During the COVID-19 pandemic, the Centers for Medicare & Medicaid Services relaxed restrictions on telehealth services, leading to rapid expansion of telehealth use for mental health care. Although postpandemic patterns are documented for commercially insured populations, little is known about Medicare fee-for-service (FFS) beneficiaries, who represent a substantial share of mental health care users. To fill the gap, we examined monthly telehealth and in-person outpatient mental health service utilization and spending rates among FFS beneficiaries. We focused on 5 major diagnostic categories representing approximately 75% of assigned diagnoses for individuals meeting criteria for any mental disorder.