Does Blue Cross Blue Shield Cover Therapy? Understanding Your Mental Health Benefits
Author:
Blossom Editorial
Dec 12, 2025
Blue Cross Blue Shield (BCBS) is the largest health insurance provider in the United States, offering coverage to over 115 million members across all 50 states. Understanding your BCBS mental health benefits can help you access therapy services while managing costs effectively.
Key Takeaways
BCBS covers therapy services: Federal mental health parity laws require BCBS plans to provide mental health coverage comparable to medical benefits, including individual therapy, group therapy, and psychiatric care.
Coverage varies by state and plan: BCBS operates through independent companies in different states, meaning your specific benefits depend on your location, plan type (PPO, HMO, EPO), and whether you have coverage through an employer or the marketplace.
In-network providers offer significant savings: Using in-network therapists typically results in copays of $20-60 per session, while out-of-network care can cost significantly more with higher coinsurance rates and separate deductibles.
What Mental Health Services Does BCBS Cover?
Blue Cross Blue Shield plans include comprehensive mental health coverage as mandated by the Mental Health Parity and Addiction Equity Act of 2008 and the Affordable Care Act. These laws ensure that mental health benefits are provided on equal terms with medical and surgical coverage.
Mental health services typically covered by BCBS include:
Individual psychotherapy (talk therapy) sessions
Group therapy and support groups
Family therapy and couples counseling
Psychiatric evaluations and assessments
Medication management with psychiatrists
Psychological testing and neuropsychological evaluations
Intensive outpatient programs (IOP)
Partial hospitalization programs (PHP)
Inpatient psychiatric hospitalization
Substance use disorder treatment
Crisis intervention services
According to research published in Health Affairs, implementation of mental health parity laws has improved access to outpatient mental health services, though disparities in network adequacy and reimbursement rates persist between mental health and medical providers.
Understanding BCBS Plan Types and Therapy Coverage
Your specific therapy benefits depend on which type of BCBS plan you have. Each plan structure has different rules about provider networks, referrals, and cost-sharing.
Common BCBS Plan Types
Preferred Provider Organization (PPO) Plans
PPO plans offer the most flexibility for accessing mental health care. You can see any licensed therapist without a referral, though you'll pay less when using in-network providers. These plans typically have higher monthly premiums but lower out-of-pocket costs when you need care.
Health Maintenance Organization (HMO) Plans
HMO plans usually require you to choose a primary care physician who coordinates your care and provides referrals to specialists, including therapists. These plans have lower premiums and predictable copays but less flexibility in provider choice.
Exclusive Provider Organization (EPO) Plans
EPO plans combine features of PPO and HMO plans. You don't need referrals to see specialists, but coverage is typically limited to in-network providers except in emergencies.
High Deductible Health Plans (HDHP) with HSA
These plans have lower monthly premiums but require you to pay the full cost of therapy until you meet your annual deductible, which can range from $1,500 to $7,000 or more. After meeting the deductible, you typically pay coinsurance.
Point of Service (POS) Plans
POS plans allow you to choose between HMO-style care with referrals and lower costs, or PPO-style care with more flexibility and higher out-of-pocket expenses.
How Much Does Therapy Cost with BCBS?
The cost of therapy with Blue Cross Blue Shield coverage varies based on several factors, including your plan type, deductible status, and whether you use in-network or out-of-network providers.
Typical Therapy Costs with BCBS
In-Network Therapy
Copays: $20-$60 per session (most common)
Coinsurance: 10%-30% after meeting deductible
Annual deductible: $0-$5,000+ depending on plan
Out-of-pocket maximum: $3,000-$9,000+ annually
Out-of-Network Therapy
Higher coinsurance: 30%-50% of allowed amount
Separate out-of-network deductible (often higher)
Balance billing possible (you pay the difference between what BCBS pays and what the provider charges)
Higher out-of-pocket maximum
Research in JAMA Network Open indicates that mental health services have higher out-of-network utilization rates compared to general medical care, making network status particularly important for managing therapy costs.
How to Check Your Specific Costs
Review Your Summary of Benefits
Your plan documents include a Summary of Benefits and Coverage (SBC) that outlines mental health copays, coinsurance rates, and deductibles.
Call Member Services
Contact the number on your insurance card to verify your exact therapy benefits, including whether you've met your deductible and how many sessions you've used.
Use the BCBS Member Portal
Log into your online account to view benefits, check claims, and see your deductible progress.
Finding an In-Network Therapist with BCBS
Using an in-network provider is one of the most effective ways to reduce therapy costs and simplify billing.
