If you've ever tried to figure out whether your health insurance covers therapy — and gotten lost in a maze of deductibles, copays, and prior authorizations — you're not alone. Insurance coverage for outpatient mental health services in Massachusetts is actually quite strong, but understanding how it works takes some effort. Here's a practical guide.
The Short Answer: Yes, Most Plans Cover Therapy in Massachusetts
Massachusetts has robust mental health parity laws, which means insurers are required to cover mental health services — including outpatient psychotherapy — on par with medical and surgical benefits. If your plan covers a primary care visit, it must cover a therapy visit under comparable terms.
But coverage isn't automatic — it depends on which plan you have, whether your therapist is in-network, and what your specific benefits look like.
Key Terms You Need to Know
In-network vs. out-of-network. If your therapist is in-network with your insurance plan, you pay a lower cost-share — usually a copay or coinsurance. If they're out-of-network, you may still get reimbursed, but you'll pay more upfront and file claims yourself. SRG Therapy Group is in-network with most major Massachusetts commercial plans.
Deductible. The amount you pay out-of-pocket before insurance kicks in. Some plans have separate deductibles for mental health. Until you meet your deductible, you may pay the full session rate — even with insurance.
Copay vs. coinsurance. A copay is a flat fee per session (e.g., $30). Coinsurance is a percentage of the session cost (e.g., 20%). Which applies depends on your plan.
Out-of-pocket maximum. The most you'll pay in a year before insurance covers 100%. Once you hit this number, your sessions are fully covered for the rest of the plan year.
Prior authorization. Some plans require prior approval before covering certain services. For outpatient psychotherapy, this is relatively rare but worth checking.
Which Plans Does SRG Therapy Group Accept?
SRG Therapy Group is currently in-network with the following Massachusetts commercial insurance plans:
- Blue Cross Blue Shield of Massachusetts
- Tufts Health Plan
- Harvard Pilgrim Health Care / Point32Health
- Aetna
- Cigna / Evernorth
- Meritain Health
- Optum
- UnitedHealthcare / UBH
We do not currently accept MassHealth (Medicaid) or Medicare. If you have one of these plans, we can provide a superbill for out-of-network reimbursement if your plan includes out-of-network benefits — or discuss self-pay rates.
How to Check Your Mental Health Benefits Before Your First Session
Call the member services number on the back of your insurance card and ask the following:
- Do I have outpatient mental health benefits?
- Is SRG Therapy Group (NPI: [group NPI]) in-network with my plan?
- What is my copay or coinsurance for outpatient therapy?
- Have I met my deductible? If not, how much remains?
- Is there a session limit per year?
- Is a referral or prior authorization required?
What About Telehealth Coverage?
Massachusetts has strong telehealth parity law, requiring commercial insurers to reimburse telehealth services at the same rate as in-person services. This means your copay for a virtual therapy session at SRG should be the same as it would be for an in-person session.
However, some plans have specific telehealth requirements — such as audio-visual (not audio-only) sessions. Our platform meets these requirements.
What If I Don't Have Insurance or My Plan Isn't Accepted?
SRG Therapy Group offers self-pay rates and can provide a superbill — an itemized receipt — for clients with out-of-network benefits. Many clients with PPO plans are eligible for partial reimbursement through their out-of-network benefits even when we are not directly in-network.
HSA and FSA funds can also be used to pay for therapy sessions.