Couples Therapy 

SPG is excited to inform you that we are offering couples therapy.  The out of pocket cost for therapy will be $180 per session.  Please note payments are due at time of service.  We accept cash or credit card (Visa, Mastercard, Discover)  The practice does not accept insurance as payment or couples cases.  

Insurance Is Built for Individuals, Not Relationships

To use insurance for therapy, three things are required:

  1. An identified client

  2. A mental health diagnosis

  3. A treatment plan that directly addresses the diagnosis—for that one client

In individual therapy, this works well. For example, if an individual is struggling with symptoms resulting from trauma, a clinician can diagnose them as having Post-Traumatic Stress Disorder (PTSD) and use an evidence-based treatment like EMDR. That’s clear, ethical, and reimbursable by insurance.

But in couples therapy, things are different.

Relationships Aren’t Diagnosable—People Are

In couples work, the relationship—not one partner—is the client. But insurance companies don’t recognize relationships as billable “clients.” They want to know which person has a diagnosis, and how treatment is helping that individual.

Even when they allow “family sessions,” they still require an identified patient. So a couple might attend therapy, but the clinician would be forced to frame it as though they are treating one partner’s anxiety, depression, or trauma, with the other there to help. That’s not couples therapy. The “Relationship Distress” Diagnosis Doesn’t Count

There is a diagnostic code for relationship issues: Z63.0 – Relationship Distress with Spouse or Intimate Partner. But insurance companies won’t reimburse for it. And if a clinician were to diagnose one partner with a mental health disorder just to access coverage—when that’s not what they are treating—that would be misleading at best, insurance fraud at worst.

So Why Do Some Therapists Bill Insurance Anyway?

You may have seen a couples therapist who did bill insurance. That doesn’t necessarily mean they were doing something wrong—but it does mean they were likely using a workaround:

  • Diagnosing one partner and coding sessions as either “Individual Psychotherapy”, or “Family Psychotherapy, with Individual Present”

  • Focusing, at least in their clinical notes, on that one partner’s symptoms with the other in a “support role”

  • Hoping the insurance company never audits the records

Why Paying Out of Pocket Might Be Worth It

When you pay for couples therapy privately, here’s what you’re getting:

  • No diagnosis required—you’re not labeled with a disorder

  • True confidentiality—no audits from insurance companies or the Federal government, no service or diagnosis codes on your record

  • Access to specialized care—from therapists trained specifically in couples work

  • Freedom in approach—The methods that best serve your relationship, not just what insurance approves

Couples therapy is an investment, not just in your relationship—but in your emotional, relational, and even physical well-being. And while it may cost more up front, the clarity, honesty, and quality of care you receive can make all the difference.

—————————————————————————————————————————————————————
Want to learn more about couples therapy or schedule a consultation?  Please email us at dr@szafranpsych.com