What Oregon's psilocybin program is
Oregon voters passed Measure 109, the Oregon Psilocybin Services Act, in November 2020; it is now ORS chapter 475A. The Oregon Health Authority (OHA) licenses manufacturers, labs, service centers and facilitators. OHA began issuing licenses in 2023. Since September 1, 2026, the program sits in OHA's Medical Cannabis and Psilocybin Section. Under state rules:
- Clients must be 21 or older. No prescription or referral is needed.
- A client first completes a preparation session with a licensed facilitator.
- Psilocybin is used only during an administration session at a licensed service center, with a licensed facilitator present. An integration session is offered afterward.
- OHA doesn't set prices; each service center and facilitator sets its own.
OHA notes that psilocybin is still a Schedule I substance under the federal Controlled Substances Act.
Why Medicare doesn't cover it
| Part of Medicare | Why it doesn't pay |
|---|---|
| Part D (drugs) | A Part D drug must be approved by the FDA and dispensed by prescription. Psilocybin isn't FDA-approved. |
| Part B (services) | Part B pays enrolled Medicare providers for covered, medically necessary services. Oregon psilocybin facilitators and service centers aren't Medicare providers, and the sessions aren't a covered service. |
| Medigap and Medicare Advantage | They follow Medicare's coverage, so they don't pay either. |
If you join a qualifying clinical research study, Medicare may cover routine costs of your care in the study; ask the study team what Medicare will and won't pay.
Mental health care Medicare does cover
- Individual and group therapy and psychiatric care from Medicare providers, with Part B cost sharing after the deductible ($283 in 2026).
- A yearly depression screening at no cost when your provider accepts assignment.
- FDA-approved drugs for depression, anxiety and substance use disorders, depending on each Part D plan's formulary.
See does Medicare cover mental health in Oregon. If you are in crisis, call or text 988.
Related questions
Does Medicare cover mental health in Oregon?
Therapy, psychiatry and drugs.
Does Medicare cover medical marijuana in Oregon?
Oregon's cannabis program and Medicare.
Does Medicare cover naturopathic doctors in Oregon?
Who Medicare pays.
Sources
- Oregon Health Authority — Oregon Psilocybin Services
- Oregon Health Authority — What are psilocybin services?
- Oregon Health Authority — Access psilocybin services
- 42 CFR 423.100 — Part D definitions (Part D drug)
- Medicare.gov — Mental health and substance use disorder services
- Medicare.gov — Clinical research studies
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Part of the guide: Learn Medicare — the Oregon starter guide · All questions
Frequently asked questions
Do I need a prescription or referral for Oregon psilocybin services?
No. OHA says a prescription or medical referral isn't required. You must be 21 or older and complete a preparation session with a licensed facilitator before an administration session at a licensed service center.
Will Medigap or a Medicare Advantage plan pay instead?
No. Medigap only pays its share of services Medicare covers, and Medicare Advantage plans cover Medicare services. Psilocybin services aren't a Medicare service, and psilocybin remains a Schedule I substance under federal law.
What mental health care does Medicare cover?
Medicare covers counseling and therapy, psychiatric care, a yearly depression screening, and FDA-approved drugs on your Part D plan's formulary. See our mental health page for details.
Medicare in your Oregon county
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