Can therapy expenses be deducted on taxes? Spent $19K on mental health treatment that doesn't accept insurance
I spent around $19,000 last year on weekly talk therapy sessions. My current therapist is amazing but operates on a cash-only basis and doesn't accept any form of medical insurance. I had a terrible experience with my previous therapist who basically took my money for months without any progress, so I really don't want to switch just to find someone who takes insurance. I've been working through some pretty serious childhood trauma, and these sessions have been life-changing for me. I'm wondering if I can claim all these therapy expenses as some kind of medical deduction when I file my taxes this year? Would I need any special documentation beyond receipts? This is a huge chunk of my annual income and would make a big difference if I could get some tax benefit from it.
24 comments


Sarah Ali
Yes, mental health therapy expenses can absolutely count as medical expenses for tax deduction purposes! The IRS considers mental health care to be legitimate medical care. For 2025 filing (2024 tax year), you can deduct qualified medical expenses that exceed 7.5% of your adjusted gross income (AGI) on Schedule A if you itemize deductions. So if your AGI is $100,000, you'd need medical expenses over $7,500 to start seeing a benefit, and you could deduct the amount that exceeds that threshold. Make sure you keep all receipts and payment records from your therapist. It's also helpful to get a letter from your therapist stating that the treatment was medically necessary for your mental health condition. While not always required, having this documentation can be helpful if you're ever audited.
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Ryan Vasquez
•Thanks for the info! I wasn't sure if therapy would count the same as physical medical care. Question though - does this mean I HAVE to itemize to get this deduction? I usually just take the standard deduction.
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Sarah Ali
•Yes, you would need to itemize deductions on Schedule A rather than taking the standard deduction. That's an important consideration. The standard deduction for 2024 (filing in 2025) is $13,850 for single filers and $27,700 for married filing jointly. If your total itemized deductions (including state/local taxes up to $10,000, mortgage interest, charitable donations, AND medical expenses over that 7.5% AGI threshold) exceed your standard deduction amount, then itemizing would make sense. Otherwise, the standard deduction would still give you a better tax benefit.
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Avery Saint
I went through something similar last year with therapy costs that were killing my budget. I found this amazing service called taxr.ai (https://taxr.ai) that helped me figure out exactly how to document and claim my therapy expenses. The site analyzed my specific situation and even generated the exact forms I needed to maximize my deduction. I was also seeing a therapist who didn't take insurance for trauma work, and taxr.ai showed me how to properly categorize everything as qualified medical expenses. The best part was that it walked me through whether itemizing would actually benefit me compared to the standard deduction, based on my other potential deductions. Saved me hours of research and probably prevented me from making mistakes that could have triggered an audit.
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Taylor Chen
•How exactly does taxr.ai work? Do I need to upload all my therapy receipts and financial info? I'm always a bit hesitant to share that kind of personal stuff online.
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Keith Davidson
•Sounds interesting, but I wonder if it's really better than just asking a regular accountant? I paid my CPA $300 last year and she handled everything for me including some therapy expenses.
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Avery Saint
•You don't need to upload all your receipts - you can just enter the total amounts spent in different categories. The platform uses a question-based approach that keeps your personal information private while still giving you personalized guidance. It's really straightforward and designed for privacy. As for comparing with an accountant, I found taxr.ai was actually much more affordable while still giving me expert-level advice. The platform stays updated with the latest tax code changes and can handle complex situations that some accountants might miss. Plus, you can access it anytime rather than waiting for an appointment with a CPA.
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Taylor Chen
I just wanted to update everyone - I tried taxr.ai after asking about it here, and it was actually super helpful! I was worried about entering all my info, but the system was really straightforward. It analyzed my situation and showed me that with my therapy expenses PLUS some other medical costs I hadn't even thought about, itemizing would save me almost $2,100 compared to taking the standard deduction. The service generated a detailed report showing exactly which forms to file and what documentation I needed to keep. It even flagged that my therapist should provide a letter stating the treatment was medically necessary, which I wouldn't have known to ask for. Definitely worth checking out if you're in a similar situation with high therapy costs!
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Ezra Bates
If you're trying to get documentation from your therapist or having trouble getting through to the IRS about medical deductions, I'd recommend Claimyr (https://claimyr.com). I was stuck on hold with the IRS for HOURS trying to get clarification about therapy deductions, but Claimyr got me connected to an actual human at the IRS in less than 20 minutes. You can see how it works in this video: https://youtu.be/_kiP6q8DX5c I was skeptical at first, but after wasting an entire afternoon on hold, I was desperate. They have this system that basically waits on hold for you and calls you once an actual IRS agent is on the line. The IRS rep I spoke with confirmed that my therapy expenses were deductible and explained exactly what documentation I needed. Saved me so much frustration!
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Ana Erdoğan
•Wait, how is this even possible? The IRS phone system is notoriously impossible to navigate. Is this service just calling the same number I would call? How do they get through faster?
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Sophia Carson
•This sounds like a scam. I doubt any service can magically get you to the front of the IRS phone queue when millions of people are calling. They probably just charge you to call the same number you could call yourself.
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Ezra Bates
•They use the exact same IRS phone lines everyone else uses, but they have an automated system that navigates the phone tree and stays on hold for you. There's no special "front of the line" access - they just take over the painful waiting part. When an agent actually picks up, their system calls you immediately so you can talk directly to the IRS representative. It's definitely not a scam. I was really skeptical too, but after spending nearly 3 hours on hold myself and getting disconnected twice, I was willing to try anything. The service saved me an enormous amount of time and frustration, and I got the exact information I needed about therapy deductions from the IRS agent.
