Which Outpatient Mental Health Care Services Does Medicare Cover?
Published by: Medicare Made Clear
Medicare covers the following outpatient mental health care services:1
Annual depression screening
Individual or group psychotherapy
Family counseling, when the goal is to help with treatment
Psychiatric evaluation and diagnostic tests
Outpatient treatment programs
Medication management and certain medications that are not self-administered, like some injections
For treatment of drug or alcohol abuse
Partial hospitalization
Which Mental Health Care Providers Will Medicare Cover?
Medicare only covers mental health care services that are provided by qualified health care professionals who accept Medicare assignment. Qualified health care professionals include the following:
Psychiatrist or other doctor
Clinical psychologist
Clinical social worker
Clinical nurse specialist
Nurse practitioner
Physician assistant
Where Can Medicare-Covered Mental Health Care Services Be Provided?
Covered outpatient mental health care services may be provided in the following settings:
A primary care doctor’s office or primary care clinic
Other approved health care providers offices
A hospital outpatient department
A community mental health center
How Much Does Medicare Pay For Mental Health Care Services?
An annual depression screening is free if the doctor accepts Medicare assignment. Otherwise, Medicare Part B pays 80 percent of the Medicare-approved amount for most covered mental health care services. You are responsible for the remaining 20 percent, and the Part B deductible applies.
Medicare Advantage plans (Part C) also help pay for mental health care services and may cover additional mental health services or items. Check with your plan provider to get coverage and cost details.
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