How Long Will Insurance Cover Therapy in Virginia?
Most plans in Virginia have NO session limit for therapy — that would violate parity. But insurers use 'medical necessity' reviews to cut off coverage, often around session 20-30, especially for ongoing depression/anxiety treatment.
Cardinal Care. Expanded 2019; STEP-VA program improves community mental health access.
Your legal right
Under MHPAEA, mental health cannot have stricter session limits than physical health. If your insurance covers unlimited physical therapy for a chronic condition, they must cover comparable mental health treatment the same way.
The medical necessity review
Around session 20-30, insurers often request a 'medical necessity' review. Your therapist submits treatment notes and justification. If you're actively engaged and making progress, coverage continues. If the review argues you're 'plateaued,' they may cut off.
What to do if they stop coverage
Appeal (see our appeals guide). The rate of successful appeals on 'no longer medically necessary' denials is high — especially if your therapist documents ongoing symptoms.
Self-pay bridge
If appeals fail, many therapists will reduce their rate for established clients losing insurance coverage. Ask.
Virginia-specific
Cardinal Care. Expanded 2019; STEP-VA program improves community mental health access.
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