Can I deduct talk therapy expenses on my taxes? Spent over $18K this year for childhood trauma treatment

So I've been seeing this amazing therapist for about 18 months now, dealing with some pretty rough childhood trauma stuff. The thing is, he doesn't accept any insurance, and I've paid completely out of pocket - approximately $18,500 last year alone. I tried a different therapist before who took my insurance, but honestly it was a complete waste of six months and I felt worse after our sessions. My current therapist has been life-changing, but the cost is really adding up. I know medical expenses can sometimes be tax deductible, but I'm not sure if mental health therapy qualifies the same way as physical health treatments. Has anyone successfully deducted therapy costs on their taxes? Do I need special documentation beyond my receipts? I'm wondering if all this money I've spent could at least help reduce my tax burden for the 2025 filing.

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18 comments

Lucas Parker

•8M

Yes, mental health therapy absolutely qualifies as a medical expense for tax deduction purposes! The IRS doesn't distinguish between physical and mental health care when it comes to medical expense deductions. There are a couple things to know though. First, you can only deduct medical expenses that exceed 7.5% of your adjusted gross income (AGI), and you'll need to itemize deductions on Schedule A rather than taking the standard deduction. So if your AGI is $100,000, you'd only be able to deduct therapy costs that exceed $7,500. In your case with $18,500 spent, you'd potentially be able to deduct $11,000 (assuming that $100k AGI example). Make sure you keep all receipts from your therapist as documentation. It's also helpful to get a letter from your therapist stating that the treatment was medically necessary, though this isn't always required unless you're audited.

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Lucas Parker

•8M

Yes, HSA funds can absolutely be used for therapy sessions! Mental health services are qualified medical expenses for HSA purposes, which is great because you're using pre-tax dollars. Basic receipts should be sufficient as long as they show the date of service, amount paid, and that it was for mental health therapy. If you're ever audited, the IRS might ask for more documentation, so it wouldn't hurt to ask your therapist for slightly more detailed receipts that specify "psychotherapy services" or similar wording.

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Harper Collins

•8M

I went through a similar situation last year with therapy costs adding up. I was totally lost trying to figure out all the documentation and requirements until I found this AI tool called taxr.ai (https://taxr.ai). It analyzed all my therapy receipts and medical expenses and told me exactly what I could deduct and how to document everything properly. The tool confirmed that mental health therapy is 100% deductible as a medical expense subject to that 7.5% AGI threshold others mentioned. It even helped me realize I could count the mileage driving to and from my therapy appointments! The best part was it generated a complete report I could give to my accountant that outlined everything perfectly. Saved me hours of research and probably found deductions I would have missed.

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Harper Collins

•8M

It's been spot-on accurate in my experience. The information it provides is referenced directly to IRS publications and tax code, so you can verify everything. Plus it doesn't actually file your taxes - it just helps you understand what qualifies and how to document it properly. No, you definitely don't need to upload actual therapy notes or personal health information! Just the financial documentation like receipts. The system doesn't need (or want) your actual health details - it's focused solely on the financial/tax aspects. I was concerned about privacy too, but was impressed with their security approach.

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Dylan Fisher

•8M

Just wanted to follow up about the taxr.ai suggestion. I decided to try it out with my therapy expenses from last year, and wow - super helpful! I discovered I could also deduct the costs of my prescription medications related to mental health treatment that I totally would have missed. The service gave me a detailed report breaking down exactly which expenses qualified and how much I could deduct after the 7.5% AGI threshold. What I really appreciated was how it explained everything in plain English without making me feel stupid for not knowing tax rules. Definitely using this for next year's taxes too.

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Edwards Hugo

•8M

If you're having trouble getting clear answers from the IRS about mental health deductions (which I definitely did), try using Claimyr (https://claimyr.com). I was on hold with the IRS for HOURS trying to get clarification about deducting my therapy expenses and getting nowhere. With Claimyr, I got connected to an actual IRS agent in about 15 minutes who confirmed that my therapy expenses were valid medical deductions and answered all my specific questions about documentation requirements. They have this demo video that shows how it works: https://youtu.be/_kiP6q8DX5c The IRS agent I spoke with was actually super helpful and walked me through exactly how to fill out Schedule A for therapy expenses and what documentation to keep in case of an audit. Totally worth it instead of wasting days trying to get through on my own.

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Edwards Hugo

•8M

It basically holds your place in the IRS phone queue so you don't have to stay on the line yourself. When an agent is about to pick up, it calls you and connects you directly. It navigates all those annoying IRS phone menus for you too. I was super skeptical too! I had previously spent over 3 hours on hold before giving up. I only tried Claimyr because a coworker recommended it. But it literally did get me through in about 15 minutes that day. I think timing matters - I used it early morning on a Tuesday, which might be less busy than other times. But regardless, it saved me from having to actively sit on hold which was the biggest benefit.

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Alfredo Lugo

•8M

Ok I need to eat my words here. After my skeptical comment I decided to try Claimyr anyway since I was desperate for answers about my own therapy deductions. Somehow it actually worked?! Got through to an IRS agent in about 20 minutes (not 15, but close enough). The agent confirmed that mental health therapy is 100% considered a medical expense and walked me through exactly how to document everything. They even advised me to get a brief letter from my therapist stating the treatment was for a diagnosed condition, which apparently makes the deduction more bulletproof if audited. None of this info was clearly explained on the IRS website. Consider me shocked that something actually worked as advertised.

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Sydney Torres

•8M

One thing nobody's mentioned yet - if your employer offers a Flexible Spending Account (FSA) for healthcare, you can use that to pay for therapy with pre-tax dollars, which is even better than taking the deduction in many cases. My therapist doesn't take insurance either but gives me a superbill that I submit to my FSA for reimbursement. The advantage is you don't have to worry about the 7.5% AGI threshold with an FSA. The downside is the use-it-or-lose-it aspect and the lower contribution limits compared to itemizing deductions.

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Sydney Torres

•8M

In my experience, the FSA administrator has never questioned my therapy expenses or asked for additional details. The superbill usually just lists the service code and amount without any specific details about what was discussed in therapy. It typically shows something generic like "psychotherapy services" or a CPT code. FSA administrators are also bound by privacy rules, so they can't share information about your specific medical treatments with your employer. I've been submitting therapy expenses to my FSA for three years now without any privacy concerns.

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