Does Medicaid Cover Psychological Counseling?

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Medicaid is a state-run program, partially funded by the federal government, that provides medical assistance to low-income individuals. Each state has its own rules, but the federal government mandates certain provisions covering all states. One such provision, the Early and Periodic Screening, Diagnostic and Treatment benefit, requires that children and adolescents under the age of 21 receive all medically necessary services, including treatment for mental, behavioral and substance abuse disorders. State Medicaid programs may offer additional benefits to children and adults.

Kinds of Assistance

  • In general, eligible individuals can receive Medicaid reimbursements for psychological counseling provided as part of physician services, hospital services or treatment by a licensed practitioner. Medicaid also pays for the cost of prescribed medications. The Affordable Care Act of 2010 requires that states enroll newly eligible Medicaid recipients in benefits plans that meet federal benchmarks. The act extended eligibility to families with incomes up to 133 percent of the federal poverty level. The benchmark packages must cover mental health and substance abuse disorders to the same extent they cover medical and surgical conditions. To find out what benefits you can receive, contact your state Medicaid office or the Centers for Medicare & Medicaid Services at cms.gov.

References

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