Marriage and Family Therapists and Counselors Will Be Eligible as Medicare Providers in 2024

As a result of legislation passed in late 2022, meaningful changes are coming to the federal Medicare program in 2024.

The most significant planned change is the inclusion of marriage and family therapists (MFTs) and counselors as eligible providers of mental health care to Medicare patients.

What exactly is changing?

As of January 1, 2024, MFTs and counselors will be able to enroll as Medicare providers and bill for services to Medicare patients. 

Like clinical social workers, MFTs and counselors will be paid 75% of the rates paid to psychologists. 

The specific rates vary by zip code. The Centers for Medicare and Medicaid Services still needs to establish rules around the enrollment process for MFTs and counselors. 

The legislation includes some other changes to mental health care under Medicare as well. There will be new billing codes for mobile mental health crisis care, and new funding for psychiatric residents. 

This was all part of the $1.7 trillion spending bill that passed in the House and Senate and was signed by president Biden in December 2022. 

Because that legislation included spending agreements on a wide variety of issues, the Medicare changes weren’t the focus of most of the bill’s media coverage.

The Centers for Medicare and Medicaid Services have proposed other 2024 Medicare changes through rule-making. 

These proposed changes focus on Medicare beneficiaries who receive mental health services through their Medicare Advantage coverage, rather than standard Medicare. 

Under the proposed rules, Medicare Advantage plans would need to clarify that they specifically include mental health services, ensure an adequate network of mental health providers, maintain data on wait times for mental health care, and generally move toward parity between mental health and physical health coverage.

More about Medicare

Medicare is the federal program providing health care coverage to those ages 65 or older, or individuals who have certain disabilities. It’s different from Medicaid programs, which are provided at the state level. 

As of 2023, 20% of Americans, more than 65 million people, are enrolled through Medicare. 

Given its size and scope, inclusion in Medicare has long been a goal of MFTs and counselors. MFTs had been actively pursuing inclusion for more than 30 years.

Medicare covers a wide variety of outpatient mental health services, including:

• Depression screening
• Individual and group therapy
• Family therapy (in some circumstances)
• Psychiatric evaluation
• Medication management 

Medicare clients are typically charged a 20% copay once their annual deductible has been met. On the clinician side, working with Medicare is, in some ways, similar to working in-network with private insurers.

Most Medicare enrollees receive mental health services through standard Medicare coverage, known as Medicare Part B. 

Some, however, receive services through Medicare Advantage plans. These plans are run by private companies, but they are required to follow rules set by Medicare. 

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