Mental health & substance use disorders
Medicare Coverage Information
Overview
Medicare provides comprehensive coverage for mental health and substance use disorder treatments, including outpatient services, inpatient care, and counseling. Beneficiaries can access a wide range of mental health services with varying levels of cost-sharing.
- Covers individual and group psychotherapy with doctors and other licensed professionals
- Includes annual depression screenings and mental health assessments
- Provides inpatient and outpatient mental health treatment services
- Covers substance use disorder treatment and counseling
- Offers partial hospitalization and psychiatric services
- Available to all Medicare Part A and Part B beneficiaries
- Accessible for Original Medicare and some Medicare Advantage plans
- No age restrictions for mental health coverage
- Part B typically covers 80% of approved outpatient mental health services
- You pay 20% coinsurance after meeting the Part B deductible
- Inpatient mental health care has different cost-sharing rules under Part A
- Some preventive mental health services may be covered at no additional cost
- Services must be deemed medically necessary
- Requires referral and documentation from healthcare providers
- Annual visit limits may apply for certain counseling services
- Some specialized treatments might require additional documentation
- Consult with your primary care physician about mental health concerns
- Verify specific coverage details with your Medicare plan
- Get a referral from your doctor for specialized mental health services
- Call 1-800-MEDICARE for detailed coverage information
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare mental healthsubstance use disorder treatmentMedicare counseling coveragemental health servicesMedicare behavioral health
Related Coverage Topics
Questions About Mental health & substance use disorders?
Our experts can help you understand your Medicare coverage for mental health & substance use disorders. Get personalized guidance on costs, eligibility, and next steps.