Medicare Coverage for Grief Counseling

Grief is a common experience among seniors, with 71% of people aged 65 and over experiencing a loss in the last 2.5 years. While grief is a natural and normal reaction to loss, when you are experiencing it, it can be intense and distressing. Many seniors seek support to help navigate grief, and may be wondering: “Does Medicare cover grief counseling?”

The answer is, yes, Medicare covers grief counseling as part of Medicare Part B, which includes outpatient therapy and counseling. However, in order for grief counseling to be covered, your provider will need to provide documentation that your sessions are “medically necessary.”

Wading through Medicare coverage documentation can be complicated and overwhelming. We’ll walk you through everything you need to know about accessing Medicare coverage for grief counseling in simple, straightforward language so you can find a Medicare-covered grief therapy provider quickly and start treatment seamlessly.

Key takeaways

• Grief counseling is covered under Medicare Part B, as well as some Medicare Advantage Plans (Part C).
• Your provider will need to present Medicare with documentation that your grief counseling is medically necessary.
• Meeting the medical necessity requirement involves providing a diagnostic code for a mental health condition related to grief, for example: depression, anxiety, prolonged grief disorder, or PTSD.

Understanding the "medical necessity" requirement for grief counseling

Medicare covers outpatient therapy services for seniors under the Medicare Part B portion of your insurance. In order for grief counseling sessions to be covered, your provider needs to:

• Be enrolled in the Medicare program as a provider
• Accept Medicare assignment
• Be legally authorized to practice therapy in the state where you live
• Provide documentation to Medicare that the services rendered are medically necessary 

Medical necessity standards

What does it mean that something is medically necessary? In terms of Medicare coverage, it has to do with billing. Each service that a therapist provides must include a patient diagnosis code, or an ICD-10 code. These codes tell Medicare what mental health diagnosis a patient has, which helps standardize care.

In order for a provider to bill Medicare for a mental health therapy session, they have to include an ICD-10. At this time, “grief counseling” doesn’t have its own ICD-10 code. As such, the provider needs to give Medicare an alternative but related diagnosis for the patient.

Many people experiencing grief also experience a co-occurring mental health condition that has a formal diagnosis which can be documented in ICD-10 language.

The most common mental health conditions associated with grief include:

• Prolonged grief disorder (PGD)
• PTSD
• Anxiety
• Depression

These complicated grief reactions each have a formal diagnosis that can be documented for Medicare coverage purposes.

Each provider is different in terms of how they bill for insurance coverage, and how this translates to your care plan. Your provider will tailor your mental health treatment to your specific needs, which usually expands beyond the billing codes provided to Medicare. In your initial session with your provider you can discuss diagnosis, Medicare billing, and therapy goals. 

How Medicare Part B covers grief therapy

When it comes to Medicare-covered grief counseling, Medicare Part B is what covers outpatient care, including mental health services like grief counseling. 

Types of therapy covered

There are several different types of mental health services covered by Medicare Part B. The services that may pertain to someone experiencing grief include:

• “Talk therapy” and other similar types of one-on-one counseling
• Group therapy
• Marriage and family counseling (when necessary for your treatment)
• Couples therapy
• Psychiatric evaluations
• Medication management
• Treatment for substance abuse
• A yearly depression screening 

Eligible providers

There are several different types of Medicare-approved grief counselors, including:

• Psychiatrists
• Medical doctors
• Physician assistants
• Clinical psychologists
• Marriage and family therapists
• Clinical social workers
• Mental health counselors
• Nurse practitioners and clinical nurse specialists 

To qualify for Medicare coverage, your provider must accept Medicare assignment, which means they agree to the amount Medicare will pay for grief counseling sessions.

How much is the annual Part B deductible for 2026?

Before any mental health services are covered, you first have to meet your Part B deductible, which depends in part on your yearly income. For 2026, the standard deductible is $283. Social Security will inform you of your specific deductible for 2026.

After the yearly deductible is met, patients are generally responsible for paying 20% of the Medicare-approved therapy cost from that point forward. Sailor Health partners with Medicare to keep costs low, with most patients paying as little as $0 out of pocket for therapy with our providers. 

Accessing grief counseling online or over the phone

Finding a therapist who takes Medicare can feel discouraging, especially when you are already dealing with the heavy weight of grief.

The reality is that many private practice therapists choose not to accept Medicare because of reimbursement rates and complex paperwork. As a result, providers who do accept Medicare for grief counseling often have long waitlists. This leaves many families calling dozens of numbers only to hear "we aren't taking new patients" or "we don't take Medicare."

