The short answer: Medicare covers outpatient therapy under Part B — you pay 20% of the approved amount after the $283 annual deductible (a Medigap plan usually covers that 20%), and since January 2024 Medicare also pays marriage and family therapists and mental health counselors, which roughly doubled the eligible bench overnight.¹ Telehealth for mental health stays covered from your home. The real work is finding someone who takes Medicare — here's how.
The Part B math
Therapy with any Medicare-enrolled clinical psychologist, LCSW, LMFT, or mental health counselor: Medicare approves an amount, pays 80% after the $283 annual Part B deductible (2026), and you owe the other 20% — often $30–45 a session in practice.² With a Medigap supplement, the 20% is typically covered too: $0. With a Medicare Advantage plan, you use their network and their copays instead — often manageable, but watch two traps: narrow mental health networks and prior-authorization requirements original Medicare doesn't have. Advantage members: the 10-day access law applies to your plan → if it's a California-regulated HMO.
The 2024 door. Before 2024, Medicare simply didn't pay LMFTs or LPCCs — a huge slice of California's therapists were off-limits to everyone over 65. Congress fixed it; MFTs and MHCs now enroll and bill Medicare directly.¹ If a therapist told you "I can't take Medicare" years ago, that answer may have changed — ask again.
Two details inside that door. Medicare pays marriage and family therapists and mental health counselors 75% of the amount it allows a clinical psychologist for the same service.⁴ For you that is mildly good news — your 20% is calculated on the smaller number — and it is part of why some therapists still decline to enrol. And the benefit category requires a full state licence: a California registered associate (AMFT, ASW or APCC) cannot bill Medicare, under supervision or otherwise.⁴
Telehealth, with the date on it. For mental health specifically, the geographic and site restrictions were removed permanently in 2021, so your home counts as an originating site anywhere in California.³ Audio-only is allowed where you cannot use or do not consent to video.³ The rule to diarise: from 1 January 2028, a mental health telehealth service requires an in-person visit with that clinician in the six months before the first one, and periodically after — a date Congress has now moved five times, most recently in February 2026.³
Finding someone, in order
Start at medicare.gov's Care Compare (filter: clinical psychologist / clinical social worker / marriage & family therapist near you), then confirm by phone: "Are you accepting new Medicare patients?" — enrolled and accepting are different things. Ask specifically about telehealth: mental health visits from your home are covered, permanently, which puts the whole state's Medicare-enrolled bench in reach.³ On both Medicare and Medi-Cal ("dual eligible")? If you are in the Qualified Medicare Beneficiary group, federal law makes Medicare's payment payment in full: no deductible, no 20%, and no provider may bill you for it — including providers who do not take Medi-Cal at all.⁵ Other dual statuses do not carry that protection — the Medi-Cal page → explains the county door. And the quick version of this whole page lives at does Medicare cover therapy? →
Helping a parent through this? The scripts and the sequence →
Q&A
Q: Does Medicare cover therapy in California? A: Yes — Part B covers outpatient therapy at 80% of the approved amount (you pay ~20%, or $0 with most Medigap plans), and since January 2024 LMFTs and mental health counselors can bill Medicare alongside psychologists and LCSWs. Telehealth mental health visits from home are covered. Medicare Advantage plans use their own networks and copays.
Our therapist directory: See its current status →
Sources
- Consolidated Appropriations Act 2023, §4121 — MFT/MHC Medicare billing from Jan 1, 2024 — cms.gov
- Medicare.gov, mental health care coverage — medicare.gov · 2026 deductible $283 verified via CMS announcement, Aug 2026
- 42 U.S.C. §1395m(m)(7)(A) — the geographic requirements "shall not apply" to telehealth for the diagnosis, evaluation or treatment of a mental health disorder (permanent, from the Consolidated Appropriations Act, 2021); §1395m(m)(7)(B)(i) — the in-person visit condition applies to services furnished "on or after January 1, 2028," a date last moved by Pub. L. 119-75 (3 February 2026); §1395m(m)(9) and 42 C.F.R. §410.78(a)(3) — audio-only where the patient cannot use or does not consent to video, and the general any-location rule, both running through 31 December 2027 — uscode.house.gov · CMS telehealth guidance, updated 26 February 2026 — cms.gov. The regulation text at 42 C.F.R. §410.78 still carries superseded 2024–2025 dates; the statute controls.
- 42 U.S.C. §1395l(a)(1)(FF) — payment is 80% of the lesser of the actual charge or 75% of the amount determined for a psychologist; 42 U.S.C. §1395x(lll)(2) and (4) and 42 C.F.R. §§410.53, 410.54 — the definitions, which require a state licence plus at least two years (3,000 hours) of post-degree supervised clinical experience, and which contain express prohibited-billing provisions.
- 42 U.S.C. §1396a(n)(3) — for a Qualified Medicare Beneficiary, Medicare's payment plus any state payment "shall be considered to be payment in full," and "the beneficiary shall not have any legal liability to make payment to a provider." CMS, "Prohibition on Billing Qualified Medicare Beneficiaries," September 2025: the bar applies to all Original Medicare and Medicare Advantage providers, "not only those that accept Medicaid" — cms.gov.
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