Types of Therapy
Telehealth Therapy: Coverage and How to Choose
Is Online Therapy Covered, and How Do You Choose a Telehealth Therapist?
Online therapy, often called telehealth, is therapy by video or phone, and NIMH says virtual care can be effective for anxiety, depression, ADHD, bipolar disorder and PTSD. Medicare covers it from home, Medicaid programs can cover it, and many private plans do too. Your therapist generally must be licensed or legally permitted to practice in the state where you are during the session. SAMHSA lists 10,324 mental health facilities that offer telehealth (October 2026); find them in the finder.
Online therapy is ordinary therapy delivered over a screen or a phone. You talk with a licensed therapist, psychologist, counselor or psychiatrist, just as you would in an office, but from your home, your car or any private spot.
This guide covers what Medicare, Medicaid and private insurance pay for, the license rule that matters most, how to keep sessions private, and how to choose a provider.
What Online Therapy Is and What You Can Get
NIMH says people now commonly connect with mental health professionals by video call, phone call, text message or email. This is usually called telehealth or telemedicine. Depending on your insurance and provider, you may be able to get:
- a mental health assessment, diagnosis and treatment plan;
- individual, group or family therapy;
- a prescription for medication;
- regular check-ins and ongoing support.
NIMH also says virtual care can be effective for treating anxiety, ADHD, bipolar disorder, depression and post-traumatic stress disorder. If you want a specific approach, such as CBT, ask whether the therapist offers it by video.
Who You Can See Online
HHS says behavioral health care by telehealth may come from psychiatrists, psychologists, social workers, counselors, therapists and nurses, and each profession answers to its own state licensing board. Medicare also pays marriage and family therapists and mental health counselors for telehealth visits. NIMH suggests asking any provider whether medication is an option and whether they can prescribe it. The psychiatrist vs therapist guide explains who does what.
Prescribing online has extra rules. HHS says providers must follow federal law and the laws of both the state where they are licensed and the state where you are, and in most cases they need an established relationship with you before writing a prescription.
Benefits and Drawbacks of Online Therapy
NIMH lists both sides:
| Benefits | Drawbacks |
|---|---|
| Convenient: no travel, so it’s easier to fit into a busy week | Technology access: you need an internet connection and a phone or computer |
| Flexible: appointments can come with less notice and at more hours | Tech problems: a weak connection or a broken device can cut a session short |
| Accessible: reaches people who can’t drive or who live far from care | Privacy: people nearby may overhear, and some people dislike being on camera at home |
| Comfortable: talking from home can feel less intimidating |
HHS adds that telehealth may not be right for everyone or every condition, and you may need in-person care at times. If you are in crisis, call or text 988 rather than waiting for a scheduled video visit.
Does Insurance Cover Online Therapy?
Most coverage that pays for therapy in an office also pays for it online, with some rules:
| Coverage | Is online therapy covered? | What to know |
|---|---|---|
| Medicare | Yes, including at home | CMS covers telehealth for mental health permanently; you pay 20% after the Part B deductible, the same as in person for most services |
| Medicaid | Often | States have broad flexibility in how they cover telehealth; ask your plan which video providers are in network |
| Private insurance | Often | NIMH says to confirm with your insurer or the provider’s billing office, because policies vary from state to state |
Medicare details. CMS says telehealth for behavioral and mental health is covered on a permanent basis, including when you are at home. Your provider must be able to offer two-way video but can use a phone call if video doesn’t work for you because of your technology, abilities or preference. Marriage and family therapists and mental health counselors who bill Medicare can see you by telehealth too. For broader telehealth, Medicare.gov says coverage from anywhere in the U.S., including your home, runs through December 31, 2027. See the Medicare therapy guide.
Medicaid details. Medicaid.gov says states have broad flexibility in designing how telehealth is used to deliver services. Call your plan, or see the Medicaid therapy guide and your state page.
Private plans. The federal parity law generally bars plans from making mental health care costlier or harder to get than comparable medical care. The insurance coverage guide explains your rights and how to appeal.
Where to Find It: Telehealth by State
SAMHSA's FindTreatment.gov lists 10,324 mental health facilities with this service (telehealth) across 55 states and territories, checked October 2026. Pick a state for its facilities, cities and treatment agency.
The License Rule: Your Therapist Must Be Allowed to Practice Where You Are
This is the rule that trips people up. HHS says health professionals must meet the licensing requirements of the state where they are located and be licensed or legally permitted to practice in the state where the patient is located. A telehealth appointment legally takes place where you are during the session.
So if you live in Ohio, your online therapist generally needs to be licensed or otherwise permitted in Ohio, even if their office is in another state. If you travel or move, tell your therapist before your next session.
HHS lists several ways a provider can be permitted to practice across state lines:
- A full license in your state.
- Temporary practice laws, which some states have for existing patients who are visiting, such as college students or seasonal residents.
- Reciprocity, where some states allow providers from neighboring states.
- Licensure compacts, where member states recognize each other’s licenses. For example, PSYPACT lets eligible psychologists practice telepsychology across member states.
- Telehealth registration, which some states offer to licensed out-of-state providers.
