I last reported about specialties opting out of Medicare in November 2023. As of September of that year, 31,603 had opted out, a 7.8% increase over January 2023. Almost 14,000 mental health clinicians had opted out, about 5500 of whom were psychologists, the single largest group opting out. Nurse Practitioners showed the largest increase (~8%) from January to September 2023, with Clinical Social Workers, Clinical Psychologists, and Family Practice showing the next greatest increases in opt out numbers during that same time span.
Current numbers as of December 2025 are shown below.
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MHCs and MFTs first became able to serve Medicare beneficiaries on an independent basis in 2024.
Combined, these mental health clinican groups comprise 33,204 opted out clinicians, 60.1% of all clinicians opting out Medicare.
Total numbers of the mental health specialties remaning in Medicare and able to serve the population will be reported in the future, but it appears clear that traditional Medicare is experiencing considerable mental health specialty flight from the system. The addition of MHCs and MFTs to Medicare as independent clinicians may not prove to be a meaningful solution to serving this population, at least under current terms of reimbursement and other features of the system.
Notes: Includes 1 Specialist coded as “Psychologist,”, 1 “Counselor Mental Health,” 1 Counselor Professional,” 2 “Psychology,” allocated to “All Other” who probably could have been allocated to obvious specialties but not recoded due to uncertainty/miscoding of specialist designation.
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