Insurance is not typically required to cover couples therapy and most couples pay “out of pocket” for their sessions. Here is why…
Under the Affordable Care Act, the Mental Health Parity and Addiction Equity Act, and other federal laws, insurers must provide equitable coverage for mental health conditions. This means they must treat mental health conditions like physical health conditions, must not exclude them from coverage, and must not charge higher co-pays for these conditions.
Insurance equity laws don’t usually apply to couples therapy because it isn’t seen as a physical health issue like depression, anxiety, addiction or PTSD. Thus, most insurance plans don’t pay for couples therapy because they are not required to do so. Even when some have it as a listed benefit, it is our experience that insurance companies will generally deny the claims by using various reasons or will pay less than a practice’s “break even” rate.
Thus, to engage in couples therapy with our provider’s, patients must prepay for their session using a credit card. We do offer a “superbill” that you can submit to your insurance and request reimbursement. (Patients have had mixed results with their insurance company). Prepaid rates are available upon request.