Coverage & Costs: What Medicare pays — and what you can expect to pay
Medicare Part B covers outpatient mental health therapy when services are provided by an enrolled provider and deemed medically necessary. Here is a plain-language summary of typical costs in 2026.
Cost Item | What to Expect |
|---|---|
Advance Beneficiary Notice (ABN) | If we believe a service may not be covered by Medicare, we will provide you an ABN before the service so you can decide how to proceed. You are never billed for a potentially non-covered service without prior notice. |
Annual Therapy Threshold | Medicare may request additional documentation once therapy costs exceed the annual threshold. We handle this paperwork on your behalf. |
Medicare Advantage / Medigap | If you have a supplemental plan, it may cover part or all of your 20% coinsurance. Check your plan's benefits. |
Your Coinsurance (after deductible) | 20% of the Medicare-approved amount per session. Medicare pays the remaining 80%. |
Our Medicare Services: Counseling areas covered under Medicare Part B
Our licensed therapists provide evidence-based therapy for a wide range of mental health needs. All services below may be billed to Medicare Part B when medically necessary.
Anxiety & Depression
Cognitive-behavioral and acceptance-based approaches to relieve persistent worry, sadness, and low mood.
Grief & Loss
Compassionate support through bereavement, major life transitions, and the losses that come with age.
Trauma & PTSD
Evidence-based trauma-focused therapy for past or recent traumatic experiences.
Life Transitions
Navigating retirement, health changes, caregiver stress, and shifts in relationships or identity.
Family & Relationship
Improving communication and connection with family members and loved ones.
Diagnostic Evaluations
Comprehensive mental health assessments to clarify diagnosis and guide treatment planning.
Please note: Telehealth mental health services are currently subject to changing Medicare regulations. Please contact our office to confirm current telehealth availability under your specific Medicare plan before your first session.
Notice of Privacy Practices (HIPAA) [REQUIRED BY FEDERAL LAW]
As a covered health care entity, we are required to provide you with a Notice of Privacy Practices describing how we may use and disclose your protected health information (PHI), including your mental health treatment records. Key points:
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Your PHI is used for treatment, payment, and healthcare operations without additional authorization
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Psychotherapy notes receive heightened protection — we require your written authorization before disclosing them, with limited legal exceptions
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You have the right to request a copy of your records, request corrections, and receive an accounting of disclosures
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Texas law may provide additional protections for your mental health records beyond federal HIPAA requirements
A full copy of our Notice of Privacy Practices will be provided at intake and is available on request.
Your Right to a Good Faith Estimate (No Surprises Act) [REQUIRED BY FEDERAL LAW]
Under the No Surprises Act, you have the right to receive a Good Faith Estimate of expected charges before your first appointment and upon request at any time. The estimate will include the expected cost of therapy services planned for the next 12 months. If your final bill is $400 or more above your Good Faith Estimate, you may dispute the charge. Contact our billing office to request your estimate at any time.
Required Disclosures: Your rights as a Medicare beneficiary
Medicare Participation Status
[REQUIRED BY FEDERAL LAW]
Fowler & Tidwell Counseling is a Medicare-enrolled provider. By accepting Medicare assignment, we agree to accept the Medicare-approved amount as payment in full (plus your applicable deductible and 20% coinsurance). We will not charge you more than the Medicare-approved amount for covered services
Advance Beneficiary Notice of Noncoverage (ABN) [REQUIRED BY FEDERAL LAW]
If we have reason to believe that Medicare may not cover a specific service, we are required by law to provide you with a written Advance Beneficiary Notice (ABN) before delivering that service. The ABN:
Identifies the specific service Medicare may deny
Explains why we believe Medicare may not pay
Provides an estimated cost you would owe if Medicare denies the claim
Gives you the choice to receive or decline the service
You will never be surprised by a bill for a potentially non-covered service.
FREQUENTLY ASKED QUESTIONS
Questions our Medicare Patients Often Ask:
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How to get started? Schedule your appointment today.
Call us or submit a request through our client portal. We'll verify your Medicare benefits at no charge and match you with a therapist who's right for you.
Phone: 832-831-8379
Getting Started: How to begin therapy with your Medicare benefits
Starting is simpler than you might think. Here is what to expect from your first call to your first session.
Step 1 — Call or submit a request
Contact our office by phone or through the client portal. Let us know you have Medicare and which therapist you're interested in, if you have a preference.
Step 2 — Benefit verification
Our team will verify your Medicare coverage, confirm your deductible status, and explain your expected out-of-pocket costs before you commit to anything.
Step 3 — Complete intake paperwork
You'll receive a Notice of Privacy Practices (HIPAA), consent forms, and a brief intake questionnaire through our secure client portal.
Step 4 — Your first session
Meet with your therapist in our Houston office. Sessions are typically 45–55 minutes. In-person appointments are available; telehealth availability depends on current Medicare guidelines.
Billing Preferences: Medicare therapy codes used at our practice
For reference, these are the CPT codes under which Medicare Part B services are billed. Your therapist will select the appropriate code based on the length and nature of your session.
Code | Service | Time | Frequency |
|---|---|---|---|
90853 | Group Psychotherapy | Per session | One unit per episode of care |
90847 | Family Therapy (with patient) | Per session | Recurring |
90837 | Psychotherapy | 53+ min | Recurring |
90834 | Psychotherapy | 38–52 min | Recurring |
90832 | Psychotherapy | 16–37 min | Recurring |
90791 | Psychiatric Diagnostic Evaluation | 45–75 min (one-time intake) | One unit per episode of care |
NOW ACCEPTING MEDICARE
Medicare Therapy Services
Does life feel like an emotional rollercoaster?
You've worked hard to get here. Quality counseling from licensed therapists you can trust — now accessible through your Medicare benefits.
[REQUIRED BY FEDERAL LAW]
Non-Discrimination Notice
Fowler & Tidwell Counseling complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We provide free language assistance services upon request. To file a civil rights complaint, contact the U.S. Department of Health and Human Services, Office for Civil Rights at hhs.gov/ocr or 1-800-368-1019.
[REQUIRED BY FEDERAL LAW]
Medicare Fraud & Abuse — Your Rights
Medicare beneficiaries have the right to report potential fraud, waste, or abuse. If you believe you have been billed improperly or charged for services not received, you may contact:
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1-800-MEDICARE (1-800-633-4227) — available 24/7
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HHS Office of Inspector General hotline: 1-800-HHS-TIPS (1-800-447-8477)
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stopmedicarefraud.gov