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For most of Medicare’s history, outpatient therapy was billable only by psychiatrists, psychologists, and licensed clinical social workers. That changed on January 1, 2024, and it significantly widened who Medicare beneficiaries can see for talk therapy.
The Consolidated Appropriations Act, 2023 added licensed mental health counselors and marriage and family therapists as Medicare Part B-billable provider types for the first time, following more than a decade of advocacy. CMS estimated roughly 400,000 additional counselors and therapists nationwide became newly eligible to enroll as Medicare providers as a result.
Practically, this matters most outside major metro areas, where psychiatrists and psychologists have historically been harder to find – it meaningfully expanded the pool of Medicare-accepting therapists.
Original Medicare vs. Medicare Advantage
Original Medicare (Part B) follows standardized federal rules nationwide, the same coverage structure and coinsurance rate no matter which state you’re in. We’re in-network with Medicare Part B.
Medicare Advantage (Part C) plans are administered by private insurers, so coverage details, networks, and referral requirements can vary by plan.
Have a different plan? We’re out-of-network with EmblemHealth, BlueCross BlueShield, 1199SEIU, Beacon, and ComPsych.
What You'll Pay in 2027
Medicare’s cost structure works differently from a commercial insurer’s flat copay. For 2027:
- The Part B annual deductible is $283. You’re responsible for this amount before Medicare starts covering services.
- After that, standard Medicare coinsurance is 20% of the Medicare-approved amount for outpatient therapy – this rate is set federally and applies consistently, rather than being negotiated per-provider the way a commercial insurance copay is.
No Referral Needed
Original Medicare doesn’t require a referral to see an outpatient therapist who bills Part B directly, you can schedule with an in-network provider without going through a primary care doctor first.