Medicare Coverage for CBT

Medicare Part B covers cognitive behavioral therapy (CBT) when medically necessary. But Medicare coverage and your share of costs (including deductibles and copays) can be confusing to navigate. 

Learn what you need to know about Medicare coverage for CBT. We make it easy to connect with Medicare-approved therapists from the comfort of your home, so you can take the first step toward feeling better. 

Key takeaways

• Medicare Part B covers CBT and other mental health treatments as long as they’re considered medically necessary. 
• After meeting the deductible you’ll be responsible for 20% of the approved amount, but most Sailor Health patients have a $0 copay. 
• Medicare recipients can benefit from CBT to help manage anxiety, depression, and other mental health conditions, and learn healthy coping strategies. 

CBT coverage details for Medicare recipients

In order to be covered under Medicare, CBT needs to be medically necessary. This means your provider has determined you need cognitive behavioral therapy to treat a mental health condition, or prevent it from getting worse. Coverage is there for care you need to help manage a mental health condition — not just for comfort or personal preference. 

Medicare doesn’t specify how many sessions are covered for CBT (meaning there is no cap on sessions) as long as your provider states they’re medically necessary for you. Older adults can qualify for Medicare-covered CBT for many common mental health conditions that CBT can treat, including:

• Anxiety
• Depression
• Phobias
• Post-traumatic stress disorder (PTSD)
• Insomnia
• Substance use disorder
• Bipolar disorder

Fortunately, you don’t need an official diagnosis or pre-approval to begin therapy for your mental health symptoms. However, the therapist you see must be a Medicare Part B provider who accepts Medicare assignment. This includes psychologists, clinical social workers, and mental health counselors. Medicare covers CBT delivered via telehealth, in person, or both. 

Deductible, copays, and out-of-pocket costs

Your annual Medicare Part B deductible amount in 2026 will be $283. After meeting the deductible, patients pay 20% of the Medicare-approved amount as a copay. However, most Sailor Health patients have a $0 copay because we partner with Medicare to keep costs low.

If you have Medicare Advantage (Part C) you may be eligible for additional benefits that Medicare alone doesn’t cover, which could include certain types of mental health counseling. Review your individual plan to find out what’s covered. Often, these plans offer lower copays and expanded therapy options.

Does Medicare cover CBT-I for insomnia?

Just as with general CBT, Medicare Part B covers cognitive behavioral therapy for insomnia (CBT‐I), as long as it’s considered medically necessary. This is because Medicare covers insomnia treatments, including prescription medications.

Research shows that as you get older, your sleeping patterns change, and this can lead to more sleep issues. About 50% of older adults have insomnia, which is a sleep condition where you struggle to fall asleep or stay asleep. Research also shows CBT‐I is helpful for older adults in creating healthier and more restful sleep environments. CBT for insomnia can help:

• Improve how well you sleep
• Increase the number of hours you spend sleeping
• Decrease the time it takes to fall asleep 

If your provider determines that CBT-I is medically necessary to treat insomnia symptoms, you may have your sessions covered by Medicare.

Why Medicare coverage for cognitive behavioral therapy matters

CBT is a type of talk therapy. It focuses on reframing unhealthy thinking and behavior patterns and learning more helpful ways of responding to stress or anxiety. It’s a practical way to catch negative thoughts, address them, and replace them with more helpful ways of thinking and responding.  

Anxiety is a common mental health condition that might affect up to 20% of older adults. That number might be even higher since it can be underdiagnosed. Seniors (and their caregivers) on Medicare can benefit from treatment with a therapist who specializes in CBT to learn more helpful ways of coping. 

For older adults, this approach is especially vital because it offers a safe, effective alternative to medication, reducing the risks of falls or confusion often associated with anxiety or sleep aids. CBT is also uniquely tailored to many specific challenges associated with aging, helping patients develop practical skills to navigate grief, chronic pain, and the loss of independence. By focusing on tangible solutions rather than open-ended discussion, CBT empowers seniors to reclaim control over their well-being and maintain a higher quality of life.

How to find a CBT provider who takes Medicare

To find a CBT provider who takes Medicare, you can start by:

• Asking your healthcare provider for a referral and contacting the therapist to confirm if they accept Medicare
• Use the Medicare provider directory to find a mental health counselor offering CBT
• Sailor Health provides a list of experienced providers who take Medicare, including those who have expertise in CBT

Therapists who accept Medicare Part B need to “accept assignment” before therapy begins. This means your therapist agrees to the approved amount from Medicare as full payment for covered services. Medicare directly pays your therapist, and you are only responsible for the deductible and any co-pay.  

Our older, experienced therapists specialize in geriatric care, offering personalized therapy to address issues like anxiety, depression, and the challenges of aging. personalize their services to your needs. Therapy with us takes place over the phone or Zoom. In as little as 24 hours, you can be matched with a CBT provider and begin therapy. Get started today.

References

1. Mayo Clinic. (2025). Cognitive behavioral therapy. https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610 
2. U.S. Centers for Medicare & Medicaid Services. (2025). Medicare & Your Mental Health Benefits. https://www.medicare.gov/publications/10184-medicare-and-your-mental-health-benefits.pdf
3. U.S. Centers for Medicare & Medicaid Services. (n.d.). Telehealth. https://www.medicare.gov/coverage/telehealth
4. U.S. Centers for Medicare & Medicaid Services. (2025). 2026 Medicare Parts A & B Premiums and Deductibles. https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
5. Suzuki, K., Miyamoto, M., & Hirata, K. (2017). Sleep disorders in the elderly: Diagnosis and management. Journal of General and Family Medicine, 18(2), 61. https://doi.org/10.1002/jgf2.27. https://pmc.ncbi.nlm.nih.gov/articles/PMC5689397/
6. Patel, D., Steinberg, J., & Patel, P. (2018). Insomnia in the elderly: A review. Journal of Clinical Sleep Medicine, 14(6), 1017–1024. https://doi.org/10.5664/jcsm.7172
7. Cleveland Clinic. (2022). Cognitive Behavioral Therapy (CBT). https://my.clevelandclinic.org/health/treatments/21208-cognitive-behavioral-therapy-cbt
8. American Association for Geriatric Psychiatry. (2025). Patient Article. https://aagponline.org/patient-article/anxiety-and-older-adults-overcoming-worry-and-fear/