How to Search for BCBS Therapists
BCBS Provider Directory
Each state's BCBS company maintains its own provider directory. Access yours through:
Your state's BCBS website (e.g., bcbsil.com for Illinois, bcbsma.com for Massachusetts)
The national Blue Cross Blue Shield website at bcbs.com
The BCBS mobile app
You can filter results by:
Provider type (psychologist, licensed clinical social worker, licensed professional counselor, marriage and family therapist)
Specialty areas (anxiety, depression, trauma, ADHD, etc.)
Location and telehealth availability
Languages spoken
Gender preferences
Accepting new patients
Verify Network Status
Provider directories aren't always current, so always call the therapist's office to confirm they:
Currently accept your specific BCBS plan
Are accepting new patients
Have availability that matches your schedule
Use Psychology Today
Many therapists list their accepted insurance on Psychology Today's therapist directory, which can be filtered by insurance provider and other preferences.
Ask for Referrals
Your primary care physician, friends, or family members may be able to recommend in-network therapists they've had positive experiences with.
Understanding BCBS State Variations
Unlike most insurance companies, Blue Cross Blue Shield operates as a federation of 34 independent companies, each serving specific states or regions. This means coverage can vary significantly depending on where you live.
Regional Differences
Independent State Plans
Each BCBS company sets its own:
Provider networks
Prior authorization requirements
Covered services beyond federal minimums
Customer service processes
Member resources
BlueCard Program
If you travel or move temporarily, the BlueCard program allows you to access care through local BCBS networks while maintaining your home state coverage. This is particularly useful for college students or people who split time between states.
Federal Employee Program (FEP)
BCBS administers the Federal Employees Health Benefits Program, which has standardized benefits across all states for federal employees, retirees, and their families.
Does BCBS Cover Teletherapy?
Virtual mental health care has become increasingly accessible, and BCBS expanded telehealth coverage significantly during the COVID-19 pandemic, with many provisions continuing.
Authorization and Referral Requirements
Whether you need prior authorization or referrals for therapy depends on your specific BCBS plan type.
When You Need Prior Authorization
Outpatient Therapy
Most BCBS plans don't require prior authorization for standard outpatient therapy sessions, allowing you to begin treatment immediately after finding a provider.
Intensive or Specialized Treatment
Prior authorization is typically required for:
Intensive outpatient programs (IOP)
Partial hospitalization programs (PHP)
Residential treatment programs
Inpatient psychiatric hospitalization
Applied behavior analysis (ABA) therapy for autism
Psychological or neuropsychological testing
Transcranial magnetic stimulation (TMS)
Extended Treatment
Some BCBS plans require periodic authorization reviews after a certain number of therapy sessions (often 20-30 sessions) to ensure continued medical necessity.
How Authorization Works
Your therapist's office typically handles the prior authorization process by submitting clinical documentation to BCBS. The insurance company reviews the request and approves a specific number of sessions or days of treatment based on clinical guidelines and medical necessity criteria.
BCBS Coverage for Psychiatry and Medication Management
In addition to therapy, many people benefit from psychiatric care for diagnosis and medication management, which BCBS covers as part of mental health benefits.
Psychiatric Services
Psychiatrist Appointments
BCBS covers visits with board-certified psychiatrists for:
Comprehensive psychiatric evaluations (usually 60-90 minutes)
Medication management follow-ups (15-30 minutes)
Combined therapy and medication appointments
Psychiatric testing when medically necessary
Copays for psychiatrists are typically the same as for therapists or slightly higher, depending on your plan.
Virtual Psychiatry
Telehealth psychiatry is increasingly available through BCBS networks, making it easier to access medication management regardless of location. This is particularly valuable given the shortage of psychiatrists in many areas.
About Blossom Health
Blossom Health is a telehealth psychiatry platform that connects patients with board-certified psychiatrists through virtual appointments covered by in-network insurance, including many Blue Cross Blue Shield plans. We provide accessible, affordable mental health care with appointment availability often within days, not weeks or months.
Our psychiatric providers offer comprehensive evaluations, medication management, and treatment planning for conditions including depression, anxiety, ADHD, OCD, bipolar disorder, and PTSD. All care is delivered virtually, eliminating transportation barriers and making it easier to fit treatment into your schedule.
If you have Blue Cross Blue Shield coverage and are looking for psychiatric care, visit https://www.joinblossomhealth.com/start to check if we're in-network with your plan and schedule your first appointment. We make mental health care simple, transparent, and accessible.
Medical Disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Insurance coverage varies significantly by plan and state. Always verify your specific benefits directly with Blue Cross Blue Shield and consult with qualified healthcare providers regarding your mental health needs. If you are experiencing a mental health crisis, contact the 988 Suicide and Crisis Lifeline by calling or texting 988.
