Couples Therapy Cost: What To Expect And How To Save

Couples therapy cost can vary widely, and the average cash rate for a therapy session was about $143 in one 2024 study. Where you live, the therapist you choose, and how you meet can all shift what you pay.

Many couples seek counseling to heal after difficult moments, make positive changes in how they parent, or navigate other relationship challenges. Below, explore the factors that affect price, how insurance may fit in, and practical ways to make couples therapy more affordable.

How much does couples therapy cost?

Couples therapy cost may vary by therapist and state, and the closest national benchmark covers therapy in general. A 2024 study in Health Affairs Scholar found average cash pay rates for psychotherapy of about $143 per session in 2023 independent-practice listings. Couples sessions may cost more than the average cost of therapy in general.

The same study reported average cash rates of about $173 in California and $177 in New York. The researchers looked at therapists listed on Psychology Today, and 64.9% of those providers accepted any insurance. Because the study didn't report a separate rate for couples, local quotes may be your best guide.

Couples work can involve more complexity, with two people's needs to consider. During your first conversation with a potential counselor, it can help to ask whether the fee is per session or per hour. The table below summarizes common ways to pay and what each may cost.

Couples therapy cost by option

If you'd like a fuller picture before you budget, you can read about how couples therapy works and what sessions may involve. Several variables help explain why prices can differ so much from one therapist to the next.

Factors that affect the cost of couples therapy

What you pay can shift based on who you see, where you live, how sessions are set up, and a therapist's approach. Knowing these variables may help you compare options and set a realistic budget. Some of the main considerations can include:

• Therapist credentials and experience
• Location and local cost of living
• Session length and format
• Therapy approach or area of specialization

Each one is worth reviewing before you commit.

Therapist credentials and experience

The background of the professional you work with may play a role in price. More experienced professionals may charge more, reflecting years of training and specialized skill.

Location and cost of living

Where you live may also affect what couples pay. In the Health Affairs Scholar study, average cash rates differed by state, with Nebraska near $140, below the California and New York figures above. A guide to finding couples therapy near you may help you compare what's available locally.

Session length and format

The way a session is structured may also shift the cost. It can help to ask each therapist how long sessions run and how session length affects the fee.

Some therapists may offer intensives, which may run a half day, a full day, or a weekend. These formats may be priced as a package rather than per session. It can help to ask what the package includes and how follow-up sessions are billed.

Therapy approach or specialization

The type of care a therapist provides may affect what they charge, since some therapists complete additional training in specific models. A 2026 review in the Journal of Marital and Family Therapy lists emotionally focused therapy (EFT) and Gottman therapy among models with modest empirical support.

Therapists with niche expertise, such as working through infidelity or supporting blended families, may charge premium rates. Learning about common couples counseling techniques may help you understand which approach fits your situation. Once you have a sense of these variables, it can help to think about how many sessions you might realistically need.

How many sessions might you need?

Many couples may attend around a dozen sessions, though the number can vary widely. The American Association for Marriage and Family Therapy (AAMFT) reports that marriage and family therapists see clients for about 12 sessions on average. AAMFT also reports an average of 11.5 sessions for couples therapy, a helpful starting point for budgeting.

Some couples may notice changes sooner, while others benefit from longer-term work. Once you've built momentum, moving to biweekly or monthly sessions may lower what you spend over a given stretch of time.

Because the number of sessions can add up, it may help to look at how insurance fits into the picture.

Does insurance cover couples therapy?

Often not, unless sessions are considered medically necessary to treat a diagnosed mental health condition. Whether relationship-focused sessions qualify may depend on your plan's terms. When coverage does apply, you may still owe a copay or deductible, so checking the details before your first session can help.

For a deeper look at plan types and billing, explore this guide to insurance coverage for marriage counseling.

Federal rules offer some useful context. The Centers for Medicare & Medicaid Services (CMS) offers Medicare billing guidance for psychotherapy, describing codes 90846 and 90847 as family psychotherapy for treating mental disorders. Employer and individual plans may set different terms.

According to HealthCare.gov, mental health coverage in Marketplace plans includes psychotherapy and counseling as essential health benefits. Limits on these services can't be more restrictive than limits on medical and surgical care. Benefits may vary by state and plan, and the HealthCare.gov page doesn't address couples therapy specifically.

Why couples therapy often isn't covered

Coverage decisions may hinge on medical necessity, and approval often depends on whether sessions address a diagnosed condition. Because plans differ, it can help to ask your insurer whether couples sessions tied to one partner's diagnosis may qualify.

Questions to ask your insurance provider

Before you schedule a session, it can help to call your insurer and ask a few specific questions. Consider asking the following:

1. Does my plan cover couples or marriage counseling?

2. What is my copay for out-of-network mental health providers?

3. Is there a deductible I need to meet first?

4. Do I need a referral or pre-authorization?

Plans can vary even within the same insurance company, so it can help to confirm that a therapist accepts your specific plan. You may also want to learn how marriage counseling works as you weigh your options.

