The cost of therapy stops a lot of people from getting started. Not because they don’t want help — but because they don’t know what their insurance actually covers, and figuring that out feels like another job on top of everything else.
This guide is meant to make that part easier. We’ll walk through what mental health coverage typically looks like in New Mexico, which insurance plans we accept at Reclaiming Wellness, what therapy costs if you’re paying out of pocket, and exactly how to check your benefits before your first session.
If you’ve been sitting on the idea of starting therapy because you weren’t sure you could afford it, keep reading.
Does Health Insurance Cover Therapy in New Mexico?
In most cases, yes — and it’s been legally required to be covered fairly for over a decade.
The Mental Health Parity and Addiction Equity Act (MHPAEA) requires that insurance plans covering mental health services must provide those benefits on par with medical and surgical coverage. In plain terms: your plan can’t impose stricter limits on therapy visits than it does on, say, physical therapy or cardiology appointments.
New Mexico also has its own Mental Health and Developmental Disabilities Code, which reinforces state-level protections for mental health coverage. If your plan covers mental health services — and most do — it’s required to be meaningful coverage, not a token offering.
What varies by plan: the copay or coinsurance amount, whether you need a referral, whether your deductible applies first, and which providers are considered in-network. That’s where the details matter, and we’ll help you work through them.
Which Insurance Plans Does Reclaiming Wellness Accept?
We currently accept the following insurance plans for therapy services:
- Blue Cross Blue Shield (BCBS)
- Presbyterian Health Plan
- United Healthcare / Optum (commercial and Turquoise Care plans)
- Molina Healthcare (Turquoise Care / Medicaid managed care plan)
- Aetna
- Cigna
- Medicare (select plans)
We accept both commercial and Centennial Care (Medicaid) plans where listed above. If you’re unsure which category your plan falls into, the back of your insurance card will show the plan name — or call the member services number listed there and ask directly.
For the most current and complete list, including any plans added since this article was published, visit our rates and insurance page.
What Does Therapy Cost With Insurance?
That depends on your specific plan, but here’s how it generally works.
Copay plans: You pay a flat fee per session — often $20–$50 — and the insurance covers the rest. This is the simplest structure and the most common for commercial plans.
Deductible + coinsurance plans: You pay the full session rate until you meet your deductible for the year, then pay a percentage (typically 20–30%) of each session after that. These plans can feel expensive early in the year, then become much more affordable once the deductible is met.
Out-of-pocket maximums: Every ACA-compliant plan has a cap on what you’ll pay in a given year. Once you hit that maximum, covered services are typically free for the rest of the year. If you’re using therapy regularly, it’s worth knowing where your OOP max sits.
The fastest way to know your actual cost: call the member services number on your insurance card and ask specifically about outpatient mental health benefits. More on how to do that below.
What If I Don’t Have Insurance — or Mine Isn’t Accepted?
We offer self-pay rates for clients who are uninsured, underinsured, or whose plan we don’t participate with. ⚠️ [VERIFY current self-pay rate with client and insert here — e.g., “Sessions are $X for individual therapy.”]
We also provide a Good Faith Estimate before your first appointment, as required by the No Surprises Act. That means you’ll know your expected cost in writing before you commit to anything.
A few other options worth knowing:
- Sliding scale: Ask us directly. Many private practices, including ours, have limited sliding scale slots for clients experiencing financial hardship.
- Employee Assistance Programs (EAP): If your employer offers an EAP, it often covers 6–12 free therapy sessions per year, separate from your health insurance. Check your HR benefits.
- Telehealth: Our online therapy sessions are available statewide across New Mexico and covered by most of the same plans as in-person sessions. For clients outside Albuquerque, this is often the most practical option.
Does Medicaid Cover Therapy in New Mexico?
New Mexico’s Medicaid program is called Centennial Care, and it does cover outpatient mental health services — including individual therapy, group therapy, and psychiatric services — for eligible members.
Centennial Care is managed by several private health plans, including Presbyterian, United Healthcare (Turquoise Care), and Molina (Turquoise Care). If your Medicaid coverage runs through one of those plans, you may be able to see our therapists at little or no cost depending on your specific benefit tier.
