Does Medicare Cover Faith-Based Counseling?

Yes, Medicare covers faith-based counseling, as long as the services are provided by a licensed mental health professional who accepts Medicare assignment.

Medicare will cover different types of licensed mental health providers who incorporate religion and spirituality into their sessions, and this can include any number of religions such as Christianity, Judaism, Hinduism, Islam, and Buddhism. However, if you receive counseling from a clergyperson who is not a licensed mental health professional, their services won’t be covered by Medicare.

The good news is that if you want a faith-based therapist or counselor, you don’t have to choose between your religion and your Medicare benefits. You have options — you just have to know what to look for.

This guide will help you navigate the ins and outs of faith-based counseling, and how to find a counselor who meets your needs and is also covered by your insurance.

Key takeaways

• Medicare will cover faith-based counseling if the provider is a licensed mental health professional who accepts Medicare assignment.
• In order for faith-based counseling services to be covered, your therapist or counselor needs to provide documentation to Medicare indicating that services are “medically necessary.”
• Many different types of providers practice faith-based therapy, which integrates traditional therapy methods with principles from religious faith.

Understanding the rules for faith-based coverage    

When looking for a therapist, most of us want someone who aligns with our mindset and beliefs, and this can include religious faith. Research has found that 77% to 83% of adults older than 55 prefer to have their faith integrated into therapy sessions.

Faith-based therapy combines religious beliefs and practices with traditional, evidence-based therapy and counseling techniques. The way this works is different from one provider to another, but it may look like a traditional therapy session with additional elements like prayer, scripture, and religious philosophy.

Clinical faith-based therapy vs. pastoral counseling

Faith-based therapy can be practiced by licensed mental health professionals or by priests, pastors, rabbis, or imams. But when it comes to Medicare coverage, the counseling has to be practiced by licensed mental health professionals who are trained in clinical therapy techniques and theories.

While some religious leaders may have studied traditional counseling techniques in addition to religion, if they aren’t licensed professionals, they can’t provide Medicare-covered counseling.

Why does Medicare require the treatment to be medically necessary rather than just for spiritual growth?

When it comes to Medicare coverage for counseling, your provider typically needs to submit documentation in order for sessions to be covered. That documentation has to explain why the care is considered “medically necessary.” In other words, Medicare needs to see that the faith-based counseling is being used to treat a recognized mental health condition, not solely for spiritual development or personal growth.

This usually includes a mental health diagnosis Medicare recognizes, such as anxiety, depression, PTSD, and more. That said, you don’t need an official diagnosis or pre-approval to start therapy if you’re experiencing mental health symptoms.

So while faith-based counseling can absolutely include religious teachings and spiritual support, your counselor needs to document that your sessions are also focused on treating a diagnosable mental health concern in order for Medicare to cover the services.

How do evidence-based therapy methods work alongside religious values?

Evidence-based therapy methods, such as cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), dialectical behavioral therapy (DBT), interpersonal therapy (IT), and others can be integrated with religious and spiritual teaching and beliefs.

In fact, studies have found that therapy which combines evidence-based methods with faith and spirituality is as effective — and in some cases, more so — at reducing mental health symptoms like depression. 

CBT faith-based therapy

In cognitive behavioral therapy, you learn to identify your thoughts and behaviors and explore how these impact your emotions and psychology.

If you are doing faith-based counseling, your counselor may integrate religious concepts into this exploration, such as:

• Using religious texts to challenge some of your negative thoughts
• Using spiritual and religious techniques for the coping and relaxation methods integral to CBT therapy
• Suggesting faith-based activities that will help you reach your therapy goals

Which providers can bill Medicare for Christian counseling?

If you are looking for Christian therapists that take Medicare or Christian counselors who accept Medicare, you may be uncertain of where to begin. Here’s what to know about getting Medicare coverage for Christian counseling.

Can a pastor or priest bill Medicare for counseling sessions?

