Is Couples Therapy Covered by Insurance?
- Kelsey Wilson
- Aug 7
- 2 min read
When couples get in touch about therapy, they often ask me, “Is couples therapy covered by insurance?” It’s a great question, and the answer depends on a number of factors!
Many of the couples I work with receive a superbill after our sessions to submit for out-of-network mental health benefits with their insurance companies. This can help them get partial reimbursement for our work together, depending on their specific plan and coverage. But even with out-of-network benefits, not all insurance plans cover couples therapy in the same way — or at all.
Here are a few more considerations about mental health benefits and insurance companies:
Diagnosis Requirements Insurance companies typically require that one partner receive a formal mental health diagnosis in order to reimburse for therapy. But often in couples work, the issue isn't one person’s mental health — it's the relationship itself. Labeling one partner as “the identified patient” can pathologize what’s really a relational dynamic.
Limited Session Control When insurance companies pay for sessions, they often limit how many you’re allowed to have, how frequently, and even what kind of interventions are allowed. By working outside of insurance, we’re free to co-create a plan that makes sense for your relationship — not one dictated by billing codes or policies.
Confidentiality & Privacy Submitting claims to insurance requires sharing sensitive information, including diagnoses and session notes. Many couples I work with appreciate the added layer of privacy that comes from keeping our work off the insurance record.
Flexibility and Personalization Out-of-pocket couples therapy allows us to focus on your unique needs and goals, whether that means meeting weekly, doing intensive sessions, or working on topics that aren’t considered “medically necessary” by insurance.
So, Can Couples Use Insurance?
If your insurance plan includes out-of-network mental health coverage, I can provide a superbill (an itemized receipt of services) that you can submit for possible reimbursement. Some clients receive 40–80% back, depending on their deductible and plan details. I always recommend calling your insurance provider to ask:
Do you cover out-of-network psychotherapy?
What is my deductible and how much have I met?
Do you reimburse for sessions with CPT code 90847 (family/couples therapy)?
Is a diagnosis required?
Some couples choose to use Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs) to pay for therapy with pre-tax dollars.
At the end of the day, therapy is an investment in your relationship, communication, and future. Whether or not your insurance covers it, couples therapy can be a transformative process — one that brings more clarity, connection, and alignment into your lives.
Still have questions about whether couples therapy is covered by insurance — or whether working together would be a good fit? Reach out today to schedule a free consultation. I’d be happy to walk you through your options and help you make a decision that feels right for your relationship.
Get in touch:
📞 (657) 339-2672