services mentioned above. You will pay for the remaining 20%.  

Medicare Advantage plans (Medicare Part C) also provide coverage for psychological therapy. They cover everything Original Medicare covers as well as offer some additional benefits. However, out-of-pocket costs will vary depending on the specifics of your plan. 

How Much Does Psychological Therapy Cost? 

A psychological therapy session’s average cost may range between $60 to $120 per 45 minutes to an hour. The national average cost of a psychological therapy session cost $90. 

However, that can cost $250 or more for an hour long session. On the lower end, some therapists charge around $50 per session. Or even as low as $20 if you visit a student therapist.  

Online options are becoming increasingly popular. There are online psychological therapy services that charge somewhere between $40 to $70 per week. Online psychological therapy usually offers 24-hour support.  

There are also individual therapists that will do online sessions. Rates are similar to in-person sessions. 

Other factors that may affect the cost of psychological therapy include what issue the therapy is designed to address, what type of therapist you see 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.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover drug rehab?


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