Yes, We Take Medicare: What Medicare Covers for Psychiatry in Los Angeles (2026)
Updated: 5 days ago
Written by the Prescribed Wellness Psychiatry team · Medically reviewed by Veronica Sanchez, MD · Updated September 2026
Yes. Prescribed Wellness Psychiatry accepts Original Medicare and Medicare Advantage plans for psychiatric evaluations, medication management, and follow-up visits, in person at our Los Angeles office between Toluca Lake and Burbank, or by telehealth anywhere in California. Medicare Part B covers outpatient psychiatry. In 2026, after the $283 Part B deductible, you pay 20% of the Medicare-approved amount per visit.
Finding a psychiatrist who takes Medicare is harder than it should be. This page explains what Medicare actually covers for psychiatric care, what you will pay, how Medicare Advantage differs, and how to book with us. Verified September 2026.
Key takeaways✓ Prescribed Wellness Psychiatry is in network with Original Medicare and accepts Medicare Advantage plans for outpatient psychiatry in Los Angeles. ✓ Medicare Part B covers psychiatric evaluation, medication management, psychotherapy, and one depression screening a year, according to Medicare.gov. ✓ With Original Medicare in 2026, you pay the $283 Part B deductible, then 20% of the Medicare-approved amount per visit. Medigap usually covers the 20% (please check with your insurance carrier for specific amounts this is an estimate from recently published data). ✓ Medicare covers mental health telehealth from home, with no in-person visit requirement currently through December 31, 2027. ✓ Psychiatric medications fall under Part D, where reported 2026 out-of-pocket drug costs are capped at $2,100 for the year. ✓ |
Does Medicare cover seeing a psychiatrist?
Yes. Medicare Part B covers outpatient mental health care, and the list on Medicare.gov is specific: psychiatric evaluation, medication management, individual and group psychotherapy with a doctor or other Medicare-enrolled licensed professional, partial hospitalization, and services delivered through telehealth.
In plain terms, that means the visits a psychiatrist actually provides are covered: the first evaluation, the follow-up visits where medication is adjusted, and therapy when a psychiatrist provides it.
How much does a psychiatrist visit cost with Medicare in 2026?
With Original Medicare, two numbers matter. The first is the Part B deductible, which the Centers for Medicare & Medicaid Services set at $283 for 2026. The second is coinsurance: after the deductible, you pay 20% of the Medicare-approved amount for visits to diagnose or treat your condition, and Medicare pays the other 80%. This is per their published reports but please ensure you check with your particular insurance provider.
The phrase "Medicare-approved amount" matters. When a provider accepts assignment, they agree to take the Medicare-approved amount as full payment and can only bill you the deductible and coinsurance. Providers who do not accept assignment can charge up to 15% more. Ask any psychiatrist whether they accept assignment before your first visit. We do.
If you have a Medigap policy, it usually pays your share of the deductible and coinsurance for Part B services, which for many patients can mean little or nothing out of pocket per visit. If you have a retiree plan from a union or former employer, it typically pays after Medicare. You might have to provide both cards.
What changes if I have a Medicare Advantage plan?
Medicare Advantage plans, sometimes called Part C, are private plans that replace Original Medicare and must cover the same services. According to Medicare.gov's comparison, the practical differences are networks, referrals, and costs. Many Advantage plans require you to use in-network providers, some HMO plans require a referral from your primary care doctor, and some services need prior authorization. Instead of 20% coinsurance, you usually pay a fixed copay per specialist visit that varies by plan.
We accept Medicare Advantage plans, and we check your specific plan when you call, because networks change and two plans from the same company can have different rules.
Can I see a Medicare psychiatrist by video?
Yes. Medicare covers mental health visits by telehealth, including from your home. The federal rule that would require an in-person visit within six months of your first behavioral health telehealth visit, and once a year after that, is not in effect through December 31, 2027, according to the U.S. Department of Health and Human Services. That means Medicare patients can start and continue psychiatric care by video without a required office visit, at least through the end of 2027.
Dr. Sanchez sees Medicare patients both ways. Many people come to the Barham Blvd office for the first evaluation and then alternate video and in-person follow-ups depending on what is easier that month. Video visits are available anywhere in California.
Does Medicare cover psychiatric medications?
Medications you take at home are covered under Medicare Part D, or under a Medicare Advantage plan that includes drug coverage, rather than under Part B. Each plan has its own list of covered drugs, called a formulary, and its own copay tiers. In 2026, out-of-pocket spending on covered Part D drugs is capped at $2,100 for the year, after which you pay nothing more for covered drugs that year. Medicare also offers a payment plan that spreads those costs across the year, though it does not lower them.
When a medication we are considering is likely to be expensive or need prior authorization, we talk through alternatives if the first choice is not covered. Weight and metabolic effects are part of that conversation too; our post on weight changes on psychiatric medication explains what to watch for.
Why is it so hard to find a psychiatrist who takes Medicare?
Because most do not. A study in JAMA Psychiatry using national survey data found that only about 55% of psychiatrists accepted Medicare, compared with 86% of physicians in other specialties. Acceptance of private insurance was similar, at 55% versus 89%. The data are from 2009 and 2010, and a 2024 analysis in Psychiatric Services found the gap persisted through 2016.
