Does Medicare Cover Psychotherapy?

One of the good things that are happening in this generation is that mental health awareness is getting the attention that it rightly deserves. And not only are people are getting more awareness, but people are starting to act on it, and one of the ways they do it is through advocating treatment for mental health issues and conditions.

So a common question many people have is, “Does Medicare cover Psychotherapy?” In this article, we answer the question in clear, plain English. You will also find the average costs of psychotherapy and other helpful info.

Does Medicare Cover Psychotherapy?

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

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

Upon enrolling in Medicare, the beneficiary will receive a Welcome to Medicare preventive visit. The preventive visit program includes a visit to your healthcare provider who will then review your risks of suffering from depression.

Another program that Medicare has when it comes to mental health maintenance is the Yearly Wellness Visits. In that program, your mental healthcare provider will discuss your mental health changes since your last visit.

Both individual and group psychological therapy is covered by Medicare Part B. However, for Medicare Part B to cover your individual or group psychological therapy, the service must be provided by a doctor or other approved state-licensed professional. The professionals who can provide the service include:

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

Medicare Part B also covers one depression screening program every year. The depression screening must occur in a primary doctor’s office or similar to make sure that there will be follow-up care if it is needed.

Medicare Part B covers 80 percent of the costs of psychotherapy. You will pay for the remaining 20 percent.

Medicare Advantage plans (Medicare Part C) also provide coverage for psychotherapy. 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 Psychotherapy Cost?

A psychotherapy session usually costs between $60 to $120 for a 45 to 60-minute session. The national average cost of a psychological therapy session is $90.

But in some cases, some therapists may charge more than the average price, reaching around $250. Some therapists only charge $50 per session.

Online psychological therapy sessions usually cost between $40 to $70 per week with a membership plan.

Some factors may affect the cost of psychological therapy. One of these factors may include who will give the service. Here is a pricelists for the costs for each mental healthcare provider:

Psychiatrists – $100 – $200 per session
Psychologist $70 – $150 per session
Counselor $20 – $80 per session
Psychotherapist $100 – $300 per session

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.