Medicare, explained for therapists.

No. You can opt in and become a Medicare provider, formally opt out and use private contracts, or simply not enroll.

Opting in means completing Medicare enrollment and credentialing. You can then bill Medicare directly and clients can use their Medicare benefits with you.

If you simply don't enroll, you can't accept private payment from Medicare beneficiaries for covered services. The only way to see them as private pay is to formally opt out and use a private contract.

Since January 2024, Licensed Mental Health Counselors (LMHCs) and Licensed Marriage and Family Therapists (LMFTs) can enroll, alongside LCSWs, psychologists and psychiatric prescribers.

Pros: access to more clients, direct reimbursement and professional credibility. Cons: lower reimbursement, strict documentation requirements and a multi-year commitment.

Consider your client base, financial goals and business model. To expand access, opting in may be best; for a boutique private-pay model, opting out may fit better. We're happy to talk it through.