The result is familiar to anyone who has tried: long call lists, full practices, and psychiatrists who only take cash. That is the gap we chose to fill. Dr. Sanchez is a board-certified, UCLA-trained psychiatrist who takes Medicare because the people who need psychiatric care most are often the ones with the fewest options. She grew up in an underserved community, where she saw how hard care was to reach, and that shaped her commitment to Medicare patients.
What does Medicare psychiatric care look like at Prescribed Wellness?
Your first visit with Dr. Sanchez is a 50-minute evaluation, not a fifteen-minute intake. Follow-up visits are 25 minutes. Care is medication management with attention to sleep, nutrition, movement, and stress, and Dr. Sanchez can coordinate with your primary care doctor and other physicians with your permission, if it's needed. Visits can be held in English or Spanish. If you are new to psychiatry, our guide to what to expect at your first psychiatric evaluation walks through the visit step by step.
Our office is at 3800 Barham Blvd, Suite 416, Los Angeles, CA 90068, off the 101 at the Cahuenga Pass, between Toluca Lake, Burbank, Studio City, and Universal City, with parking in the building. Many of our Medicare patients are retirees from the studios and networks nearby, and our guide for people who work in entertainment covers how we handle privacy and scheduling.
How do I book a Medicare psychiatry appointment?
Call or text us at (626) 681-3729 or request an appointment online. Tell us whether you have Original Medicare or a Medicare Advantage plan, and the plan name.
Have your red, white, and blue Medicare card ready, plus your Medicare Advantage or Medigap card if you have one, and any retiree plan card.
We verify your coverage and tell you what to expect for cost before your first visit, including whether your plan needs a referral.
Bring a list of your current medications and any recent lab results to the first evaluation. More on what to bring is on our FAQ page.
If you are helping a parent or spouse find a psychiatrist who takes Medicare in Los Angeles, you are welcome to call on their behalf to ask about availability and coverage. We cannot discuss a patient's care without their permission, but we can explain how the process works.
What a first evaluation involves, the plans we take and where the office is are on our page for psychiatrists in Los Angeles.
Coverage varies by plan, and benefits change. This page is general information, not a guarantee of coverage. Always confirm your specific benefits with your plan before your visit. Verified September 2026.
Frequently asked questions
Does Medicare cover seeing a psychiatrist?
Yes. Medicare Part B covers outpatient mental health care, including psychiatric evaluation, medication management, and psychotherapy with a doctor, according to Medicare.gov. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for each visit. One depression screening a year is covered at no cost when your provider accepts assignment.
How much does a psychiatrist visit cost with Medicare in 2026?
With Original Medicare, you first pay the 2026 Part B deductible of $283, then 20% of the Medicare-approved amount per visit. A Medigap policy usually covers that 20%. Medicare Advantage plans set their own copays, often a flat amount per specialist visit. Call your plan and they will tell you what to expect before you book.
Do you take Medicare Advantage plans?
Yes. Prescribed Wellness Psychiatry accepts Original Medicare and Medicare Advantage plans. Advantage plans use networks and sometimes require a referral or prior authorization, so we confirm your specific plan when you call. Have your plan card ready and we will check it before your first visit so there are no surprises.
Do I need a referral to see a psychiatrist with Medicare?
With Original Medicare, no referral is needed to see a psychiatrist who accepts Medicare. Some Medicare Advantage plans, especially HMO plans, do require a referral from your primary care doctor or prior authorization. Check your plan's rules, because they will help you sort out what your plan requires.
Can I see a psychiatrist by video with Medicare?
Yes. Medicare covers mental health visits by telehealth from your home. Federal telehealth rules currently waive the in-person visit requirement for behavioral health telehealth through December 31, 2027, according to HHS. Dr. Sanchez sees Medicare patients in person at our Barham Blvd office or by secure video anywhere in California.
Does Medicare cover psychiatric medications?
Prescription medications are covered under Medicare Part D or a Medicare Advantage plan that includes drug coverage, not under Part B. In 2026, out-of-pocket spending on covered Part D drugs is capped at $2,100 for the year, per Medicare.gov. Each plan has its own formulary, so we check that a medication is covered before prescribing when possible.
Sources
Medicare.gov. Mental health care (outpatient).
Centers for Medicare & Medicaid Services. 2026 Medicare Parts A & B Premiums and Deductibles. November 2025.
Medicare.gov. Does your provider accept Medicare as full payment?.
Medicare.gov. Compare Original Medicare & Medicare Advantage.
Medicare.gov. Medigap basics.
Medicare.gov. Costs for Medicare drug coverage, 2026.
Medicare.gov. Depression screenings.
U.S. Department of Health and Human Services, Telehealth.HHS.gov. Telehealth policy updates, 2026.
Bishop TF, Press MJ, Keyhani S, Pincus HA. Acceptance of insurance by psychiatrists and the implications for access to mental health care. JAMA Psychiatry, 2014.
Carlo AD, Basu A, Unützer J, Jordan N. Acceptance of Insurance by Psychiatrists and Other Physicians, 2007–2016. Psychiatric Services, 2024.
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