How to Check an Online Therapist’s License
Each profession has its own state board: psychologists, counselors, social workers, marriage and family therapists and nurses are licensed separately. Before your first session:
- Ask for the therapist’s full name, license type and license number, and which state issued it.
- Look the license up on your state board’s website. Your state page links the official lookups, and the license lookup guide walks through it.
- Confirm the license is active and check for any discipline.
- Ask what happens in an emergency. HHS says every provider should have an emergency plan, especially out-of-state providers. Make sure they have your location and a local crisis contact.
If you’re unsure whether you need a psychologist, counselor or psychiatrist, the psychiatrist vs therapist guide explains the differences.
Keeping Your Sessions Private
HHS says HIPAA rules protect your health information, including what you share during telehealth visits. You can do your part:
- Find a private spot: a quiet room, a parked car or a private room at a library or friend’s home.
- Use a patient portal for messages, and don’t record sessions.
- Look for a lock or shield icon before entering personal details.
- Skip public WiFi, keep your devices updated and put a password on your home WiFi.
- Use your own device when you can.
- Be sure who you’re talking to. If someone claims to be a provider and you aren’t certain, call your regular provider’s office at the number you usually use.
NIMH also suggests choosing a provider who uses a secure platform that protects your privacy and verifies your identity.
How to Choose a Telehealth Therapist
NIMH suggests weighing a few things:
- Insurance: confirm the visit is covered before you book.
- Security: a secure platform and identity checks.
- Experience: someone who has treated what you’re dealing with. Ask about their methods and how long treatment usually takes.
- Fit: some providers offer a free introductory session so you can decide whether you click.
If you don’t know where to start, NIMH says a primary care provider can often refer you to a psychologist, psychiatrist or clinical social worker who sees patients virtually. For step-by-step help, see how to find a therapist and what happens at a first session.
Low-Cost Online Therapy
Under Medicare, a telehealth visit usually costs the same as an in-person one. Public options can lower the price further:
- Clinics in the finder. SAMHSA lists 10,324 mental health facilities that offer telehealth (October 2026). Ask each one whether its sliding fee applies to video visits.
- Sliding-fee care. SAMHSA lists 5,028 facilities with a sliding fee scale. See the sliding scale therapy guide.
- Medicaid. SAMHSA lists 10,558 facilities that accept Medicaid.
The low-cost care checker matches your state and coverage to options that fit, and the anxiety therapy guide covers treatment choices if anxiety brought you here.
If You Need Help Now
Call or text 988, or chat at 988lifeline.org, any time. Veterans can press 1 after dialing 988. If someone is in immediate danger, call 911. The crisis guide explains what happens when you reach out.
Frequently Asked Questions
Can I Get Free Online Therapy?
Some public clinics offer video visits and charge by income, sometimes nothing. SAMHSA lists 10,324 facilities with telehealth and 5,028 with a sliding fee scale (October 2026); ask a sliding-fee clinic whether its rates apply to video sessions. If you are in crisis, the 988 Lifeline offers free chat at 988lifeline.org. See the free mental health care guide.
Can a Therapist in Another State See Me Online?
Only if they are licensed or legally permitted to practice in the state where you are during the session. HHS says the appointment happens where the patient is located. Some states allow it through compacts, temporary practice laws or telehealth registration. Check the therapist with your state board before you start.
Can a Psychiatrist Prescribe Medication Online?
Authorized providers may prescribe by telehealth if they meet certain criteria, HHS says. They must follow federal law and the laws of both the state where they are licensed and the state where you are, and in most cases they need an established relationship with you first. See the psychiatrist vs therapist guide.
Does Medicare Cover Phone-Only Therapy?
Sometimes. CMS says your provider must be able to offer two-way video, but can use audio only if video doesn't work for you because of your technology, abilities or preference.
Is Online Therapy Right for Everyone?
Not always. HHS notes telehealth may not be right for everyone or every condition, and you may need in-person care at times. If you are having suicidal thoughts or are in crisis, call or text 988 now rather than waiting for a scheduled video visit.
Does Online Therapy Work for Couples?
NIMH lists family therapy among the services available virtually. If you want to meet as a couple by video, ask whether the therapist offers it; both partners need to be in a state where the therapist is licensed or permitted to practice. See the couples therapy guide.
More on Types of Therapy
- CBTWhat CBT is, what it treats and how to find it
- DBTWhat DBT is, who it helps and how to find a program
- EMDREMDR for trauma and PTSD and how to find it
- Psychiatrist vs TherapistWho prescribes, who provides therapy, and which license to check
- AnxietyThe therapies NIMH describes for anxiety disorders and how to find one near you
- DepressionTherapy for depression, who provides it and how to pay for it
This guide explains mental health care in plain language from official sources. It isn't medical advice; a licensed clinician can assess what care fits your situation.
Sources
- NIMH: Getting Mental Health Support Virtually
- Medicare.gov: Telehealth
- CMS: Medicare and Mental Health Coverage (MLN Booklet, March 2026)
- Medicaid.gov: Telehealth
- Telehealth.HHS.gov: Licensure for Behavioral Health
- Telehealth.HHS.gov: Licensure Compacts
- Telehealth.HHS.gov: How Do I Protect My Data and Privacy?
- SAMHSA FindTreatment.gov listing data, checked October 2026