Only licensed mental health professionals can bill Medicare for counseling sessions. So a pastor or priest who doesn’t hold these credentials can’t bill Medicare for services. However, a pastor or priest who is also a licensed mental health professional can bill Medicare for services.

What specific licenses must a counselor hold to accept Medicare insurance?

Plan B is the portion of Medicare that covers mental health services that occur outside of hospital settings. These are typically one-on-one therapy or counseling sessions that occur in an office or clinic or via telehealth.

There are several types of health professionals who can bill Medicare for mental health services, including:

• Psychiatrists (PhDs or PsyDs)
• Doctors (MDs or DOs)
• Clinical psychologists
• Clinical social workers (LCSWs)
• Nurse practitioners (PMHNPs)
• Physician assistants (PAs)
• Marriage & family therapists (LMFTs)
• Mental health counselors (LPCs, LPCCs, LMHCs)

Some people confuse “Christian Counselors” with other types of licensed mental health professionals, such as “Licensed Professional Counselors” or LPCs. But while Christian counselors are often highly trained and credentialed, they are not licensed by states and therefore can’t accept Medicare. 

Are marriage and family therapists or mental health counselors eligible to treat Medicare patients?

If you are looking for a marriage and family therapist (MFT) or mental health counselor (MHC), there’s good news. In 2024, both MFTs and MHCs became eligible to bill Medicare.

These mental health professionals often practice faith-based counseling, so they may be a good option if you’re looking for marriage and family counseling from a faith-based counselor who accepts Medicare. To be eligible, the MFT or MHC needs to reside in your state and have an up-to-date license. While they can practice faith-based counseling with you, they will need to provide documentation to Medicare that your counseling sessions are medically necessary. 

How does the provider's enrollment status affect your out-of-pocket costs?

In order for a Medicare provider – including a faith-based counselor – to bill for services, they must:

• Be enrolled in Medicare as a provider
• Accept Medicare assignment, meaning that they will accept the agreed-upon amount that Medicare is willing to pay
• Be authorized to practice therapy in your state

Once these requirements are met, you can begin services. After you’ve met your yearly deductible, your out-of-pocket expenses will be 20% of the amount that Medicare has agreed to pay your provider. However, most Medicare patients receiving therapy through Sailor Health have a $0 copay.

How to find a Medicare-approved Christian counselor

There are many different ways that you can go about looking for a Christian counselor who accepts Medicare. For example:

• You can ask your church leaders or fellow churchgoers for recommendations
• You can search on local message boards
• You can do an internet search for Christian counselors who are licensed mental health professionals

Once you’ve found a Christian counselor, you need to verify that they accept Medicare assignment by asking directly or by searching for their name in the Medicare provider directory here. 

How to assess a potential therapist to ensure they respect your faith

Anytime you’re searching for a therapist, it’s a good idea to feel things out with them to make sure they are a good match for you. This is especially important if you are looking for a faith-based provider.

You can do this by asking them a few simple questions, including:

• Have you worked with people who want their faith included in therapy?
• What is your overall approach to therapy and how does your faith inform this?
• How do you integrate faith-based practices into your therapy sessions? 
• Are you comfortable integrating my faith values into our work together?
• Are you open to incorporating prayer, scripture, or spiritual reflection if I ask for that?
• How do you handle it if a patient’s beliefs differ from your own?
• If faith comes up in a session, how do you balance spiritual support with evidence-based care?
• Are there any topics where you prefer to stay more neutral (religiously or spiritually)?

How Sailor Health can help

Sailor Health is a therapy platform specifically for older adults. We offer therapy from the comfort of your home via telehealth, either by phone (landline or cellular) or by video (phone or computer). All of our older, experienced therapists accept Medicare, and we work hard to ensure that our services are affordable but exceptional.

Many of our providers offer faith-based therapy along with clinical therapy, and you can schedule a complimentary call with our director of care to find a therapist who aligns with your faith.

