Therapy, psychiatry, counseling, and most mental health treatment costs are deductible as medical expenses. The IRS treats mental healthcare the same as physical healthcare under Publication 502 — your copays, out-of-pocket session fees, and psychiatric medication are all qualifying expenses. Here’s exactly what’s covered and when claiming them makes financial sense.
What Mental Health Expenses Are Deductible?
All of the following qualify as deductible medical expenses under IRS Publication 502:
- Individual therapy sessions with a licensed psychologist, therapist, counselor, or social worker
- Couples or marriage counseling — if for the diagnosis or treatment of a mental illness
- Family therapy — same condition applies
- Group therapy
- Psychiatrist visits — including medication management appointments
- Prescription psychiatric medications — antidepressants, anti-anxiety medications, mood stabilizers, ADHD medications
- Inpatient mental health treatment — psychiatric hospital stays
- Intensive outpatient programs (IOP) and partial hospitalization programs (PHP)
- Substance use disorder treatment — including residential programs
- EMDR therapy, TMS (transcranial magnetic stimulation), and other clinically recognized treatments
- Mental health apps — if prescribed by a licensed provider for treatment of a diagnosed condition (emerging area, consult a CPA)
What Doesn’t Qualify
- Life coaching — coaches are not licensed medical providers and life coaching is not a medical service
- Stress management classes not prescribed for a diagnosed condition
- Wellness or mindfulness apps purchased without a clinical prescription or diagnosis
- Marriage counseling for general relationship improvement — the IRS requires that the service be for diagnosing or treating a mental illness, not general wellness
The line between what counts and what doesn’t can be blurry. A licensed therapist treating diagnosed depression: qualifies. A life coach helping you set career goals: doesn’t qualify, even if it improves your mental wellbeing.
Transportation to Therapy: Also Deductible
The cost of getting to and from therapy appointments counts as a qualifying medical expense, just like transportation to any other medical appointment. If you drive, you can deduct 21¢ per mile (the 2025 medical mileage rate), plus parking and tolls. If you take rideshare or public transit, the actual cost is deductible. Add these transportation costs to your total medical expenses — they count toward the same 7.5% AGI threshold.
Teletherapy and Online Sessions
Teletherapy sessions with a licensed provider are fully deductible — the delivery method doesn’t matter. What matters is that the provider is a licensed medical professional and the service is for treatment of a medical condition. You also won’t have transportation costs to deduct, but the session fees are identical to in-person visits for deduction purposes.
The 7.5% AGI Threshold: When Therapy Costs Add Up
Mental health expenses are pooled with all other qualifying medical expenses and subject to the 7.5% of AGI floor. Only the total above that floor is deductible.
Weekly therapy at $150/session (out-of-pocket after insurance) is $7,800 per year. At a $65,000 AGI, the threshold is $4,875. Combined with prescription costs, dental, and eye care, many people with ongoing therapy costs do clear the threshold — especially if they’re paying out-of-pocket for therapy rather than through insurance.
Use the medical expense calculator to see whether your therapy costs — combined with your other medical expenses — put you over the line.
FSA and HSA: Already Pre-Tax
Therapy sessions paid with HSA or FSA funds cannot also be deducted on Schedule A. The tax benefit was already applied when those funds were contributed pre-tax. Only sessions paid with after-tax money count toward the Schedule A deduction.
Mental Health Insurance Premiums
If you pay health insurance premiums that include mental health coverage with after-tax dollars, those premiums count as qualifying medical expenses. You can’t separate out the mental health portion — the entire premium is counted as one medical expense. For employees whose premiums come out of payroll pre-tax, the premiums are already excluded from taxable income and are not deductible.
For the full list of qualifying medical and dental expenses, see the medical deductions guide. If you’ve been paying for therapy out of pocket, it’s worth running your numbers through the free calculator to see where you stand.