If you’re not sure whether your Centennial Care plan is one we work with, the best step is to call us directly at (505) 261-9770. We’ll verify your coverage before your first session so there are no surprises.
How to Check Your Therapy Benefits in 5 Steps
This is the part most guides skip. Here’s exactly what to do before you book:
- Find your insurance card. You’ll need your member ID number and the member services phone number on the back. Some plans also let you check benefits through their member portal online.
- Call member services and ask about outpatient mental health benefits. Specifically, ask:
- Is outpatient therapy (CPT codes 90837, 90834) covered under my plan?
- Do I have a separate mental health deductible, or does it apply to my general deductible?
- What is my copay or coinsurance for outpatient therapy?
- What is my out-of-pocket maximum, and how much have I met so far this year?
- Ask whether a referral is required. Some HMO-style plans require a referral from your primary care physician before they’ll cover specialty mental health visits. If yours does, get that in place before booking.
- Let us verify your benefits for you. When you reach out to schedule, our team will contact your insurance directly to confirm your coverage details and let you know your expected copay or cost before your first appointment. You don’t have to navigate this alone.
- Book your first session. Once you know your coverage, request an appointment here. We’ll match you with a therapist whose availability, approach, and specialty fits what you’re looking for.
Common Questions About Insurance and Therapy
Will my insurance company know what I talk about in therapy?
Your insurer receives a diagnosis code and a billing code for each session — that’s required for reimbursement. They do not receive session notes or the content of what you discuss. Your therapist’s notes are protected under HIPAA and are not shared with your insurance company without your written consent. More details are in our FAQs.
Does insurance cover telehealth therapy in New Mexico?
Yes, in most cases. Following the expansion of telehealth during the pandemic, most commercial plans and Medicaid managed care plans in New Mexico now cover telehealth therapy on the same terms as in-person sessions. Our online therapy page has more on how our virtual sessions work.
How many therapy sessions will insurance cover per year?
Federal parity law prohibits plans from setting arbitrary session limits on mental health treatment that don’t apply to medical care. In practice, this means most plans don’t impose a hard session cap — but some do require ongoing authorization after a certain number of sessions, or may require documentation of medical necessity. Ask your insurer specifically whether prior authorization is required.
Can I use my HSA or FSA for therapy?
Yes. Therapy with a licensed mental health provider is a qualified medical expense under IRS guidelines, which means you can use a Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for sessions. This applies to both in-person and telehealth appointments.
What if my insurance denies a claim for therapy?
You have the right to appeal. Ask your insurer for the specific reason for denial in writing, then contact your therapist’s office — we can help with documentation to support an appeal. If the denial involves mental health parity (i.e., your insurer is applying stricter limits to therapy than to medical care), you can also file a complaint with the New Mexico Office of Superintendent of Insurance.
One Thing Worth Knowing
A lot of people wait longer than they need to because the insurance question feels complicated. It’s actually not — once you know which plan you have and whether it’s in-network, the process is usually straightforward. And if something doesn’t work out with insurance, we’ll help you figure out the next option.
Cost should not be the reason you don’t get support. If you’re experiencing symptoms of trauma, anxiety, or depression, you can read more about what those look like in our post on signs your body is releasing trauma — and then reach out. We’ll handle the insurance piece together.
Check our rates and insurance page → Request an appointment →
Resources
- Mental Health Parity and Addiction Equity Act (MHPAEA) — Centers for Medicare & Medicaid Services
- New Mexico Centennial Care — NM Human Services Department
- Know Your Mental Health Rights — SAMHSA
- No Surprises Act and Good Faith Estimates — CMS
- New Mexico Office of Superintendent of Insurance — File a complaint or check plan information
- Our Rates and Insurance Page — Reclaiming Wellness
Erika Martínez-Gonzales, LPCC is the founder of Reclaiming Wellness Counseling & Medication Management in Albuquerque, NM. She has served the New Mexico mental health community for over a decade. NPI: 1588928568.