It’s critical to verify coverage before you book an appointment to avoid unexpected bills. If a therapist has "opted out" of Medicare:

• Medicare pays nothing: You will be responsible for 100% of the cost.
• You can’t submit claims: You generally cannot send the bill to Medicare yourself for reimbursement.
• No cap on fees: The therapist can charge whatever rate they choose, without the limits Medicare usually sets.

To protect your wallet, don't just ask a vague question such as, "Do you take Medicare?" Instead, ask the billing office more specific questions:

• "Do you accept Medicare assignment?" (Medicare assignment is the "magic word" that means they accept the Medicare-approved amount as payment in full).
• "Have you formally opted out of Medicare?" (If they say yes, then Medicare will not pay for your counseling).
• "Will I be responsible for any excess charges beyond my standard copay?"

You shouldn't have to spend hours navigating directories or playing phone tag, especially when you’re grieving.

Sailor Health bypasses "directory fatigue" by matching you directly with a licensed, compassionate therapist who accepts Medicare. Getting started is easy, and you could start speaking with a grief counselor from the comfort of your home within as little as 24 hours later.

How Sailor Health can help

As a telehealth therapy platform created specifically for older adults, all of our therapists older, experienced, and accept Medicare assignment. Most Sailor Health Medicare patients receive grief counseling with little or no out-of-pocket cost.

We’re happy to answer your questions, provide assistance scheduling a therapy session, or explain how our services work - get in touch today.

FAQ

Is there a limit to how many grief counseling sessions Medicare will cover?

There’s no limit to how many counseling sessions Medicare will cover. However, your provider will have to provide documentation to Medicare that the services continue to be medically necessary.

Does Medicare cover grief support groups?

Medicare covers group psychotherapy with licensed providers who are enrolled with Medicare. This usually doesn’t include support groups, but there may be exceptions to this rule under certain circumstances. You should contact the support group directly to learn more about coverage.

What happens if my grief counselor opts out of Medicare?

If your grief counselor opts out of Medicare, you will have to pay them directly for care. However, if you have other insurance besides Medicare (employer insurance, Medicaid, Medigap) and your provider accepts this insurance, your grief counseling may be covered.

Does Medicare require a referral from my primary care doctor to see a grief counselor?

Most of the time, original Medicare doesn’t require referrals to see therapists and other specialists. On the other hand, Medicare Advantage plans often require referrals to see specialists like therapists.

If a loved one is in hospice, will Medicare’s hospice benefit cover grief counseling for the family?

Yes, if your loved one is in hospice, Medicare will cover individual or family grief counseling either before or after their death. 

References

1. Gerber, K., Brijnath, B., Lock, K., Bryant, C., Hills, D., & Hjorth, L. (2022). 'Unprepared for the depth of my feelings' - Capturing grief in older people through research poetry. Age and ageing, 51(3), afac030. https://doi.org/10.1093/ageing/afac030
2. Social Security Administration (2026). Medicare. https://www.ssa.gov/pubs/EN-05-10043.pdf
3. Centers for Medicare and Medicaid Services (2025). Medicare & Mental Health Coverage. https://www.cms.gov/files/document/mln1986542-medicare-mental-health-coverage.pdf 
4. Centers for Medicare and Medicaid Services (2025). ICD Code Lists. https://www.cms.gov/medicare/coordination-benefits-recovery/overview/icd-code-lists
5. Buur, C., Mackrill, T., Hybholt, L., Nissen, E. R., & O'Connor, M. (2024). Older bereaved individuals’ experiences of cognitive-behavioral therapy for complicated grief reactions: A qualitative multistage focus group approach. Cognitive and Behavioral Practice. Advance online publication. https://doi.org/10.1016/j.cbpra.2024.06.002
6. Medicare.gov (2025). Medicare & Your Mental Health Benefits. https://www.medicare.gov/publications/10184-medicare-and-your-mental-health-benefits.pdf
7. Medicare.gov (2026). 2026 Medicare costs. https://www.medicare.gov/publications/11579-medicare-costs.pdf
8. Medicare.gov (n.d.). Telehealth. https://www.medicare.gov/coverage/telehealth
9. Medicare.gov (n.d.). Compare Original Medicare & Medicare Advantage. https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage
10.  Centers for Medicare and Medicaid Services (2024). Hospice. https://www.cms.gov/medicare/payment/fee-for-service-providers/hospice