Why We Don’t Bill Insurance for Couples Therapy

At Savvy Intuition, we believe your relationship deserves support that’s fair, balanced, and fully focused on the two of you — not paperwork or diagnosis codes. That’s why we don’t bill insurance for couples therapy.

This isn’t about rejecting insurance. It’s about protecting the integrity of the work and making sure therapy stays centered on what truly matters: your connection.

Is Couples Counseling/Therapy covered by insurance?

How Insurance Works in Mental Health

Insurance was created to cover medical care — treatment for illness, injury, or diagnosable conditions.In therapy, that same structure applies. To use insurance, a therapist must identify one person as the “patient of record,” give that person a mental health diagnosis, and show in every note how the sessions are helping reduce that person’s symptoms.

That means even if both partners attend, the sessions are still technically individual therapy for the diagnosed person. The other partner is considered “supportive,” not a client in their own right.

So when the focus is on your relationship — how you communicate, how you rebuild trust, or how you show up for each other — the session no longer fits the definition of medical necessity.Insurance can only pay for services that treat a mental health condition in one individual, not the health of a relationship.

Why This Matters for You

If couples therapy were billed under insurance, one of you would need to be labeled as having a mental health disorder — even if that’s not accurate or relevant. Your treatment goals would have to focus on that person’s diagnosis, not the relationship as a whole.

That can quickly create an imbalance in therapy and make it harder to stay neutral as a clinician. True couples therapy is designed to support both partners equally. It’s about patterns, cycles, and shared growth — not assigning blame or diagnosing one person.

By keeping couples therapy separate from insurance, we’re able to maintain fairness, neutrality, and integrity in the process.

Common Questions

Can we still use insurance for individual therapy? Yes. If one partner is working on their own mental health, those sessions can be billed to insurance as individual psychotherapy. Sometimes, a conjoint or “family” session might be added to help support that person’s treatment plan. However, this is different from couples therapy. In that case, the focus still remains on the individual’s diagnosis and progress.

What if we both want therapy? If both partners want to focus on their relationship, couples therapy is the most ethical and effective option. It allows both of you to participate equally, without labels or medical constraints.

Protecting Integrity and Transparency

We never want clients to be surprised by how insurance works — or to be billed later because of something their plan didn’t actually cover. Submitting claims for couples therapy under one partner’s diagnosis may seem convenient, but it can create legal or financial problems later if insurance determines it wasn’t billable.

By choosing private-pay couples therapy, you’re making a transparent, informed decision. You’ll know exactly what’s covered, what isn’t, and how your sessions are structured.

Your Options at Savvy Intuition

We offer several ways to support your relationship outside of insurance:

• Private-pay couples therapy: Designed to help both partners equally, with full neutrality and confidentiality.

• Relationship intensives: Focused, extended sessions to work through patterns and rebuild connection more quickly.

• Individual therapy: Covered by insurance when addressing personal mental health concerns.

• Flexible payment options: We accept CareCredit for eligible services, making it easier to invest in your relationship through flexible monthly payments.

If you’re unsure which option fits best, we can talk through your goals and clarify what type of support will serve you most.

The Bottom Line -  Why We Don’t Bill Insurance for Couples Therapy

Insurance covers medical treatment for mental health conditions. Couples therapy isn’t medical treatment — it’s relational growth.

When you invest privately, you’re not paying for a diagnosis.You’re investing in clarity, connection, and lasting change — the kind of work that helps you both thrive.