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Substance Abuse Care (Outpatient) Medicare Coverage Detailed

Your Medicare Coverage

Substance Abuse Care (Outpatient) Detailed

Coverage: Conditions that must be met before Medicare will provide coverage, and limits to coverage.

Medicare covers mental health care furnished by a doctor or health care professional who can be paid by Medicare. Ask your doctor, psychologist, social worker, or other health professional if they accept Medicare payment before you get treatment.

Outpatient Mental Health Care: Medicare covers mental health services when furnished on an outpatient basis by either a doctor, clinical psychologist, clinical social worker, clinical nurse specialist or physician assistant in an office setting, clinic, or hospital outpatient department.

Medicare covers substance abuse treatment in an outpatient treatment center that is certified by Medicare.

CoPayment: The amount you need to pay.

You usually pay 50% of Medicare-approved amounts.

Medicare Part: The part of Medicare that pays for this service or supply.


Organization Name: The organization name that this coverage topic is associated with.

Important Notes: Details regarding important notes about the coverage.

You must pay an annual $147 deductible for Part B services and supplies before Medicare begins to pay its share.