Using your insurance for therapy

Picture the moment. You have finally decided to talk to someone, maybe about the distance that has crept into your marriage, maybe about a teenager who has stopped talking at dinner. Then a practical question lands on top of the emotional one: will my insurance help pay for this? This page gives you a straight answer, the plans that can be billed, and the exact questions to ask so you know what to expect before the first session.

Which insurance plans can be billed for therapy with Iryna?

Sessions with Iryna Morhunova-Sutton, LLMFT, can be billed to the following plans through her group practice’s billing system:

• Blue Cross Blue Shield of Michigan
• Blue Care Network
• Aetna
• Cofinity
• Medicare
• United Behavioral Health (UBH)
• Optum
• ASR Health Benefits
• Priority Health

Being able to bill a plan is not the same as a promise of coverage. What your plan pays, your copay or coinsurance, and whether couples or family sessions are covered all depend on your individual plan. Each page above explains how that company’s plans tend to work for outpatient therapy and where to look up your own benefits.

How billing works

Iryna’s sessions are billed through her group practice’s billing system, so you are not expected to file the insurance claim yourself. When you reach out, name your plan and have your member ID card nearby. The name on the front of the card, and sometimes a second logo or a separate behavioral health phone number on the back, tells you who actually manages your mental health benefits.

It also helps to run your own quick benefits check using the questions below. Ten minutes on the phone now can save a confusing bill later.

Online sessions, anywhere in Michigan

Iryna sees clients by secure video only. There is no office to visit, which means a couple in Marquette and a family in Monroe can work with her the same way. Because she is licensed in Michigan, you need to be physically located in Michigan during each session. Insurers apply the same idea; Blue Cross Blue Shield of Michigan, for example, requires telemedicine providers to be licensed where the patient is. Learn more about how online therapy in Michigan works.

How to verify your benefits before the first session

Call the member services or behavioral health number on your ID card, or log in to your plan’s member website. Then ask:

1. Is outpatient behavioral health covered? Ask about outpatient mental health visits with an in-network provider.
2. Is telehealth covered? Ask whether video sessions are covered and whether they cost the same as in-person visits.
3. What will I owe? Ask about your deductible (and how much you have met this year), plus any copay or coinsurance per visit.
4. Is prior authorization or a referral required? Some plans require one for certain services. Ask whether there is a visit limit too.
5. Are family psychotherapy codes covered? Ask specifically about CPT 90847 (family psychotherapy with the patient present) and CPT 90846 (without the patient present), and whether any marriage or couples counseling exclusion applies.

Write down the date, the representative’s name and a call reference number. If an answer sounds uncertain, ask where it appears in your plan documents.

Why couples therapy may or may not be covered

Health insurance generally pays for treating a health condition, and a relationship is not a patient. For couples sessions to be billed, insurers usually look for medical necessity: one partner has a diagnosed condition, and the couple’s work together is part of treating it. The family psychotherapy codes reflect this. AAPC describes CPT 90847 as a provider counseling the family, with the patient present, on the psychological issues affecting the patient and the family.

Relationship distress on its own is usually coded with a Z code such as Z63.0, “Problems in relationship with spouse or partner.” Z codes describe circumstances rather than mental disorders, and claims built only on them are often not reimbursed. Medicare states the principle plainly in its own coverage list: family counseling is covered if its main purpose is helping with the patient’s treatment.

Two honest notes. A diagnosis becomes part of your health record, and some people prefer to pay privately for that reason. And a diagnosis must always be accurate; it is never something to invent to get a claim paid. For a deeper look, read does insurance cover couples therapy.

What about family therapy?

The same logic applies. When a child, teen or adult in the family is being treated for a diagnosed condition and family sessions support that treatment, plans may cover them under the family psychotherapy codes. If you are considering family therapy, ask your plan who would be listed as the patient and whether sessions without that person present are covered.

Paying on your own and the Good Faith Estimate

Some people choose not to use insurance: their plan excludes couples work, they would rather not have a diagnosis on file, or they simply want more privacy. If you are uninsured or decide not to use your coverage, the federal No Surprises Act gives you the right to a Good Faith Estimate of expected charges before care begins. Read more about your right to a Good Faith Estimate.

Can you use an HSA or FSA?

Often, yes, for therapy that is medical care. IRS Publication 502 counts amounts paid for therapy received as medical treatment as a medical expense. Sessions that treat a diagnosed condition generally fit that description, while relationship enrichment alone may not. Your HSA or FSA administrator makes the final call, so check before you spend.

Ready to take the next step?

You do not need to have every insurance answer figured out before reaching out. Request an appointment, mention your plan when you reach out, and you can sort out the details together. As Iryna puts it, therapy is not about fixing you; it starts with meeting you where you are.