TABLE C-2, Range of Behavioral Health and Wellness Services Covered by Medicare - Expanding Behavioral Health Care Workforce Participation in Medicare, Medicaid, and Marketplace Plans

The range of behavioral health and wellness services covered by Medicare varies depending on the care setting and profession but includes:
Alcohol misuse screening and up to four brief, face-to-face counseling sessions per year for adults who use alcohol but are not dependent
Annual wellness visits to develop or update a personalized prevention plan, including health risk assessment and depression screening
Behavioral health integration by clinical staff to assess, monitor, and plan care
Bundled opioid use disorder payments for management and counseling and in-office services such as overall case management, care coordination, individual and group psychotherapy, and substance use counseling
Caregiver-focused behavioral health risk assessment of their own behavior and health risks, which benefits the patient
Cognitive assessment and care planning
Depression screening up to 15 minutes annually when staff-assisted depression care supports can assure accurate diagnosis, effective treatment, and follow-up
Diagnostic psychological and neuropsychological tests
Electroconvulsive therapy
Family psychotherapy
Health and behavioral assessment and intervention identifying or treating psychological, behavioral, emotional, cognitive, and social factors important to prevent, treat, or manage physical health issues
Individual and group psychotherapy Hypnotherapy Medication-assisted treatment for SUDs Psychoanalysis
Psychiatric evaluation that systematically evaluates a psychiatric disorder’s causes, symptoms, and course and consequences

The range of behavioral health and wellness services covered by Medicare varies depending on the care setting and profession but includes:

Alcohol misuse screening and up to four brief, face-to-face counseling sessions per year for adults who use alcohol but are not dependent

Annual wellness visits to develop or update a personalized prevention plan, including health risk assessment and depression screening

Behavioral health integration by clinical staff to assess, monitor, and plan care

Bundled opioid use disorder payments for management and counseling and in-office services such as overall case management, care coordination, individual and group psychotherapy, and substance use counseling

Caregiver-focused behavioral health risk assessment of their own behavior and health risks, which benefits the patient

Cognitive assessment and care planning

Depression screening up to 15 minutes annually when staff-assisted depression care supports can assure accurate diagnosis, effective treatment, and follow-up

Diagnostic psychological and neuropsychological tests

Electroconvulsive therapy

Family psychotherapy

Health and behavioral assessment and intervention identifying or treating psychological, behavioral, emotional, cognitive, and social factors important to prevent, treat, or manage physical health issues

Individual and group psychotherapy

Hypnotherapy
Medication-assisted treatment for SUDs
Psychoanalysis

Psychiatric evaluation that systematically evaluates a psychiatric disorder’s causes, symptoms, and course and consequences

From: Appendix C, Chapter 3 Tables

Expanding Behavioral Health Care Workforce Participation in Medicare, Medicaid, and Marketplace Plans.

National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Care Services; Committee on Strategies to Improve Access to Behavioral Health Care Services through Medicare and Medicaid; Perera U, Godwin A, Polsky D, editors.

Washington (DC): National Academies Press (US); 2024 Oct 7.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

TABLE C-2Range of Behavioral Health and Wellness Services Covered by Medicare