Networks change. We verify your specific Medicare (Original Part B) plan before your first visit; call with your member ID and we will confirm benefits, copay and any referral or authorization requirements.
Also appears on cards as: Original Medicare, Medicare Part B, classic Medicare, traditional Medicare.
Original Medicare covers outpatient mental health under Part B, which pays 80 percent of the Medicare-approved amount for psychiatric evaluations, medication management and psychotherapy after you have met the annual Part B deductible, which is $257 in 2025 and adjusts each January. You pay the remaining 20 percent unless you have a Medigap supplement, which typically covers it, or Medicaid as secondary coverage. There are no referrals and no network restrictions beyond seeing a provider who accepts Medicare assignment, which Stedfast Psychiatry does. Since 2024, Medicare also covers services from licensed mental health counselors and marriage and family therapists, broadening who you can see for therapy.
Telehealth mental health visits from home are a permanent Medicare benefit, with the requirement of an in-person visit within six months before starting telehealth and at least once every 12 months afterward, unless an exception applies. For transcranial magnetic stimulation, Medicare coverage is set by the local coverage determination of First Coast Service Options in Florida and Palmetto GBA in South Carolina. Both cover TMS for severe major depressive disorder after failure of at least two antidepressants and a psychotherapy trial, with the 20 percent coinsurance applying to each session. Spravato is covered under Part B as a physician-administered drug, with coinsurance on both the drug and the monitoring visit.
What we check before your visit
- Whether your plan is in network at the office you chose and for telehealth
- Your copay or coinsurance for an evaluation and for follow-ups
- Whether a primary-care referral is required (common with HMO plans)
- Prior-authorization criteria for Deep TMS and Spravato, if those are being considered
Frequently asked questions
Does Stedfast Psychiatry accept Original Medicare?
Yes. Stedfast Psychiatry accepts Medicare assignment at all 13 offices in Florida and South Carolina. That means we bill Medicare directly and accept its approved amount as full payment, so you are responsible only for the Part B deductible and 20 percent coinsurance, or less if you have a supplement.
What does a psychiatry visit cost with Medicare Part B?
After the annual Part B deductible, Medicare pays 80 percent of the approved amount and you pay 20 percent. For a typical medication management visit, that coinsurance is usually $20 to $40. A Medigap plan generally covers the 20 percent, leaving you with nothing out of pocket after the deductible.
Does Medicare cover telehealth psychiatry visits from home?
Yes. Medicare permanently covers video and audio-only mental health visits from your home at the same payment rate as office visits. You need an in-person visit with the practice within six months before your first telehealth visit and at least once a year afterward, unless you qualify for an exception.
Does Medicare cover Deep TMS?
Medicare covers TMS for major depressive disorder under local coverage determinations in Florida and South Carolina when you have failed at least two antidepressants at adequate dose and duration and have tried psychotherapy. No prior authorization is needed, but documentation must meet the criteria. You pay 20 percent coinsurance per session unless a supplement covers it.
Does Medicare Part B pay for Spravato?
Yes. Spravato is a physician-administered drug covered under Part B when you have treatment-resistant depression and take an oral antidepressant. Medicare pays 80 percent of the drug cost and the monitoring visit, and you pay 20 percent of each. Because the drug is expensive, that coinsurance can be substantial without a Medigap plan; ask our staff for an estimate.