Over the past few years, mental illness stigma has slowly begun to fade in America, and a larger number of people have started to seek out therapy. As demand for mental health care remains on the rise, one urgent question is still at the forefront of everyone’s minds: Is therapy covered by insurance?

The short answer is yes, insurance can cover therapy in the U.S.—but how much that coverage will help depends on several important factors. From the form of insurance plan to provider networks and mental health parity laws, this guide will assist you with learning how to get the best out of your insurance for therapy.

Understanding Insurance Coverage for Therapy

1. The Role of Mental Health Parity Laws

Previously, mental health care was seen as less urgent than medical care, so it was less likely to be covered. All that changed with the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, which mandates health insurance policies that provide mental health or substance use disorder coverage to include them on equal terms relative to medical or surgical treatment.

This means that:

  • Co-pays, deductibles, and limits on visits for therapy should be equal to those for medical conditions.

  • Insurance providers cannot have more stringent expectations for mental health treatment than they do for medical treatment.

Subsequently, the Affordable Care Act (ACA) of 2010 solidified these reforms by mandating all ACA-conformable plans to provide mental and behavioral health coverage as an essential health benefit. This was a monumental victory for access to therapy in the United States.

2. Types of Insurance Plans and What They Cover

Insurance coverage for treatment is mainly a function of the type of plan you have. Here is a breakdown:

Employer-Sponsored Health Insurance

The majority of U.S. employers provide health insurance plans with mental health coverage due to parity laws and ACA mandates. These kinds of plans generally cover:

  • Individual therapy sessions

  • Group therapy

  • Family counseling

  • Psychiatric evaluations

  • Medication management

It’s also worth reviewing the Summary of Benefits to know certain details, such as how many sessions are covered annually, co-pays, and if pre-authorization is required.

Marketplace Insurance (ACA Plans)

If you bought insurance on the federal or state healthcare exchange, your policy has to cover mental health and substance abuse disorder services because they are among the ten essential health benefits mandated by law.

Mental health services covered under ACA plans include:

  • Outpatient therapy

  • Emergency mental health services

  • Behavioral health treatment

  • Substance use disorder treatment

Medicaid

Medicaid provides comprehensive mental health benefits, such as therapy, in every state. Yet, coverage can differ by state. Medicaid typically covers:

  • Counseling services

  • Psychiatric evaluations

  • Medication-assisted treatment

  • Crisis intervention

Case management and community-based mental health services are included in some states. Medicaid expansion under the Affordable Care Act further expanded access to mental health care for low-income adults.

Medicare

If you’re 65 or older or have a qualifying disability, Medicare Part B covers outpatient mental health care like:

  • Individual and group therapy

  • Family counseling

  • Psychiatric evaluation

  • Medication management

You‘ll usually pay 20% of the Medicare-approved amount for mental health care after paying the Part B deductible.

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3. In-Network vs. Out-of-Network Therapists

One of the most crucial things to verify when searching for coverage for therapy is whether the therapist is in-network or out-of-network.

  • In-network providers have agreements with your insurance company to provide services at a set rate. These services are usually more affordable.

  • Out-of-network providers don’t have contracts with your insurance, which could result in higher out-of-pocket costs—or no reimbursement at all.

Some insurance plans (like PPOs) offer partial reimbursement for out-of-network therapists, while others (like HMOs) do not.

Tip: Always check with the therapist and your insurance company to see if the provider is in-network and what you will be responsible for paying.

4. Common Therapy Costs and Billing Codes

Even with insurance, therapy is not always free. Here are some costs you may find yourself facing:

  • Co-payments: Usually $20 to $50 per session

  • Deductibles: You may have to satisfy an annual deductible before insurance will cover it

  • Coinsurance: A portion of the cost you have to pay after you’ve satisfied your deductible

Therapists typically charge insurance with standardized codes, including:

  • 90834: Individual psychotherapy (45 minutes)

  • 90837: Individual psychotherapy (60 minutes)

  • 90847: Family or couples therapy with patient present

Knowing these can be helpful when reading your Explanation of Benefits (EOB).

5. Limitations and Restrictions

Even with legal requirements, insurance for therapy may include some limitations:

  • Preauthorization Requirements: Some insurers require approval before covering therapy sessions.

  • Session Limits: While less common today, some plans still cap the number of covered sessions per year.

  • Diagnoses Required: In some cases, therapists must assign a mental health diagnosis (like anxiety or depression) to qualify for coverage.

6. What to Do if You’re Not Covered

If your plan does not include therapy—or if you can‘t find a provider who takes your insurance—there are alternatives:

  • Employee Assistance Programs (EAPs): Some employers provide short-term counseling free of charge.

  • Sliding Scale Fees: Some therapists charge according to your income.

  • Community Mental Health Centers: Provide low-cost or free therapy based on financial need.

  • Online Therapy Sites: Some sites, such as Better Help or Talk space, might have more flexible payment options and some insurance coverage.

7. How to Maximize Your Insurance for Therapy

To get the most from your insurance:

  • Call Your Insurance Provider: Ask for a list of in-network therapists.

  • Verify Coverage: Confirm what’s covered and what your out-of-pocket costs will be.

  • Keep Records: Save invoices and receipts in case you need to submit claims manually.

  • Ask Your Therapist: They can help navigate insurance paperwork and provide necessary documentation.

Read more: IV Infusion Therapy Certification for LPNs: Everything You Need to Know

Conclusion

So, can therapy be covered under insurance in the USA? Yes—and fortunately, it‘s easier than ever to get it. From employer-sponsored plans to Medicaid and Medicare, there are several ways to access the help that you need at an affordable price.

But the subtleties of insurance coverage—networks, deductibles, and session limits—make it important to be well-informed and proactive. By knowing your plan and how you’re protected by parity laws, you can make therapy more affordable and predictable part of your health care.
Therapy Therapy Be Covered by Insurance