Is Your Relationship Worth It? Understanding Insurance for Couples Therapy

The answer depends on your policy, provider, and how your therapist bills the sessions. Let’s break down what you need to know about insurance for couples therapy and how to make it more affordable — even if your plan doesn’t cover it.

Does Health Insurance Cover Couples Therapy?

The tricky part about insurance coverage for couples counseling is that most plans are designed to treat individual mental health disorders — not relationship issues. That means your sessions might only be covered if a specific mental health diagnosis applies to one partner.

For example, if one partner has anxiety, depression, or post-traumatic stress disorder (PTSD), and therapy addresses how that condition affects the relationship, insurance may help pay for it. In contrast, if you’re simply seeking help for communication or marital conflict, insurers might classify the sessions as not medically necessary — and deny coverage.

When Insurance Usually Covers Couples Therapy

Insurance can help with the cost of couples therapy when:

• One partner has a documented mental health diagnosis (such as depression or anxiety).
• The therapy is led by a licensed mental health professional (psychologist, clinical social worker, or licensed marriage and family therapist).
• The therapist bills the session under the diagnosed partner’s name using the appropriate medical codes.
• Your plan includes mental health or behavioral health benefits.

In these cases, the insurance company views therapy as treatment for a mental health condition, even if both partners attend the session.

When Insurance Does Not Cover Couples Therapy

Unfortunately, there are many scenarios where insurance won’t cover couples therapy — even if it’s beneficial for your relationship. This usually happens when:

• Sessions focus solely on relationship issues without a mental health diagnosis.
• The therapist is not part of your insurance network.
• The provider does not bill using insurance-accepted diagnosis codes.
• Your plan explicitly excludes marriage or family counseling.

If your insurance company deems therapy “self-improvement” or “relationship enhancement,” it’s considered out-of-pocket.

Typical Costs of Couples Therapy Without Insurance

Without insurance, the cost of couples therapy can vary depending on location, therapist qualifications, and session length. On average, you can expect:

• $75 – $150 per session with a licensed counselor
• $150 – $300 per session with a psychologist or specialized marriage therapist

Therapists in major cities tend to charge more than those in smaller towns. Some providers also offer sliding-scale fees based on income or package discounts for prepaid sessions.

How to Check If Your Insurance Covers Couples Therapy

Before scheduling your first session, it’s worth confirming your benefits. Follow these steps:

1. Call the number on your insurance card for mental health services.
2. Ask if your plan covers therapy when both partners attend sessions.
3. Confirm if marriage or family therapy is included under behavioral health benefits.
4. Request information about in-network providers who specialize in couples counseling.
5. Ask whether you need a referral or pre-authorization before starting therapy.

Be sure to note any copayments, deductibles, or visit limits that apply. Knowing these details upfront helps you plan your budget and avoid unexpected costs.

Billing and Diagnostic Codes That Affect Coverage

Therapists use specific CPT (Current Procedural Terminology) codes when billing insurance. For couples therapy, the most relevant ones include:

• 90847: Family or couples therapy with the patient present.
• 90846: Family therapy without the patient present.
• 90837: Individual psychotherapy (often used when a mental health diagnosis applies).

For the insurance to approve coverage, one partner usually must have an official diagnosis — such as generalized anxiety disorder (F41.1) or major depressive disorder (F32.9).

Alternative Ways to Afford Couples Therapy

If your insurance doesn’t cover couples therapy, there are still several affordable options:

1. Sliding-Scale Clinics

Community mental health centers and nonprofit organizations often offer sessions based on your income, sometimes as low as $40 per visit.

2. Online Therapy Platforms

Services like BetterHelp, ReGain, or Talkspace provide affordable virtual counseling for couples, usually costing $65–$90 per week, billed monthly.

3. Employee Assistance Programs (EAPs)

Many employers offer free or discounted therapy sessions through EAPs, which can include couples counseling for short-term support.

4. University Counseling Centers

Universities with psychology or social work programs often have clinics where graduate students offer counseling at reduced rates under supervision.

5. Package Deals or Group Workshops

Some therapists provide discounts for prepaid session bundles or relationship workshops that address communication and conflict resolution.

Tips to Maximize Your Therapy Investment

Couples therapy is an investment in your emotional health and relationship stability. To make the most of it:

• Set clear goals with your therapist at the start.
• Attend sessions consistently, even during busy weeks.
• Be honest and open about your expectations and challenges.
• Apply strategies discussed in therapy to real-life situations.
• Consider occasional check-in sessions after your main therapy ends.

Even if insurance doesn’t cover the cost, the long-term benefits — improved communication, emotional connection, and reduced conflict — are often worth every dollar.

Final Thoughts: Investing in Love and Well-Being

So, is your relationship worth it? Absolutely. Whether insurance helps or not, couples therapy is a powerful tool for strengthening your bond and improving emotional health. If your coverage is limited, explore affordable alternatives and talk openly with your therapist about financial options.

At the end of the day, investing in your relationship can prevent years of emotional strain, reduce mental health issues, and lead to a happier, more fulfilling partnership. Love is priceless — but with the right plan, therapy doesn’t have to break the bank.