How to Find a Psychiatrist That Accepts Medicare

The short answer

Start with Medicare's Care Compare tool or your Medicare Advantage directory, then call to confirm the psychiatrist is accepting new Medicare patients, because directories are often out of date. Medicare Part B covers psychiatric evaluations, medication management, psychotherapy, TMS and Spravato at 80 percent after the deductible. Stedfast Psychiatry accepts Medicare at all 13 offices and by telehealth.

Psychiatry has one of the lowest Medicare participation rates of any medical specialty. Surveys from the American Medical Association and analyses of Medicare's own data have put the share of psychiatrists who accept new Medicare patients somewhere between half and two thirds, well below primary care and most other specialties. If you have called four offices and been turned away by three, that is not bad luck. It is the market.

I want to explain why that is, and then give you a practical method for finding a psychiatrist who takes Medicare, including what to ask on the phone so you do not waste a week waiting for an appointment that was never going to happen.

Why so many psychiatrists do not take Medicare

Three things drive it. First, Medicare reimburses psychiatric visits at rates that are often lower than commercial insurance and far lower than cash, and psychiatry is a specialty where cash practices are viable because demand exceeds supply. Second, a psychiatrist can formally opt out of Medicare and bill patients directly, something that is rare in surgery or oncology but common in psychiatry. Third, many psychiatrists work solo or in very small groups and do not have the billing staff to manage Medicare's documentation and audit requirements.

None of this is about you as a patient. It is about practice economics. Larger group practices with billing infrastructure, like Stedfast Psychiatry, are more likely to accept Medicare because the administrative cost is spread across many clinicians.

What Medicare covers for psychiatric care

Original Medicare Part B covers outpatient mental health services. That includes the initial psychiatric diagnostic evaluation, follow-up medication management visits, psychotherapy from a psychiatrist, psychologist, clinical social worker or, since 2024, licensed mental health counselors and marriage and family therapists. It also covers annual depression screening at no cost, and partial hospitalization when needed.

Medicare Part B also covers transcranial magnetic stimulation for major depressive disorder that has not responded adequately to medication, under local coverage determinations set by each regional Medicare administrative contractor. Florida and South Carolina fall under First Coast Service Options and Palmetto GBA respectively, and both have TMS coverage policies with specific criteria around prior antidepressant trials and symptom severity. Spravato (esketamine) is covered under Part B as a physician-administered drug, because it must be given in a certified clinic with monitoring, which is also why it is not a Part D pharmacy benefit.

Prescription medications you fill at a pharmacy fall under Part D or your Medicare Advantage plan's drug coverage. Nearly all antidepressants, mood stabilizers, antipsychotics and ADHD medications are on formulary, though some newer brand-name drugs sit in higher tiers.

What you pay

Under Original Medicare, after you meet the annual Part B deductible, Medicare pays 80 percent of the approved amount and you pay 20 percent. For a typical follow-up medication visit that works out to a coinsurance in the range of 15 to 30 dollars. For a TMS course of 36 sessions, the 20 percent adds up, which is why many patients carry a Medigap supplement that covers the coinsurance entirely. If you have a Medigap Plan G or similar, your out-of-pocket cost for psychiatric visits is usually zero after the deductible.

Medicare Advantage plans replace Original Medicare with a private plan that must cover the same services but can set its own copays, networks and prior authorization rules. Psychiatric visit copays on Advantage plans typically run 0 to 50 dollars. The catch is the network: your psychiatrist has to be in that specific plan's network, not just "accept Medicare" in general. TMS and Spravato on Advantage plans almost always require prior authorization.

A step-by-step way to find one

Step 1: Use the right directory

If you have Original Medicare, the official search tool is Medicare's Care Compare at medicare.gov, which lists physicians who are enrolled in Medicare. Filter by specialty "psychiatry" and your zip code. If you have a Medicare Advantage plan, use that plan's provider directory instead, because Care Compare does not know your plan's network. Psychiatry Online's directory and Psychology Today also allow filtering by "Medicare," but those listings are self-reported and frequently stale.

Step 2: Call and ask three questions

Directories are wrong often enough that the phone call is where the real search happens. Ask these three things, in this order.

"Is Dr. X currently accepting new patients with Medicare?" Some psychiatrists are enrolled but have closed their panel to new Medicare patients.
"Do you accept assignment?" A participating provider who accepts assignment agrees to Medicare's approved amount and cannot bill you more than the 20 percent coinsurance. A non-participating provider may charge up to 15 percent more.
If you have Medicare Advantage: "Are you in network for [exact plan name]?" Say the full plan name from your card, not just the insurer.

