Finding a Therapist Who Accepts Medicare: A Practical Guide

Medicare now covers therapy from a much wider pool of providers than it did just two years ago. Here’s how to find one in your area.

As of January 1, 2024, the pool of therapists who can accept Medicare expanded significantly. For decades, Medicare covered therapy only from psychiatrists, psychologists, and Licensed Clinical Social Workers (LCSWs). That changed when Licensed Marriage and Family Therapists (LMFTs) and Mental Health Counselors — including Licensed Professional Counselors (LPCs) and Licensed Mental Health Counselors (LMHCs) — became eligible Medicare providers.

If you or a family member has Medicare and needs therapy, the search is easier than it was, but there are still some important things to understand about how to find the right provider.

What “accepts Medicare” actually means

Not every therapist who sees Medicare patients bills Medicare the same way. There are three categories worth understanding:

• Medicare-enrolled and participating. The therapist has enrolled with Medicare and agreed to accept Medicare’s approved payment as payment in full. The patient pays the Part B deductible and 20 percent coinsurance, and the therapist bills Medicare directly for the rest.
• Medicare-enrolled but non-participating. The therapist can see Medicare patients but can charge up to 15 percent above the Medicare-approved amount. The patient may have a higher out-of-pocket cost.
• Opted out of Medicare. The therapist has formally opted out of Medicare. Medicare will not pay for services from this provider. Patients pay entirely out of pocket through a private contract.

When searching for a therapist, it is worth asking which category they fall into. Most Medicare patients want to work with a participating provider to minimize cost-sharing.

Where to search

Medicare.gov Care Compare

The most direct official resource is the Care Compare tool on Medicare.gov. It allows you to search for health care providers by ZIP code, specialty, and distance, including mental health professionals. Filter by provider type to see psychologists, social workers, marriage and family therapists, and mental health counselors in your area.

Your Medicare Advantage plan directory

If you have a Medicare Advantage plan (Part C) rather than traditional Medicare, your plan has its own network of providers. Call the number on your member ID card or log into your plan’s member portal to search the network directory. Medicare Advantage plans often have different cost-sharing for in-network vs. out-of-network providers.

Your primary care provider

Primary care providers often have referral relationships with local therapists and can recommend a Medicare-enrolled provider who is accepting new patients.

Your state psychological association or licensing board

Many state professional associations maintain searchable directories of their members that can be filtered by insurance accepted, including Medicare.

Online directories

Psychology Today, GoodTherapy, Zencare, and similar directories allow searches by insurance accepted. Filter by “Medicare” to see providers in your area who accept it.

What to ask when you call

Before scheduling a first appointment, it is worth confirming a few specifics. Useful questions include:

• Are you currently enrolled with Medicare, and do you accept Medicare assignment?
• Are you a participating provider or non-participating?
• Do you take my specific Medicare Advantage plan, if applicable?
• What would my out-of-pocket cost be per session after Medicare?
• Are you accepting new patients with Medicare?
• What is your specialty or area of clinical focus?
• Do you offer telehealth sessions covered by Medicare?

A few of these questions — particularly about Medicare Advantage plans — can make a real difference in what you pay out of pocket.

The telehealth option

Medicare coverage of telehealth for mental health services has been extended and expanded over the past several years. Many Medicare-enrolled therapists now offer video or audio sessions that are covered the same way as in-person sessions would be.

For patients in rural areas, patients with mobility limitations, or patients who simply prefer the convenience of telehealth, this expands the pool of available providers considerably — a therapist in your state who accepts Medicare and offers telehealth can see you without requiring you to travel.

Telehealth rules for Medicare mental health services have been the subject of ongoing legislative extensions, so the specific rules in effect when you are searching may differ from the rules described in older online resources. Verifying current coverage at the time of service is always worth doing.

Finding a specialist

Medicare-enrolled therapists work across the full range of clinical specialties. When your clinical need is specific — trauma, grief, couples work, late-life depression, substance use, PTSD from military service — you can often find a therapist whose practice focus aligns with what you need.

• Trauma and PTSD — look for providers with training in EMDR, prolonged exposure, or cognitive processing therapy
• Grief and bereavement — many therapists specialize in grief work, including complicated grief treatment
• Late-life depression and anxiety — some therapists focus specifically on geriatric mental health
• Couples therapy — note that Medicare coverage for couples therapy requires one partner to have a covered mental health diagnosis
• Veterans — the VA provides mental health services, but Medicare-enrolled community providers with military-culture training are also an option

What to do if you can’t find a Medicare therapist

In some areas, especially rural communities, the supply of Medicare-enrolled therapists remains limited despite the 2024 expansion. If local search is not producing results:

• Expand your search area to include telehealth providers anywhere in your state
• Contact your local Area Agency on Aging for referral assistance
• Consider community mental health centers, many of which accept Medicare and operate on a sliding scale
• Ask primary care about integrated behavioral health services, which are increasingly available in primary care settings and covered by Medicare
• Contact your state’s SHIP program (State Health Insurance Assistance Program) for free Medicare counseling, which can include help finding providers