Medicare pays for one depression screening every year at no cost, and covers ongoing therapy and counseling that many older adults assume they must pay for entirely on their own. The screening sits inside routine Part B preventive care, while outpatient mental-health treatment — visits to psychiatrists, psychologists, clinical social workers and counselors — falls under standard Part B coverage. The distinction shapes what a beneficiary owes: the annual screen is free, while continued treatment carries the same cost-sharing as other medical care.
The free annual depression screening
Part B covers one depression screening per year at no charge when the provider accepts assignment, under Medicare’s outpatient mental-health coverage rules. The screening must take place in a primary-care setting that can provide follow-up treatment and referrals, a condition meant to ensure that a positive result leads somewhere rather than ending at a questionnaire.
The screening is often folded into the yearly wellness visit, itself a no-cost Part B benefit that reviews health risks and preventive needs. Medicare’s wellness-visit coverage makes the two a natural pair, since the visit is designed to catch conditions early — including the mood changes, isolation and grief that frequently accompany retirement, chronic illness or the loss of a spouse.
Despite being free, the screening is widely missed. Older adults may not raise mental-health concerns with a doctor, and some assume Medicare treats therapy as an out-of-pocket luxury. The result is untreated depression among a population where the condition is common but frequently unspoken, even though the entry point to care costs nothing at all.
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What outpatient mental-health treatment costs
Beyond the free screen, Part B covers individual and group psychotherapy, family counseling tied to a patient’s treatment, psychiatric evaluation and medication management. Unlike the screening, this care is subject to cost-sharing: after the annual Part B deductible, a beneficiary generally pays 20% of the Medicare-approved amount for each session, the same structure that applies to other Part B services.
The roster of professionals Medicare will pay has widened. Along with psychiatrists and psychologists, Medicare covers services from licensed clinical social workers, and more recently marriage and family therapists and licensed mental-health counselors, expanding access in areas where psychiatrists are scarce. A supplemental Medigap policy or a Medicare Advantage plan can further reduce the 20% share a beneficiary owes.
Telehealth has become a durable part of the benefit. Mental-health visits conducted by video, and in some cases by audio only, are covered, which matters for homebound retirees and those far from a provider. That access lowers a practical barrier that once kept many older adults from starting treatment at all.
The benefit has no arbitrary annual cap: Medicare covers mental-health visits as long as they remain medically necessary, and it also pays for partial hospitalization, a structured daytime program run through a hospital outpatient department or community mental-health center for people who need intensive help but not an overnight stay. A Medicare Advantage plan must cover at least what Original Medicare does, though it may use its own network and copay structure.
Where the screening fits in Medicare’s preventive care
The depression screening is one piece of a wider set of no-cost preventive services. New enrollees can use a one-time “Welcome to Medicare” preventive visit during their first 12 months on Part B, which includes a review of risk factors for depression along with basic health measurements and referrals. After the first year, the yearly wellness visit takes over as the recurring checkpoint, and the standalone annual depression screening can be provided alongside it.
The distinction between the two visits matters for cost. Both the Welcome to Medicare visit and the annual wellness visit are covered without a deductible or coinsurance when the provider accepts assignment, so the preventive scaffolding around the depression screen is itself free. Where a charge can appear is when a routine visit turns into treatment — if the doctor diagnoses a condition and begins managing it during the same appointment, that portion may fall under ordinary Part B cost-sharing rather than the free preventive benefit.
Inpatient and intensive options exist too
For more serious needs, Medicare’s coverage extends past the outpatient office. Part A covers inpatient psychiatric hospital care, and Medicare has added coverage for intensive outpatient programs — structured treatment for people who need more than weekly sessions but not a full hospital stay. These tiers give the benefit a range that few enrollees realize is available.
One limit is worth knowing: Medicare caps coverage in a freestanding psychiatric hospital at 190 days over a person’s lifetime, a restriction that does not apply to psychiatric care delivered in a general hospital. For most enrollees the cap never comes into play, but it is a rare hard ceiling in a benefit that is otherwise renewable.
Taken together, the coverage runs from a no-cost annual screening to therapy at standard Part B cost-sharing to intensive and inpatient care when a condition demands it. The practical step is to treat the free screening as the front door: confirming it against Medicare’s outpatient mental-health rules, pairing it with the annual wellness visit, and understanding that follow-up care is covered even though it is not free turns an underused benefit into real support.
This article was researched and drafted with the assistance of AI and reviewed by The Money Overview editorial team.
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