EMDR Therapy Cost and Insurance What Shapes the Cost and How Coverage Usually Works

Jeremy Fox, LPC, CPCS EMDRIA Approved Consultant · Published in the Journal of EMDR Practice and Research · Alpharetta, GA

Cost is one of the first things people want to know about EMDR, and the honest answer starts with "it depends." What you pay is shaped by how your sessions are scheduled, how many you end up needing, and how your insurance handles therapy. This page walks through each of those pieces in plain language so you can get a clear answer from your plan before you begin. Authentic Answers is in-network with TRICARE East, accepts several major insurers, and offers sessions in person in Alpharetta or by telehealth anywhere in Georgia.

What Affects the Cost of EMDR

Session length. Standard sessions here are 50 to 60 minutes. Insurers pay for psychotherapy by time, so the length of a session affects how it is billed and what your plan pays.

Weekly sessions or an intensive. Weekly sessions are billed one visit at a time and can go through insurance. EMDR intensives use longer, focused blocks over one or more days. They are a private-pay service, so the cost is arranged directly with the practice rather than through your plan.

How many sessions you need. This varies a great deal from person to person. A single recent event is a different starting point than layered trauma that began in childhood, which usually calls for more time on preparation and stabilization. Nobody can give you an exact count in advance, and Jeremy will talk with you about a treatment plan and revisit it as you go.

Your plan's cost sharing. If you use insurance, your share depends on your deductible, your copay or coinsurance for outpatient therapy, and whether the therapist is in your plan's network.

How Insurance Usually Covers EMDR

There is no separate billing code for EMDR. Insurers treat it as psychotherapy, so an EMDR session is generally billed with the same CPT codes as other individual therapy, chosen by the face-to-face time spent: 90834 for 38 to 52 minutes and 90837 for 53 minutes or more, with 90832 used for 16 to 37 minutes. A first assessment visit is commonly billed as a psychiatric diagnostic evaluation (90791). These time ranges come from CMS billing guidance for psychotherapy services.

Coverage generally depends on medical necessity, meaning therapy is treating a diagnosed condition. Some insurers also publish written policies on EMDR. Aetna's clinical policy bulletin, for example, considers EMDR medically necessary for PTSD and lists many other conditions as not covered for EMDR. Policies differ between insurers and between plans, which is why the questions below include one about EMDR specifically.

Federal parity law also matters. For the plans it applies to, the Mental Health Parity and Addiction Equity Act requires that copays, deductibles and visit limits for mental health care be no more restrictive than those for medical and surgical care. It does not require a plan to offer mental health benefits in the first place.

In-Network, Out-of-Network and Superbills

In-network means the therapist has a contract with your plan. You generally pay the plan's in-network cost sharing, and the practice files claims for you. Out-of-network means there is no contract. Plans that include out-of-network benefits may pay back part of what you paid, with their own deductible and cost sharing rules, and some plans have no out-of-network benefits at all.

A superbill is a detailed receipt that lists the services, codes and diagnosis your insurer needs to process a claim you submit yourself. Here, EMDR intensives come with a superbill you may submit for possible out-of-network reimbursement, depending on your plan. If your insurance is not one of the plans listed below, ask about your options when you reach out.

Questions to Ask Your Insurer

Call the member services or behavioral health number on the back of your card and ask:

• Do I have outpatient mental health benefits, and is Jeremy Fox, LPC at Authentic Answers in-network for my plan?
• What is my deductible, and how much of it have I met this year?
• What is my copay or coinsurance for outpatient psychotherapy, CPT codes 90834 and 90837?
• Is there a limit on the number of therapy sessions per year?
• Do I need a referral or prior authorization for outpatient therapy?
• Does my plan have a policy on EMDR, and which diagnoses does it cover?
• Are telehealth sessions covered the same way as office visits?
• If the therapist is out-of-network: do I have out-of-network benefits, and how do I submit a superbill?

Write down the date, the name of the person you spoke with, and any reference number for the call. If any of this feels confusing, we are happy to help you work through it.

TRICARE and EMDR

Authentic Answers is in-network with TRICARE East through Humana Military. TRICARE covers office-based outpatient psychotherapy when it is medically or psychologically necessary, with individual sessions covered up to 60 minutes. Whether you need a referral depends on who you are and your plan. According to TRICARE, active-duty service members need a referral or pre-authorization for civilian care, other TRICARE Prime beneficiaries do not need a referral to see a network provider for in-office outpatient mental health care, and TRICARE Select beneficiaries can see any TRICARE-authorized provider, with lower costs in network.

EMDR intensives are not a covered TRICARE benefit, so TRICARE beneficiaries use standard weekly sessions, in person or by telehealth. Veterans, service members and military families can read more on the TRICARE and veterans page.

Insurance Plans Accepted

Along with TRICARE East (Humana Military), Authentic Answers accepts UnitedHealthcare (Optum), Aetna, Cigna, Oscar Health, and Blue Cross Blue Shield (Anthem). Coverage still depends on your specific plan, so it is worth checking your benefits before your first session.

Self-pay is also an option. If you do not have insurance or choose not to use it, the federal No Surprises Act generally gives you the right to a good faith estimate of expected charges when you schedule care at least 3 business days ahead or when you ask for one. Current fees are shared directly when you reach out.

Telehealth Across Georgia

EMDR is available in person at the Alpharetta office or by secure, HIPAA-compliant video anywhere in Georgia, as long as you are in Georgia during the session. Georgia's Telehealth Act (O.C.G.A. § 33-24-56.4) generally requires state-regulated health plans to cover telehealth on the same basis as in-person care. Some employer plans follow federal rules instead, so confirm video coverage with your plan.