Telehealth Therapy: Everything You Need to Know

Telehealth therapy is mental health services provided remotely, typically in real time via video and sometimes through telephony or secure messaging. It has been demonstrated to be effective for most of the common disorders, such as depression, anxiety, and PTSD, to a similar degree as face-to-face treatment. It is virtually covered by most private insurance plans, Medicare and state Medicaid programs, and at the same cost as other office visits. In general, a session can be as short as 45 minutes to as long as 60 minutes and cost anywhere from $0 to approximately $200.

How telehealth therapy works

You collaborate with a certified therapist with a secure video system rather than an office. Other practices have phone sessions or messaging between appointments. It can be referred to as virtual therapy, virtual counseling, telehealth counseling. The same thing – real treatment from a real clinician, done on a screen.

The first session will be similar to an office intake. Your therapist asks about your past, your symptoms and what you would like to change, then plans a treatment. Platforms are required to comply with federal HIPAA privacy regulations, which went back into full effect when the enforcement flexibility during the pandemic ended in May 2023.

This is no longer a "bonus" special feature. Mental health care accounts for about two-thirds of all telehealth claims nationally, according to data from FAIR Health's telehealth tracker, and data from the Centers for Disease Control and Prevention (CDC) indicates that 37% of all US adults utilized telemedicine during one year.

Is telehealth therapy effective?

Yes for the majority. A systematic review of 57 studies in Clinical Psychology Review revealed that videoconference–based care achieved similar results to face-to-face care for various conditions. The evidence is most robust for cognitive behavioral therapy in the treatment of depression, anxiety, PTSD and insomnia.

According to the American Psychological Association, the majority of psychologists continued to treat their patients virtually as demand and results have not suffered. Virtual therapy isn't second-rate treatment. It's the authentic article, online!

There are limits. In-person or more intensive levels of care are required for some substance emergencies, active suicidal crisis and psychosis. Call or text 988 Suicide & Crisis Lifeline if you are in crisis now.

What telehealth therapy costs

National claims data indicate that a 45-60 minute psychotherapy session, prior to any discounts, costs $100 to $200 without insurance. In large metros rates are higher. Subscription therapy apps typically charge a weekly fee and cost anywhere from $260 to $400 per month.

If you have insurance, you are responsible for the plan's typical cost sharing, which usually applies once telehealth benefits are covered, a $0 to $50 copay. Much cheaper are sliding scale therapists, community mental health centers, and university training clinics.

One surprise that people typically don't anticipate is that online couples therapy is typically cash pay. Typically, any treatment that is related to a diagnosis is covered by insurance, but relationship counseling is not, in itself.

Does insurance cover telehealth therapy?

Typically, yes, if the therapist is in your network. The Center for Connected Health Policy reports that more than 40 states have legislation mandating that private health plans reimburse providers for telehealth services and roughly half of them require the same reimbursement for telehealth as for in-person services.

Your insurance company's directory is the quickest method to discover online therapy that is covered by insurance. Log in, search for telehealth or video visits, and ensure that the clinician takes new patients. The answer to whether online therapy is covered by insurance depends on three factors: what insurance plans the provider accepts, the state's telehealth law, and the type of insurance plan you have.

Medicaid and Medicare rules

Every state Medicaid program plus DC covers behavioral health delivered by telehealth in some form, though audio-only rules vary by state, per KFF's review of state policies. If you are searching for online therapy that takes Medicaid, start inside your state plan's provider directory or your managed care plan's app rather than a national platform.

Medicare's coverage is permanent for mental health. You can join telehealth therapy from home, anywhere in the country, and audio-only visits count when video is not an option. One caveat: Congress has repeatedly postponed a rule requiring an occasional in-person visit for tele-mental health patients. Check Medicare.gov for the current status before you rely on it.

When in-person care is the better call

Choose an office visit if you are in active crisis, have symptoms that include losing touch with reality, need a formal evaluation for court or disability paperwork, or simply lack a private space and stable internet. Young children also tend to do better in the room with a clinician. Many people land on a hybrid: video most weeks, in-person when it matters. The format should serve the treatment, not the other way around.

How to find a telehealth therapist

Start with your insurer's directory or your state Medicaid portal, filter for video visits, and shortlist two or three clinicians. Confirm each one is licensed in the state where you will physically be during sessions; psychologists in the PSYPACT compact can treat patients across more than 40 states. Ask for the full session price in writing, including no-show fees. If the insurance language is the confusing part, you can ask August, a free AI health assistant, to explain your plan's mental health benefits in plain English before you book.

Telehealth therapy has moved from pandemic stopgap to a standard way Americans get mental health care. If the research, the coverage rules, and the costs above line up for you, the next step is a single booked session.