If you’re considering EMDR therapy, one of your first questions may be whether your insurance will cover it.
The cost of mental health care can feel like another concern when you’re already trying to find support. Understanding your benefits before scheduling can help you make an informed decision and avoid unexpected expenses.
The good news is that EMDR therapy may be covered by health insurance when it is provided as part of an eligible mental health treatment. However, coverage depends on your insurance plan, provider, diagnosis or medical necessity requirements, and the way the service is billed.
Here’s what to know before getting started.
Does Health Insurance Cover EMDR Therapy?
Many health insurance plans provide benefits for outpatient mental health treatment. EMDR may be included when it is delivered by an eligible mental health professional as part of covered psychotherapy.
However, insurance companies do not necessarily have a separate benefit specifically labeled EMDR therapy.
Instead, coverage may depend on whether the underlying psychotherapy service is covered and whether the treatment meets your plan’s requirements.
Your insurance company may consider:
- Whether your plan includes outpatient mental health benefits
- Whether your therapist is in-network
- Whether the treatment meets medical necessity requirements
- Whether referrals or prior authorization are required
- Your deductible, copayment, or coinsurance
- Any limitations on covered services or sessions
A therapist’s training in EMDR does not automatically guarantee insurance coverage.
Which Insurance Plans Cover EMDR Therapy?
Coverage varies by insurance company and individual policy.
Some plans may cover psychotherapy provided by eligible clinicians who use EMDR as their treatment approach. Other plans may have provider restrictions, documentation requirements, or limitations.
The important distinction is that coverage for psychotherapy does not mean every provider or every treatment arrangement will automatically be covered.
Before scheduling, confirm both the provider’s eligibility and the service’s coverage with your insurance company.
Is EMDR Therapy Covered by Blue Cross Blue Shield, Aetna, Cigna, or UnitedHealthcare?
People often search for EMDR coverage by insurance company. However, coverage can differ between plans offered by the same insurer.
For example, two people with the same insurance company may have different benefits because they have different employer plans, networks, or policy arrangements.
When contacting your insurance company, ask whether outpatient psychotherapy is covered when the therapist uses EMDR as part of treatment.
You should also confirm whether the specific provider is in-network for your plan.
How to Check Whether Your Insurance Covers EMDR Therapy
Before booking an appointment, contact the member services number on the back of your insurance card.
Ask the representative to help you verify your behavioral health benefits.
Here are questions worth asking:
- Does my plan cover outpatient mental health counseling or psychotherapy?
- Does my plan cover telehealth psychotherapy?
- Can EMDR be used as part of a covered psychotherapy session?
- Is the therapist I am considering in-network?
- Do I need a referral or prior authorization?
- What is my copayment or coinsurance for each session?
- Have I met my annual deductible?
- Are there limits on the number of covered sessions?
- What billing or procedure codes should I ask my provider about?
- Can I receive a call reference number for this benefits verification?
Write down the representative’s name, the date of your call, and the reference number.
This information can be helpful if you need to clarify your benefits later.
What If My EMDR Therapist Is Out-of-Network?
You may still have options if the therapist you want to work with is not in your insurance network.
Some insurance plans offer out-of-network mental health benefits. Depending on your policy, you may be able to pay the provider directly and submit a claim for potential reimbursement.
Before choosing this arrangement, ask:
- Does my plan include out-of-network mental health benefits?
- What percentage of the allowed amount may be reimbursed?
- Is there a separate out-of-network deductible?
- Does the provider need to submit a claim?
- What documentation will I need?
- How long does reimbursement usually take?
Remember that reimbursement is not guaranteed. Confirm the details directly with your insurer.
Does Insurance Cover Online EMDR Therapy?
Some health plans cover eligible telehealth psychotherapy services. However, coverage may depend on your policy, the provider’s network status, the type of service, and the location where you are physically attending the appointment.
If you plan to receive virtual EMDR therapy, ask your insurer whether telehealth psychotherapy is covered and whether any additional requirements apply.
You should also confirm that your therapist is authorized to provide services in the state where you will be located during the session.
What If My Insurance Does Not Cover EMDR Therapy?
If your insurance does not cover your preferred treatment arrangement, ask about other payment options.
Depending on your circumstances, you may consider:
- Self-pay therapy
- An in-network therapist who offers an appropriate treatment approach
- Out-of-network reimbursement, if included in your plan
- Lower-cost services with an eligible supervised graduate-level clinical intern, if clinically appropriate and available
Understanding the cost before starting treatment can help you make a decision that works for your needs and budget.
Exploring Therapy Options at The Empowering Space
At The Empowering Space, we want clients to understand their available care and payment options before beginning therapy.
We offer virtual therapy and insurance and self-pay options for eligible clients in Texas, Ohio, California, and Michigan.
If you’re interested in EMDR, our team can help you explore potential provider options and explain the next steps for verifying your benefits.
Insurance participation and coverage depend on your specific plan and the provider delivering care. Contacting our team does not guarantee that your insurer will approve or reimburse a particular service.
You don’t have to figure out the process alone.
Explore your options through our Find Your Therapist tool or contact The Empowering Space with questions about getting started.
