Yes, Medicare covers inpatient mental health services under Part A, and under Part B it covers outpatient mental health services, including evaluation and visits with a mental health provider.
Previously, Medicare charged beneficiaries more for outpatient psychiatric treatment than other physicians’ services. But in 2008, Congress passed a law that gradually reduced the copayment for those services from 50 percent to 20 percent of the Medicare-approved cost. Now Medicare pays the same share of the cost, 80 percent, for outpatient mental health services that it pays for other Part B medical services.
Does Medicare cover inpatient mental health?
Medicare Part A covers mental health services if you’re admitted as a hospital inpatient, whether at a general or a psychiatric hospital. The coverage and cost sharing are typically the same as other inpatient hospital stays.
For each benefit period, you’ll pay:
- Part A hospital deductible, which is $1,600 in 2023.
- No coinsurance for days 1 to 60.
- $400 daily coinsurance for days 61 to 90.
You’ll also pay $800 coinsurance for each lifetime reserve day after 90 days for each benefit period. You can use up to 60 reserve days over your lifetime.
A benefit period begins the day you’re admitted to a hospital as an inpatient or become a patient in a skilled nursing facility. It ends when you’ve been out of the hospital or skilled nursing facility for 60 consecutive days.
However, Medicare treats billing for mental health differently in one key way: It will cover only 190 days total over your lifetime in a psychiatric hospital that specializes in mental health conditions. Days spent in a general hospital — even if you’re being treated for a mental health condition — don’t count toward the 190-day lifetime limit.
Need immediate help for suicidal thoughts or other self-harm?
If you or a loved one is considering self-harm, go to your nearest crisis center or hospital or call 911.
The 988 Suicide & Crisis Lifeline, formerly known as the National Suicide Prevention Lifeline, is the federal government’s free 24-hour hotline. The nonprofit Crisis Text Line also has 24/7 counselors. Both use trained volunteers nationwide, are confidential and can be reached in ways most convenient to you:
- Dial or text 988. A phone call to 988 offers interpreters in more than 240 languages.
- Call 800-273-TALK (8255), a toll-free phone number, to reach the same services as 988.
- For hearing- impaired users with a TTY phone, call 711 and then 988.
- Text HOME to 741741, the Crisis Text Line.
- In WhatsApp, message 443-SUP-PORT.
- Go to crisistextline.org on your laptop, choose the Chat With Us button and stay on the website.
Does Medicare cover outpatient mental health?
Medicare Part B covers mental health services you receive when you’re not a hospital inpatient, such as in a doctor or therapist’s office, hospital outpatient department or community health center. Medicare generally covers mental health services and visits with psychiatrists, other doctors, clinical psychologists, clinical nurse specialists, clinical social workers, nurse practitioners and physician assistants.
Each provider must consent to the amount Medicare approves as payment in full, called accepting assignment. But not all mental health professionals accept Medicare.
What you pay for outpatient mental health services. Once you’ve met the standard Part B deductible, $226 in 2023, you’ll pay 20 percent of the Medicare-approved amount for the services.