Out-of-network reimbursement

Even if a therapist is outside your insurance network, some plans offer partial out-of-network reimbursement. The National Association of Insurance Commissioners (NAIC) notes you may need to file a claim with your insurer yourself for out-of-network care. Asking the therapist for an itemized bill with session dates and billing codes may help.

Can you use an HSA or FSA for couples therapy?

The IRS guidance on medical expenses says therapy to treat a diagnosed mental illness counts as a medical expense, but marital counseling doesn't. That distinction may matter if sessions address one partner's diagnosed condition. Your plan administrator can confirm what qualifies, and this overview of using an HSA for marriage counseling covers more detail.

When coverage falls short, there are still several ways to make care more affordable.

Ways to make couples therapy more affordable

Couples therapy may cost less through income-based fees, supervised training clinics, community health centers, workplace benefits, or payment plans. Online therapy with subscription pricing may be another option to compare. Asking each provider about fees upfront can help you find a fit for your budget.

Eligible members' average copay is about $23 per session.* Connect with a licensed therapist *Insurance availability, coverage, and cost may vary by state, plan, provider network, therapist availability, and deductible status.

Cost doesn't have to be a barrier to getting support. Some approaches to consider include:

• Sliding scale fees based on income
• University training clinics
• Community health centers
• Employee assistance programs
• Payment plans

Sliding scale fees

Low-cost counseling options can make therapy far more attainable for couples on a tighter budget. Many therapists offer sliding scale fees based on income, and asking about them is common and nothing to feel awkward about.

University training clinics

Graduate programs in counseling and psychology often run low-cost clinics where trainees work under faculty supervision. The University of Maryland's couple and family therapy clinic uses a sliding scale of about $15 to $120 per session, based on income. Michigan State University's clinic lists $20 to $80 per session, and Texas Tech University's clinic lists $10 to 70.

Community health centers

Health centers funded by the Health Resources and Services Administration (HRSA) offer sliding-fee discounts based on income and family size. Not every center offers couples counseling, so it can help to ask about behavioral health services. SAMHSA's FindTreatment.gov locator can also help you search for mental health care near you.

Employee assistance programs (EAPs)

Workplace benefits can be an overlooked source of support. In OPM's overview of employee assistance programs, the U.S. Office of Personnel Management notes that federal agency EAPs offer free short-term counseling to employees. Other employers may offer EAPs as well, and some programs may include couples counseling worth asking HR about.

Payment plans

Flexible payment arrangements may ease the financial pressure of ongoing care. It can help to ask a therapist whether payment plans are available. Beyond these strategies, how you meet with a therapist may also shape what you pay.

Online vs. in-person couples therapy costs

Costs for online and in-person therapy can differ by platform, provider, and plan. BetterHelp's individual online therapy costs around 70 to $100 per week, billed monthly or weekly, while in-person sessions typically run around $100 to $350 each. Comparing what each option includes may help you choose.

Subscription pricing is based on factors such as your location, referral source, preferences, therapist availability, and any applicable discounts or promotions. Online sessions may also save travel time and the need to take time off work.

A 2022 study published in Frontiers in Psychology found no significant difference in outcomes when comparing online couples therapy to its in-person counterpart.

With these factors in mind, online therapy may be worth comparing alongside local options.

When using insurance, certain BetterHelp features may be limited or unavailable, including chat-based sessions, groups/classes, and select self-help tools.

Source

For couples who'd like to meet together online, Regain, BetterHelp's sister site, offers couples-focused care with predictable pricing and no travel required. While BetterHelp may not offer couples therapy, it can be an appropriate start to learn more about online therapy in general and get support.

For support on your own during relationship challenges, BetterHelp offers individual online therapy with a licensed therapist from the comfort of your home. Subscription pricing may make your costs easier to predict. You can also schedule sessions at times that fit your routine, which may make care easier to keep up.

When you're ready, you can get started with a licensed therapist at your own pace.

Cost is one part of the decision, and value is the other.

Is couples therapy worth the cost?

Couples therapy can be worth the cost for many partners, since it may strengthen communication, connection, and relationship satisfaction. Results can vary, and no therapist can promise a specific outcome. Still, the skills couples build in sessions may last well beyond the final appointment.

Some of the value factors to consider can include:

• Relationship satisfaction and connection may grow.
• Communication skills may last well beyond therapy.
• Both partners may experience mental health benefits.

Seeking support earlier may mean addressing concerns before they grow, rather than waiting until a relationship reaches a crisis point. For a closer look at the value side, explore why marriage counseling can be worth it.