Does Medicare cover EMDR therapy?

Medicare EMDR coverage details

Medicare Part B covers outpatient mental health services, including EMDR therapy provided by licensed clinical social workers, clinical psychologists, and other qualified mental health providers. The 90837 code (53+ minutes) has no defined upper time limit, supporting longer EMDR sessions. Medicare covers EMDR for appropriate diagnoses including PTSD, anxiety disorders, and depression.

How EMDR is billed with Medicare

CPT codes

EMDR uses standard Medicare psychotherapy codes: 90834 (38-52 min) or 90837 (53+ min). The G2212 add-on code can be used for prolonged psychotherapy sessions when clinically appropriate. Medicare pays based on the fee schedule for your geographic area.

Typical copay

After meeting your Part B deductible (which increases annually), Medicare pays 80% of the approved amount for outpatient mental health. You pay the remaining 20% coinsurance. If you have a Medigap (supplemental) plan, it may cover your 20% coinsurance.

Prior authorization

Medicare does not require prior authorization for outpatient psychotherapy, including EMDR. No referral is needed to see a mental health provider.

Session limits

Medicare does not limit the number of outpatient mental health sessions. Treatment continues as long as it's medically necessary as documented by your provider.

Finding Medicare-covered EMDR therapists

For Original Medicare, any provider who accepts Medicare assignment can provide covered EMDR. Medicare Advantage plans have their own networks — see specific plan details. Loma does not currently accept Medicare — any provider who accepts Medicare assignment can provide covered EMDR.

Frequently asked questions

What's the difference between Original Medicare and Medicare Advantage for EMDR?

Original Medicare (Parts A & B) lets you see any provider who accepts Medicare. Medicare Advantage plans have specific networks. Both cover EMDR, but network restrictions differ. Note that Loma does not currently accept Medicare.

Does Medicare cover telehealth EMDR?

Yes. Medicare expanded telehealth coverage significantly and continues to cover mental health telehealth services including EMDR. You can receive EMDR via video from your home.

Do I need a referral for EMDR with Medicare?

No. Medicare does not require a referral to see a mental health provider. You can directly schedule with an EMDR therapist who accepts Medicare.

Will Medicare cover EMDR for anxiety, not just PTSD?

Yes. Medicare covers EMDR for clinically appropriate diagnoses including anxiety disorders, depression, adjustment disorders, and other conditions — not just PTSD.