Outpatient care under Part B
Medicare.gov lists these outpatient mental health services, among others:
- Individual and group psychotherapy, and family counseling when its main purpose is your treatment.
- Psychiatric evaluation, medication management and tests to see whether treatment is working.
- One depression screening a year in a primary care setting, plus a depression risk review at your Welcome to Medicare and yearly Wellness visits.
- Intensive outpatient program services, and substance use disorder treatment, including medications.
- Safety planning if you're at risk of suicide or overdose, and a follow-up call after an emergency department visit for a behavioral health crisis.
Covered providers include psychiatrists and other doctors, clinical psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, physician assistants, marriage and family therapists and mental health counselors.
What you pay
| Service | Original Medicare, 2026 |
|---|---|
| Yearly depression screening | $0 if the provider accepts assignment |
| Therapy and psychiatric visits | 20% of the Medicare-approved amount after the $283 Part B deductible |
| Inpatient psychiatric stay | Part A deductible of $1,736 per benefit period, then daily coinsurance after day 60 |
Hospital outpatient departments may add a copayment. Medicare Advantage plans cover the same services but use their own networks and costs, so check that your therapist is in network.
Telehealth
Medicare covers mental health visits by telehealth, and through December 31, 2027, Medicare covers telehealth services from anywhere in the U.S., including your home. That helps in North Carolina's mountain and rural eastern counties, where the nearest therapist may be far away. Ask your provider whether a video or phone-only visit works for your service. See does Medicare cover telehealth in rural North Carolina.
Help in North Carolina
- 988 Suicide & Crisis Lifeline: call, text or chat 988, any time. NCDHHS reports that 988 in North Carolina handles an average of 11,443 contacts a month.
- Your county's LME/MCO: North Carolina has one Local Management Entity/Managed Care Organization for each county. Each runs a 24-hour behavioral health crisis line, listed in the NCDHHS LME/MCO directory.
- NC Medicaid: if you also have full NC Medicaid, it covers behavioral health services too, after Medicare pays, and NC Medicaid's rides can take you to mental health and substance use appointments. NC Medicaid Contact Center: 1-888-245-0179.
A licensed insurance agent who works with Benefits Life can help you check whether your therapist is in a plan's network, at no cost to you. You can request a call from a licensed insurance agent, or see plans for your ZIP code.
Related questions
Can I keep my doctor with Medicare?
Networks and assignment.
Does Medicare cover home health care?
Skilled care at home.
How do I get rides to the doctor?
County DSS rides and more.
Sources
- Medicare.gov — Mental health care (outpatient)
- Medicare.gov — Mental health care (inpatient)
- Medicare.gov — Telehealth
- NCDHHS — LME/MCO Directory
- NCDHHS — Division of Mental Health, Developmental Disabilities and Substance Use Services
- NC Medicaid — Non-Emergency Medical Transportation (NEMT)
- 988 Suicide & Crisis Lifeline
More questions in this guide
- Can I keep my doctor when I go on Medicare in North Carolina?
- Does Medicare cover assisted living in North Carolina?
- Does Medicare cover dental in North Carolina?
- Does Medicare cover eye exams and glasses in North Carolina?
- Does Medicare cover hearing aids in North Carolina?
- Does Medicare cover home health care in North Carolina?
- Does Medicare cover nursing home care in North Carolina?
- How do I get rides to the doctor with Medicare in North Carolina?
Part of the guide: Medicare basics for North Carolinians · All questions
Frequently asked questions
Can I see a licensed counselor in North Carolina with Medicare?
Yes. Medicare covers visits with marriage and family therapists and mental health counselors, along with psychologists and clinical social workers, when they're enrolled in Medicare. Ask whether the counselor accepts Medicare before your first visit.
Is there a limit on psychiatric hospital stays?
Yes. Part A pays for up to 190 days of inpatient care in a freestanding psychiatric hospital in your lifetime. The limit doesn't apply to psychiatric care in a general hospital.
I have Medicare and NC Medicaid. Who coordinates my behavioral health care?
People with Medicare and full NC Medicaid are in NC Medicaid Direct. NCDHHS says the LME/MCO for your county coordinates certain behavioral health services for NC Medicaid Direct members. Medicare pays first for services it covers.
Medicare in your North Carolina county
Plans, local agents and help, county by county: Wake · Mecklenburg · Guilford · Forsyth · Durham · Cumberland · Buncombe · Union · Johnston · Cabarrus · New Hanover · Gaston · Onslow · Iredell · Alamance · Pitt · Davidson · Brunswick · Catawba · Rowan · All 100 counties →
