Does Insurance Cover DBT?

Dialectical behavioral therapy (DBT) is a common type of psychotherapy (also known as talk therapy) that helps people identify unhealthy thought processes so they can change them. 

Whether you’re seeking help for yourself, or for someone you care about, understanding the ins and outs of DBT insurance coverage is a crucial part of the equation. To determine if DBT is covered by insurance, you need to first understand that insurance benefits can widely vary based on plan specifics. 

While knowing if DBT therapy is covered by insurance is important, you should also keep in mind that there are other ways to manage the cost of therapy, even if your insurance doesn’t cover everything. 

Continue reading to find out if insurance covers DBT therapy. 

Is DBT Usually Covered by Insurance?

The short answer is yes — DBT insurance coverage is offered by virtually all insurance companies. However, the extent and conditions of your specific dialectical behavior therapy coverage can vary based on your insurer and plan.

All major health insurance providers offer some level of coverage for mental health services. In fact, they’re required by law to do so. This means that insurance providers like Aetna and Cigna, for example, legally must cover some or all of the cost of behavioral talk therapies like DBT. The efficacy of comprehensive DBT for certain mental health conditions is clinically proven, further increasing the likelihood that insurers will cover the treatment.  

That said, the specifics of exact DBT treatment coverage will vary from plan to plan. Your out-of-pocket costs — the portion you’re financially responsible for — can differ based on things like copays, deductibles, and plan maximums that might limit how many individual therapy sessions are covered annually.

“Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) may offer different coverage options. It’s important to note that even if insurance covers DBT, there might be out-of-pocket costs involved. Insurance plans often establish a network of preferred providers, and if you receive DBT from a provider within your insurance network, it’s more likely to be covered.”

– Talkspace therapist Famous Erwin, LMHC 

Factors that can influence dialectical behavior therapy coverage might include things such as:

• Number of sessions allowed: Some plans have a maximum individual therapy session amount per year they’ll cover.
• Your deductible: Check if you must meet a specific deductible before coverage kicks in; this can significantly impact how much out-of-pocket costs you’ll pay for comprehensive DBT treatment.
• Your copay: Most health care plans have copays, which is the amount you’ll pay at every session. 
• Therapist qualifications: Many insurers require therapists to be licensed and certified in DBT treatment.
• Your type of policy: Different types of health care policies can have varying levels of coverage. For example, a PPO vs an HMO will have different referral requirements, provider options, and costs for mental health services.
• In-network vs out-of-network: If you see a therapist who isn’t considered “in-network,” you should expect to pay more for treatment.  

How to Find Out if Your Insurance Covers DBT

For DBT therapy covered by insurance inquiries, contact your insurer directly. You can reach out by phone or through an online portal from the website to ask specifically about DBT insurance coverage. If you already have a therapist, you can ask them what Current Procedural Terminology (CPT) code they use when they submit bills to your insurance company.

“Understanding the specifics of your insurance coverage and the network of providers can significantly impact the accessibility and affordability of mental health treatments.” 

– Talkspace therapist Famous Erwin, LMHC

It’s helpful to know what type of coverage you have beforehand:

• PPOs typically offer more flexibility, but you might have a higher copay or deductible.
• HMOs often limit the treatment options they provide to keep costs lower.
• EPOs are a combination of PPOs and HMOs; they’ll generally cover more services than an HMO, but like a PPO, they tend to restrict the doctors you see.

You should also know as much as possible about your plan’s details, for example:

• Are pre-authorizations required? 
• What is your copay? 
• Do you have an annual cap on sessions?

Affordable DBT Therapists with or without Insurance

Don’t be overwhelmed by the thought of trying to figure out if DBT is covered fully by insurance. Remember that most health insurance plans will cover DBT since it’s a recognized effective treatment for numerous mental health conditions, including borderline personality disorder (BPD), post-traumatic stress disorder (PTSD), depression, and more. 

If cost is a concern, know that getting DBT within your budget is possible. Even if you don’t have insurance, or if your coverage is inadequate, there are many other options available for therapy without insurance. 

• Sliding scale therapy fees can reduce the cost of therapy based on your ability to pay. 

• Community and nonprofit entities often provide need-based, low- or no-cost treatment. 

• Online therapy, like Talkspace, is typically more affordable and convenient than traditional in-person therapy. Plus, Talkspace has trained, skilled, qualified therapists with experience in treating all types of mental health conditions using the DBT method. 

Mental healthcare should never be out of reach as a result of financial constraints. With or without insurance, DBT can be an accessible, effective, affordable treatment option on your journey toward better mental health. Reach out to Talkspace today to learn more about the benefits of DBT and how you can get online therapy covered by insurance. We partner with major healthcare plans across the country like Cigna, Anthem, Optum, Aetna, Medicare, TRICARE, and more.