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Mental health care (outpatient)

Published by: Medicare.gov

Medicare Part B covers certain doctor’s services, outpatient care, medical supplies, and preventive services.

  • One depression screening per year. The screening must be done in a primary care doctor’s office or primary care clinic that can provide follow-up treatment and referrals.
  • Individual and group psychotherapy with doctors (or with certain other licensed professionals, as the state where you get the services allows).
  • Family counseling, if the main purpose is to help with your treatment.
  • Testing to find out if you’re getting the services you need and if your current treatment is helping you.
  • Psychiatric evaluation.
  • Medication management.
  • Certain prescription drugs aren’t usually “self-administered” (drugs you would normally take on your own), like some injections.
  • Diagnostic tests.
  • Partial hospitalization.
  • A one-time “Welcome to Medicare” preventive visit. This visit includes a review of your possible risk factors for depression.
  • A yearly “Wellness” visit. Talk to your doctor or other healthcare provider about changes in your mental health since your last visit.

Part B also covers outpatient mental health services for the treatment of substance abuse.

Your costs in Original Medicare

You pay nothing for your yearly depression screening if your doctor or healthcare provider accepts the assignment.

After you meet the Part B deductible, you pay 20% of the Medicare-Approved Amount for visits to your doctor or other healthcare provider to diagnose or treat your condition.

If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital.

What it is

Mental health services help diagnose and treat people with mental health disorders, like depression and anxiety. These visits are often called counseling or psychotherapy.

Things to know

Part B covers mental health services and visits with these types of health professionals:

  • Psychiatrists or other doctors
  • Clinical psychologists
  • Clinical social workers
  • Clinical nurse specialists
  • Nurse practitioners
  • Physician assistants

Medicare only covers the visits if you get them from a healthcare provider who accepts assignments.

Part B covers outpatient mental health services, including services that are usually provided outside a hospital, in these types of settings:

  • A doctor’s or other health care provider’s office
  • A hospital outpatient department
  • A community mental health center

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