Step 3: Ask about what you actually need

If you are looking for medication management, almost any Medicare psychiatrist can help. If you are looking for TMS, Spravato, geriatric expertise or in-facility visits at an assisted living community, ask directly. Many Medicare-accepting psychiatrists do not offer interventional treatments, and you will save time by asking up front.

Step 4: Consider telehealth

Medicare has covered telehealth for mental health services since the pandemic, and Congress made mental health telehealth coverage permanent, including visits from your home. That widens your search from "psychiatrists near me" to "psychiatrists licensed in my state." For a Florida or South Carolina resident, that is a much larger pool. Some in-person visit requirements apply in certain situations, so ask the office how they handle it.

Red flags and realistic expectations

Be cautious of an office that says "we take Medicare" but then asks you to sign a private contract or pay the full fee and "submit it yourself." A psychiatrist who has opted out of Medicare cannot bill Medicare for you, and you cannot submit the claim either. Opt-out status is public on Medicare's website if you want to check.

Expect wait times. Even among psychiatrists who accept Medicare, new-patient waits of four to eight weeks are common, especially in South Florida and the Lowcountry where retiree populations are large. Ask to be placed on a cancellation list, and ask whether a psychiatric nurse practitioner in the same practice can see you sooner. In most group practices, nurse practitioners and physician assistants work under psychiatrist supervision and can start treatment while you wait for the physician if that is your preference.

What Stedfast Psychiatry does

We accept Original Medicare and most Medicare Advantage plans at all 13 offices across Florida and South Carolina, and by telehealth for patients located in either state. We accept assignment. Medicare patients can be seen for evaluations, medication management, psychotherapy, Deep TMS at Palm Beach Gardens and Spravato at Boynton Beach, Palm Beach Gardens and Royal Palm Beach. Our Stedfast Living program brings psychiatric care directly into assisted living, independent living and skilled nursing facilities, which is often the only practical way for a resident with limited mobility to see a psychiatrist regularly.

When you call, our staff will verify your specific plan before the first visit so there are no surprises. If you have a Medicare Advantage plan we are not contracted with, we will tell you that on the phone rather than at checkout.

If you cannot find anyone

If every Medicare psychiatrist within reach has a closed panel, there are fallbacks. Your primary care physician can start first-line treatment for depression and anxiety and often does. Federally Qualified Health Centers accept Medicare and usually have behavioral health staff. Community mental health centers in both Florida and South Carolina serve Medicare patients. And a self-pay evaluation at a practice that also takes Medicare, at a rate like our $185 new-patient visit, can get treatment started while you wait for an in-network opening, though note that you cannot later bill Medicare for a visit you chose to self-pay with a participating provider.

The search is harder than it should be. But Medicare does cover psychiatric care well, and the psychiatrists who accept it are out there. The method above finds them faster.

Frequently asked questions

Does Medicare cover psychiatrist visits?

Yes. Medicare Part B covers psychiatric evaluations, medication management and psychotherapy at 80 percent of the approved amount after the annual deductible. Medicare Advantage plans cover the same services with their own copays and networks. Many patients with a Medigap supplement pay nothing out of pocket for visits.

Why do so many psychiatrists not accept Medicare?

Reimbursement rates are lower than commercial or cash rates, psychiatrists can formally opt out and bill patients directly, and small practices often lack the billing staff for Medicare's requirements. Larger group practices are more likely to participate.

Can I see a Medicare psychiatrist by telehealth?

Yes. Medicare permanently covers mental health telehealth visits, including from your home. The psychiatrist must be licensed in the state where you are located during the visit. Stedfast Psychiatry sees Medicare patients by telehealth throughout Florida and South Carolina.

Does Medicare cover TMS and Spravato?

Both are covered under Part B when criteria are met. TMS coverage follows the local coverage determination for your region and generally requires documented failure of antidepressant trials. Spravato is covered as a physician-administered drug given in a certified clinic. Medicare Advantage plans usually require prior authorization for both.

What is the difference between accepting Medicare and accepting assignment?

A provider who accepts assignment agrees to Medicare's approved amount and bills you only the 20 percent coinsurance. A non-participating provider can charge up to 15 percent above the approved amount. Stedfast Psychiatry accepts assignment.