Medicare Expands Mental Health Care Coverage; CA has one of the largest Mental Health care systems

Written by Parriva — December 20, 2023
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Medicare

The largest expansion of Medicare’s mental health services in a generation can provide a critical lifeline to America’s seniors — if enough providers sign up.

Starting Jan. 1, some 400,000 marriage and family therapists and mental health counselors for the first time can accept Medicare payment, following years of advocacy and amid a mental health crisis that has weighed heavily on seniors.

These providers, representing about 40% of the country’s mental health workforce, have been largely shut off to Medicare enrollees who couldn’t afford to pay out of pocket.

Medicare for decades has covered psychiatrists, psychologists, social workers and services provided by some other mental health professionals. But many refuse to see Medicare patients because of low reimbursement and bureaucratic headaches.

1 in 4 older adults reported anxiety or depression in 2020, at the height of the pandemic. But less than half of seniors with mental health or substance use problems are getting help.

Congress in 2022 approved a law allowing Medicare to reimburse licensed marriage and family therapists and mental health counselors, the first expansion of mental health providers covered by the program since 1989.

“Sometimes it takes a focusing event like a disaster or crisis — which in this case was the COVID-19 pandemic — to bring significant attention to the problem of mental health workforce shortages in Medicare,” Sen. Debbie Stabenow (D-Mich.) said this fall at an event celebrating the expansion.

1 in 4 older adults reported anxiety or depression in 2020, at the height of the pandemic. But less than half of seniors with mental health or substance use problems are getting help.

The expansion is “critical” for people in rural areas, “who often face the greatest shortage of mental health providers,” Sen. John Barrasso (R-Wyo.), who cosponsored last year’s legislation, said in an emailed statement.

Seniors in some states will especially benefit from the expansion, said Clese Erikson, deputy director of the Health Workforce Research Center at George Washington University.

California has more licensed marriage and family therapists than any other mental health provider type, while Georgia and Texas have high concentrations of licensed professional counselors, according to a GWU tracker.

It’s unclear how many providers may sign up or how quickly they’ll start seeing Medicare patients. It typically takes time for providers, as well as enrollees, to learn about new benefits.

Medicare is planned to pay the new provider types 75% of what the program pays psychologists. For some providers, that could make it a tough sell.

A survey of American Association of Marriage and Family Therapists members this month found that just 11% so far had gone through the process of registering for Medicare payment, the group’s chief strategy officer Amanda Darnley said.

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