Does Insurance Cover Infidelity Counseling? (What’s Typically Covered, What Isn’t, and Your Options)

The short answer

Most health plans don’t cover “marriage” or “infidelity” counseling as a stand-alone service. Coverage usually applies only when therapy treats a diagnosable mental health condition (like PTSD, depression, or anxiety) and the sessions are medically necessary for that treatment.¹²⁶

When coverage exists, it’s generally for:

• Individual psychotherapy (CPT 90834/90837) where a partner may join some sessions
• Family psychotherapy (CPT 90846/90847) when treatment is focused on a patient’s diagnosis rather than generic “marital counseling”¹

Why marriage counseling is often excluded

Insurance pays for medical care — diagnoses, treatment, or prevention of illness. Relationship distress (such as “problems with spouse/partner,” ICD-10 Z63.0) is coded for documentation but isn’t considered a covered disorder.³

Put simply:

• If your goal is “help us communicate better after the affair,” most plans won’t reimburse.
• If the goal is “treat panic attacks, trauma symptoms, or stress triggered by the affair,” and your clinician documents and treats that diagnosis, coverage is more likely (depending on plan rules).¹

What Medicare and commercial plans actually cover

• Family psychotherapy (CPT 90846, 90847) and individual psychotherapy (90832/90834/90837) are typically covered when medically reasonable and necessary.¹
• Insurance and the IRS distinguish between therapy for a diagnosed condition and “marriage counseling.” The IRS allows HSA/FSA use for therapy treating illness, but not for marital counseling.²

What about our 2-Day Affair Recovery Bootcamp?

• The weekend retreat itself is rarely reimbursed. Many plans categorize intensives as workshops or retreats, not therapy.
• Follow-up sessions may be reimbursable if:
  • Your clinician is in-network or your plan offers out-of-network benefits
  • Sessions are billed under covered codes (e.g., 90837 or 90847)
  • Documentation shows medical necessity for a diagnosable condition (for example, trauma-related symptoms in the betrayed partner)¹

If your plan won’t cover marital or relationship services, we’ll provide a superbill so you can pursue any out-of-network reimbursement.

Typical coverage: yes vs. no

Often covered (plan-dependent):

• Individual psychotherapy (90834/90837) for a diagnosis; partner may attend as “collateral”¹
• Family psychotherapy (90846/90847) when sessions are for the patient’s treatment¹
• Telehealth psychotherapy (if your plan and state allow)¹

Often not covered:

• Marriage counseling, couples counseling, or infidelity counseling without a diagnosis¹⁶
• Retreats, workshops, or bootcamps (weekend format), unless your plan explicitly includes them
• Coaching or educational services not deemed medically necessary²⁶

Using HSA/FSA for infidelity counseling

Sometimes possible. The IRS allows HSA/FSA use for therapy when it treats a disease or diagnosable mental illness.² Marital counseling, however, is not eligible. Some couples use HSA/FSA funds for follow-ups tied to a diagnosis — but check with your administrator.

CPT & diagnosis basics (so you can ask smart questions)

• Common psychotherapy CPT codes: 90834/90837 (individual), 90846/90847 (family)¹
• Relationship distress codes (like Z63.0) document context but usually don’t trigger benefits³
• Coverage hinges on both diagnosis and medical necessity¹

How to check your benefits (sample script for your insurer)

When you call your insurance company, ask:

• Do I have in-network or out-of-network benefits for outpatient mental health (office and telehealth)?
• Are 90837 (individual) and 90847 (family) covered? Any session limits?¹
• What’s my copay/coinsurance and deductible status?
• Do you cover sessions when a partner attends as part of my treatment?¹
• Are retreats or workshops covered? (Usually no.)
• Can I use HSA/FSA if therapy is tied to a diagnosis?²

If insurance won’t cover it, what are your options?

• Out-of-network + superbill: We provide itemized receipts for any eligible follow-ups.
• HSA/FSA: Check with your administrator if sessions are tied to a diagnosis.²
• Hybrid path: Many couples invest in the weekend intensive for momentum, then use covered weekly/family sessions for ongoing care.¹

FAQs

Q1. Is marriage counseling covered by insurance?
Usually no — unless sessions treat a diagnosable mental health condition and meet medical necessity.

Q2. Are family therapy codes 90846/90847 covered?
Often yes, but only when tied to a diagnosis.

Q3. Can we use HSA/FSA for infidelity counseling?
Sometimes. Eligible if sessions treat a diagnosable illness; not for marital counseling.²

Q4. Will a 2-Day Affair Recovery Bootcamp be reimbursed?
Rarely for the weekend itself. Some follow-ups may qualify if billed under covered codes.

Q5. What should I ask my insurer?
Ask about coverage of 90837/90847, in-/out-of-network benefits, partner attendance, retreat coverage, and HSA/FSA eligibility.

Key takeaways

• Insurers pay for medically necessary treatment of mental health diagnoses — not general “marriage counseling.”¹²
• Individual and family therapy codes may be covered if treatment targets a diagnosis.¹
• HSA/FSA may reimburse therapy for illness, but not marital counseling.²
• Weekend intensives are usually self-pay; some follow-ups may qualify for reimbursement.

Sources

1. Centers for Medicare & Medicaid Services (CMS). Medicare & Mental Health Coverage (MLN Booklet). April 2025.
2. Internal Revenue Service (IRS). Medical Expenses FAQs (HSA/FSA/HRA). Updated 2023; Publication 502 (2024).
3. ICD-10-CM Z63.0 — Problems in relationship with spouse or partner. ICD10Data, 2025 edition.
4. GoodRx Health. “Is Marriage Counseling Covered by Insurance?” 2022.