Is Couples Therapy Covered by Insurance?

You may be able to pay out of pocket and receive partial reimbursement through your insurance using out-of-network benefits.

This can help reduce the overall cost of therapy, depending on your plan.

To receive reimbursement, you will typically need to:

1. Pay for sessions upfront
2. Submit a Superbill (a detailed receipt) to your insurance company
3. Receive partial reimbursement based on your plan

Some clients choose to use services like Mentaya or Reimbursify to submit claims on their behalf.

A Superbill is an insurance-ready receipt that includes:

• Diagnosis and procedure codes
• Session dates
• Provider information

You will automatically receive a Superbill each month, and you can access it at any time through your client portal.

Your insurance company uses this document to review and process reimbursement claims.

Most insurance plans will only reimburse therapy if one partner has a diagnosable mental health condition, such as:

• Anxiety
• Depression
• PTSD
• OCD

Because couples therapy focuses on the relationship – not a single diagnosed individual – many plans do not cover it unless this requirement is met.

If you’re considering using out-of-network benefits, it’s helpful to ask:

• Do I have out-of-network mental health benefits?
• What percentage of sessions will be reimbursed?
• Do I need to meet a deductible first?
• Is a mental health diagnosis required for reimbursement?

Getting clear answers upfront can help you avoid surprises.

Many insurance plans do not cover relationship-focused work unless there is a diagnosed condition.

This can be frustrating – especially given how strongly relationships impact mental and physical health.

However, lack of coverage does not mean therapy isn’t worthwhile or effective. It simply reflects how insurance systems are structured.

I believe that constraints imposed by insurance companies are often deliberate and exist to increase profits for shareholders and executives. Thus, I’ve made a deliberate choice not to get paneled in-network with health insurance companies.

This way, therapy can stay focused on your relationship and not limited by diagnosis requirements or external restrictions, and I can support myself and many of my colleagues who are morally opposed this these systemic barriers to fair treatment.

If you’d like more context on my decision, you can read more here:

If cost is a concern, you still have options:

• Use HSA or FSA funds
• Seek partial reimbursement through out-of-network benefits
• Adjust session frequency over time

We can also discuss what approach makes the most sense for your situation during the consultation.