The short answer

Most health plans don’t cover “marriage” or “infidelity” counseling as a stand-alone relationship service. Coverage is usually available only when therapy is treating a diagnosable mental health condition (for example, PTSD, major depression, anxiety), and the sessions are medically necessary for that treatment.¹² ⁶

When coverage exists, it’s typically for:

• Individual psychotherapy (e.g., CPT 90834/90837) where a partner may join some sessions, or
• Family psychotherapy (CPT 90846/90847) when therapy is for the patient’s mental health condition, not generic “marital counseling.”¹

Why “marriage counseling” is often excluded

Insurance pays for medical care—care that diagnoses, treats, or prevents disease. Relationship distress (like “problems with spouse/partner,” ICD-10 Z63.0) is a Z-code—useful for documentation but not itself a covered mental disorder. Plans generally won’t reimburse services whose primary purpose is relationship improvement rather than treatment of a mental health diagnosis.¹ ³

Plain English: If the goal is “help us communicate better after the affair,” many plans say no. 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—subject to your plan rules.¹

What Medicare and many commercial plans actually cover

• Family psychotherapy (CPT 90846, 90847) and individual psychotherapy (90832/90834/90837) are covered when medically reasonable and necessary, with patient treatment as the primary purpose—not generic marital work.¹
• Payers (and the IRS, for tax-advantaged accounts) distinguish between therapy for a diagnosed condition vs marital counseling. The IRS states therapy for disease can be HSA/FSA-eligible, but marital counseling isn’t.²

So…will our 2-Day Affair Recovery Bootcamp (+ eight 90-minute follow-ups) be covered?

• The intensive weekend is rarely reimbursed—it’s a nonstandard format many plans categorize as an educational “program” or retreat.
• The eight follow-ups may be partially reimbursable if (a) your clinician is in-network or your plan has out-of-network benefits, (b) sessions are billed under covered psychotherapy codes (e.g., 90837 or 90847), and (c) documentation shows medical necessity for a diagnosable condition being treated (for example, trauma-related symptoms in the betrayed partner).¹

We never miscode. If your plan won’t cover marital/relationship services, we’ll tell you straight and give you a superbill so you can seek any available out-of-network reimbursement.

Covered vs. not covered (typical—not universal)

Often covered (plan-dependent):

• Individual psychotherapy (90834/90837) for a diagnosed condition; partner may attend portions as “collateral” to help treatment¹
• Family psychotherapy (90846/90847) when sessions are for the patient’s mental health treatment (not generic “marriage counseling”)¹
• Telehealth psychotherapy where allowed by your plan and state rules¹
  

Often not covered:

• “Marriage counseling,” “couples counseling,” or “infidelity counseling” without a diagnosable condition as the treatment focus¹ ⁶
• Retreats/workshops/bootcamps (weekend format), unless your plan explicitly includes them (rare)
• Coaching, education-only services, or services not medically necessary² ⁶
  

Can we use HSA/FSA for infidelity counseling?

Sometimes. The IRS says therapy is an eligible medical expense when it treats a disease/diagnosed mental illness; marital counseling is not.² If your intensive weekend isn’t covered, some couples use HSA/FSA for eligible follow-ups tied to a diagnosis; check with your plan/administrator.² IRS

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

• Common psychotherapy CPT codes: 90834/90837 (individual), 90846/90847 (family psychotherapy).¹
• Diagnosis matters: Coding a Z-code like Z63.0 (relationship distress) documents context; it usually doesn’t unlock benefits on its own.³ Coverage hinges on a mental health diagnosis and medical necessity.¹

How to check your benefits (copy-paste to your insurer)

Call the number on your card and ask:

1. Do I have in-network and/or out-of-network benefits for outpatient mental health? (Office & telehealth)
2. Are 90837 (individual) and 90847 (family psychotherapy) covered? Any pre-auth or session limits?¹
3. What’s my copay/coinsurance after deductible? Any deductible left this year?
4. Do you cover sessions when a partner attends as part of treatment for my diagnosis?¹
5. Are workshops/retreats covered? (Usually no.)
6. Can I use HSA/FSA for psychotherapy tied to a diagnosis? (IRS allows therapy for disease; not marital counseling.)²
   

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

• Use OON + superbill: If you have out-of-network benefits, we provide itemized receipts for any eligible follow-ups.
• HSA/FSA: If sessions treat a diagnosis, ask your administrator about eligibility.²
• Hybrid path: Many couples do the weekend for momentum, then use covered weekly or family sessions for ongoing care when focused on a diagnosis and medical necessity.¹

FAQ (for page body + schema)

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

Q2. Are family therapy codes 90846/90847 covered?
A. Often, yes—when used for treatment of a diagnosis (not generic “marriage counseling”).

Q3. Can we use HSA/FSA for infidelity counseling?
A. Sometimes—therapy for a diagnosed illness can be eligible; “marital counseling” is not.

Q4. Will a 2-Day Affair Recovery Bootcamp be reimbursed?
A. Rarely for the weekend; some follow-ups may be reimbursable if billed to covered codes and criteria are met.

Q5. What should I ask my insurer?
A. Ask about in-/out-of-network benefits, coverage of 90837/90847, pre-auth, deductibles, partners attending, retreats, and HSA/FSA.

Key takeaways

• Insurers pay for medically necessary treatment of mental health diagnoses—not generic “marriage counseling.”¹ ²
• Family (90846/90847) and individual (90834/90837) psychotherapy may be covered when sessions treat a diagnosis; relationship-only goals usually aren’t covered.¹
• HSA/FSA can reimburse therapy for disease, but not marital counseling.²
• Our 2-Day Affair Recovery Bootcamp is typically self-pay; eight follow-ups may be reimbursable if plan rules are met. ¹ ² How long does infidelity recovery usually take?

Sources

1. Centers for Medicare & Medicaid Services (CMS). Medicare & Mental Health Coverage (MLN Booklet). Family psychotherapy is covered when medically reasonable and necessary and patient treatment is the primary purpose; includes code list (90846/90847, etc.). April 2025. Centers for Medicare & Medicaid Services
2. Internal Revenue Service (IRS). Medical Expenses — FAQs (HSA/FSA/HRA). “Therapy for a disease is a medical expense… marital counseling is not.” (Q7). Updated 2023; Publication 502 (2024) for general rules. IRS+1
3. ICD-10-CM Z63.0 — Problems in relationship with spouse or partner (Z-code describes relational context, not a mental disorder). 2025 edition. ICD10Data
4. GoodRx Health. “Is Marriage Counseling Covered by Insurance?” (Consumer explainer reflecting plan norms; always check your SPD/EOC). 2022. GoodRx