Faith-based counseling FAQ

How long does Medicare cover faith based counseling?

There’s no limit to the number of therapy sessions Medicare will cover, as long as treatment continues to be medically necessary.

Does Medicare require a referral from my doctor to see a Christian counselor?

If you have original Medicare, you don’t need a referral to see a therapist. But Medicare Advantage plans sometimes do require referrals for therapists and other specialists.

Can I receive faith-based counseling through telehealth or online video calls?

Yes! Therapy and counseling sessions that are covered by Medicare – including faith-based counseling – can take place in-person or through telehealth. This might include phone or video sessions.

What happens if my counselor is Christian but doesn’t accept Medicare?

If your counselor is Christian, but doesn’t accept Medicare, your sessions won’t be covered by Medicare. You may be able to find a different Christian therapist who accepts Medicare, or you may be able to arrange for a payment plan that works for your circumstances. 

Will Medicare pay for marriage retreats or couples workshops hosted by churches?

Retreats and workshops are integral parts of religion for many people. While Medicare covers group therapy in certain cases, they don’t cover retreats or workshops. In terms of treatment for couples, Medicare will cover couples therapy, as long as it’s deemed medically necessary as part of treatment for the primary patient. 

Is faith-based counseling for bereavement or grief covered, if there is no mental health diagnosis?

Grief and loss are common experiences, especially as you get older. Many people find their faith an important part of the grieving and healing process. While Medicare will cover grief counseling, your provider will need to show that treatment is medically necessary. 

What happens if someone’s faith-based counselor opts out of Medicare?

If your faith-based counselor opts out of Medicare or stops accepting it, you will have to pay out-of-pocket for your care. 

How do the rules differ for religious nonmedical health care institutions?

Some people seek care from a religious nonmedical health care institution, which is an institution that provides care for people who don’t use traditional medical care based on their religious beliefs. Medicare Part A will cover certain aspects of this care, but not the religious medical care that these institutions offer. 

References

1. Pearce, M. J., Koenig, H. G., Robins, C. J., Nelson, B., Shaw, S. F., Cohen, H. J., & King, M. B. (2015). Religiously integrated cognitive behavioral therapy: a new method of treatment for major depression in patients with chronic medical illness. Psychotherapy (Chicago, Ill.), 52(1), 56–66. https://pmc.ncbi.nlm.nih.gov/articles/PMC4457450/
2. Social Security Administration (2026). Medicare. https://www.ssa.gov/pubs/EN-05-10043.pdf
3. de Abreu Costa, M., & Moreira-Almeida, A. (2022). Religion-Adapted Cognitive Behavioral Therapy: A Review and Description of Techniques. Journal of religion and health, 61(1), 443–466. https://pmc.ncbi.nlm.nih.gov/articles/PMC8837510/ 
4. Medicare.gov (n.d.). Mental health care (outpatient). https://www.medicare.gov/coverage/mental-health-care-outpatient
5. National Association of Christian Counselors (n.d.). Board Certified Christian Counseling Program.
6. https://nacconline.org/board-certified-christian-counseling-program/ 
7. Centers for Medicare and Medicaid Services (2024). MFT and MHC Benefit.
8. https://www.cms.gov/files/document/marriage-and-family-therapists-and-mental-health-counselors-faq.pdf 
9. Centers for Medicare and Medicaid Services (2025). Medicare & Mental Health Coverage. https://www.cms.gov/files/document/mln1986542-medicare-mental-health-coverage.pdf 
10. Medicare.gov (2025). Medicare & Your Mental Health Benefits. https://www.medicare.gov/publications/10184-medicare-and-your-mental-health-benefits.pdf
11. Medicare.gov (2026). Religious nonmedical health care institution items & services.
12. https://www.medicare.gov/coverage/religious-nonmedical-health-care-institution-items-services
13. 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
14. Medicare.gov (n.d.). Telehealth. https://www.medicare.gov/coverage/telehealth