Decoding Insurance Coverage for Relationship Therapy: What’s Up?
The quality of our relationships affects our mental health, and our mental health affects our relationships. If your relationships get better, your mental health usually gets better too. But if you improve your mental health, it doesn’t always make your relationships better. Even though there's clear evidence that good relationships can boost mental health, insurance companies often don't cover relationship counseling. Some therapists might still accept insurance, but they have to find a workaround to do so.
Billing for Relationship Counseling
When therapists bill insurance for relationship counseling, they usually have to do it under a different code meant for family or couples therapy with the patient present; the billing code for this is 90847. This means that only one person in the relationship is officially considered the “patient” with a mental health issue. Since only one person in the relationship is officially considered the “patient” that means that all goals worked on in those sessions are legally (and ethically) meant to be in support of only that person's treatment. Perhaps you can see where I’m going with this…..
When one individual in the relationship is the “patient” that means that the concerns being addressed should really only be the identified “patients” concerns. The reason many relationship counselors/therapists do not take insurance for relationship therapy is because we view the relationship as the patient. That means that all of the work we are doing is meant to strengthen the relationship as a whole, addressing the concerns and difficulties that are being experienced for ALL members of the relationship. Approaching the work this way means that I can not ethically take insurance for this service. I would be committing fraud if I billed insurance for relationship therapy under an identified “patient” who I have diagnosed with a mental health disorder in order to be reimbursed. Not to mention that therapeutic notes and diagnoses are part of your medical record, which could later impact employment offers or healthcare costs. For relationship therapy focused on communication, intimacy or betrayal within the relationship (my areas of specialization) without a specific mental health diagnosis, coverage is generally not provided.
Navigating the Limitations of Insurance Coverage for Relationship Therapy
I could list many reasons why this situation feels deeply unfair to me. It often seems like insurance companies act in ways that hurt their customers. I genuinely believe that insurance should cover relationship therapy because research shows it would benefit people. Unfortunately, that’s not how things work right now. This is why I offer 90-minute sessions and relationship intensives. These services allow for deeper work, in a shorter period of time. I deeply value the time and financial commitment my clients make to enhance their relationships. I believe this investment is truly worthwhile because I think love and healthy relationships are profoundly important.
If you are struggling with communication, intimacy, or betrayal within your relationship and would like more information about our services please click the button below.
