What Part B covers
Medicare.gov describes outpatient mental health care, often called counseling or psychotherapy, as care to diagnose and treat conditions such as depression, anxiety and substance use disorder. Medicare Part B (medical insurance) covers a wide range of these services, including:
- Individual and group psychotherapy with doctors or certain other Medicare-enrolled licensed professionals, as state law allows
- Family counseling when its main purpose is to help with your treatment
- Psychiatric evaluation and medication management
- One depression screening each year in a primary care setting
- A review of depression risk factors at the one-time "Welcome to Medicare" visit, and a chance to discuss mental health changes at the yearly Wellness visit
- More intensive options, such as intensive outpatient programs and partial hospitalization
Who can provide it
Medicare.gov lists psychiatrists and other doctors, clinical psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, physician assistants, marriage and family therapists, and mental health counselors. The clinician must be enrolled in Medicare (or have a different arrangement, explained below), so ask before you book. Psychologist, Psychiatrist or Counselor? explains how these professionals differ in Michigan.
What you pay in 2026
As of November 2026, Medicare.gov lists these Original Medicare Part B amounts for 2026:
- Standard Part B premium: $202.90 a month (higher for some people, based on income)
- Part B deductible: $283 for the year
- After the deductible: usually 20% of the Medicare-approved amount for each visit, when the clinician accepts assignment
If you see a therapist in a hospital outpatient clinic, Medicare.gov notes you may owe an additional copayment or coinsurance to the hospital. The yearly depression screening costs nothing if the provider accepts assignment. These amounts usually change every January.
If you also have a Medicare Supplement (Medigap) policy, retiree coverage or Medicaid, check whether it pays part of your share before deciding what a session will cost.
A worked example
Suppose, with made-up numbers, the Medicare-approved amount for a therapy session is $150 and you see a clinician who accepts assignment. Early in the year, your first visits go toward the $283 deductible, so you pay the approved amount until it is met. After that, Medicare pays 80% and you owe 20%, or $30 a session. Weekly sessions for a month would then cost about $120 out of pocket, before any supplemental coverage. Ask the office for the actual approved amount for the service you will receive.
Assignment, non-participating and opt-out clinicians
This is the part that most often surprises people. Medicare.gov explains three arrangements:
- Accepts assignment: the clinician agrees to the Medicare-approved amount as full payment, bills Medicare directly, and usually waits for Medicare to pay before asking for your share. This is generally your lowest cost.
- Non-participating: the clinician accepts Medicare but not always assignment. You may have to pay in full at the visit, and they can charge up to 15% more than the approved amount in many cases (the "limiting charge"). They must still submit the claim.
- Opted out: the clinician has chosen not to work with Medicare, for at least two years at a time. Medicare will not pay for their services (except emergencies), even covered ones. You would sign a private contract and pay their fee yourself.
Medicare.gov suggests talking with your State Health Insurance Assistance Program (SHIP) before signing a private contract. Medicare.gov also lets you look up providers who have opted out.
If you have a Medicare Advantage plan
Medicare Advantage plans set their own networks, copays and rules, separate from Original Medicare. A therapist who accepts Original Medicare may not be in your Advantage plan's network. Call the plan and ask whether the clinician is in network for outpatient mental health visits, what the copay is, and whether you need a referral or prior authorization.
Telehealth therapy with Medicare
Medicare.gov says that through December 31, 2027, Medicare covers telehealth services from anywhere in the U.S., including your home, and lists outpatient psychotherapy and depression screening among them. For most telehealth services you pay the same as you would in person. Some Medicare Advantage plans offer additional telehealth benefits. Because this date could change, check the current rule if you plan to rely on video sessions after 2027.
What to bring to the first appointment
- Your Medicare card, plus any Medicare Advantage, Medigap or secondary insurance card
- A list of current medications and the prescriber for each
- A few notes on what has been hard lately: sleep, worry, mood, energy, and when it started
- The name of your primary care doctor, if you would like the therapist to coordinate with them
Questions to ask a therapist's office
- Are you enrolled in Medicare, and do you accept assignment?
- If not, have you opted out? If so, what would a private contract cost per session?
- Are you in network with my Medicare Advantage plan (give the plan name)?
- Do you bill my Medigap or secondary insurance?
- Are video sessions billed the same way as office visits?
For Dr. Lehmann's practice, the only in-network plan listed is Blue Cross Blue Shield PPO. If you have Medicare, call the office at (248) 270-2030 to confirm how your coverage would work before scheduling. The fees and insurance page lists the private-pay rate.
Start with a conversation
Help for anxiety and depression is worth seeking at any age. If you are unsure where to begin, the yearly Wellness visit is a good moment to tell your doctor how your mood and worry have been. Depression and Anxiety in Older Adults covers what that can look like, and depression therapy describes how Dr. Lehmann works.