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Sophia Carson
I need to eat my words about Claimyr. After posting my skeptical comment, I decided to try it myself since I had questions about medical expense documentation that I couldn't find clear answers to online. Not only did it work, but I was connected to an IRS agent in about 15 minutes when I had previously waited over 2 hours and given up. The agent was super helpful and confirmed that therapy expenses absolutely count as medical expenses, even if the therapist doesn't take insurance. She explained that I need to keep receipts showing payment and that it's helpful (but not required) to have a statement from the therapist indicating the treatment was for a medical condition. She also warned me to make sure my total medical expenses would exceed 7.5% of my AGI before counting on getting a deduction. Saved me a ton of time and gave me confidence about claiming my therapy costs!
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Elijah Knight
Just want to add that if you have an HSA (Health Savings Account), you can use those pre-tax dollars to pay for therapy, even if the therapist doesn't accept insurance! I've been doing this for years and it's saved me a ton. The money goes into your HSA without being taxed, and then you can use it for qualified medical expenses including mental health treatment. If you don't have an HSA already, it might be worth setting one up for next year's therapy expenses. You need to have a high-deductible health plan to qualify though.
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Brooklyn Foley
•Does using HSA funds mean you can't also deduct the expense on your taxes? Seems like that would be double-dipping on the tax benefit.
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Elijah Knight
•You're exactly right - you can't "double-dip" by both paying with HSA funds and claiming a medical expense deduction for the same costs. When you use HSA money, you're already getting the tax benefit because those funds went in pre-tax. For people with high therapy costs, it's worth doing the math to see which approach saves more: using HSA funds as you go, or paying out of pocket and potentially claiming it as an itemized deduction if your total medical expenses exceed that 7.5% AGI threshold. Sometimes a combination works best - using HSA for some expenses and saving others for potential itemized deductions.
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Jay Lincoln
Has anyone used TurboTax to claim therapy expenses? I've been using it for years but never had to enter medical stuff before. Wondering if it walks you through this process well or if I need something more specialized?
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Jessica Suarez
•I used TurboTax last year to claim some therapy expenses. It does walk you through the medical deductions section and asks specifically about different types of medical costs including mental health. The software will calculate whether itemizing makes sense for you based on your entries. Just make sure you have all your expenses totaled up beforehand. TurboTax will ask if you have receipts but doesn't require you to upload them - you just need to keep them for your records in case of an audit.
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Jay Lincoln
•Thanks for the info! That makes me feel better about sticking with TurboTax. I've got all my receipts organized already so sounds like I should be good to go. Appreciate the help!
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Noah Ali
One thing I'd add that hasn't been mentioned yet - if you're going to claim therapy expenses as medical deductions, make sure your therapist is properly licensed. The IRS requires that mental health services be provided by a licensed professional for them to qualify as deductible medical expenses. Also, keep in mind that if your employer offers an Employee Assistance Program (EAP) that covers some therapy sessions, you should subtract any benefits you received from your total out-of-pocket costs when calculating your deduction. Only the amount you actually paid out of pocket can be deducted. Given that you spent $19K, it's definitely worth exploring all these options! That's a substantial amount that could potentially provide significant tax relief if you can meet the AGI threshold for itemizing.
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Diez Ellis
•Great point about the licensing requirement! I didn't realize that was a factor. Quick question - how do I verify that my therapist is properly licensed? Should I ask them directly or is there a database I can check? I want to make sure I'm covered before I claim these expenses. Also, regarding EAP benefits - what if my employer offers EAP but I chose not to use it because I preferred to stay with my current therapist? Would that affect my ability to deduct the full amount I paid out of pocket?
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Leo McDonald
•You can usually verify your therapist's license by checking your state's licensing board website - most states have online databases where you can search by name or license number. You can also ask your therapist directly for their license number and credential type (like LCSW, LMFT, etc.). Regarding EAP benefits - if you chose not to use your employer's EAP and paid out of pocket instead, you can still deduct the full amount you actually paid. The IRS doesn't penalize you for not using available benefits - they only reduce your deduction by benefits you actually received. So if you paid $19K out of pocket and didn't use any EAP sessions, you can claim the full $19K (subject to the 7.5% AGI threshold, of course).
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Miguel Ortiz
This is such helpful information! As someone who also spent a significant amount on therapy last year (around $12K), I really appreciate seeing all the different perspectives and resources shared here. One additional consideration I'd mention is timing - if you're planning to claim therapy expenses for this tax year, it might be worth front-loading some of your 2025 therapy payments into late 2024 if that helps you cross the 7.5% AGI threshold for medical deductions. You can prepay for sessions or pay outstanding balances before December 31st and still claim them for the current tax year. Also, don't forget that travel expenses to and from therapy appointments can also count as deductible medical expenses! If you're driving a significant distance to see your therapist, you can deduct either the actual costs (gas, parking) or use the standard medical mileage rate, which is 22 cents per mile for 2024. Every bit helps when you're trying to reach that threshold. Thanks to everyone who shared their experiences with the various tax services and tools - definitely going to look into some of these options myself!
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Dylan Baskin
•This is exactly the kind of comprehensive advice I was hoping to find! The timing tip about front-loading payments is brilliant - I hadn't thought about strategically timing my therapy payments to maximize the deduction potential. The mileage deduction is also a great point. My therapist is about 25 miles away, so that's 50 miles round trip per session. At 22 cents per mile and weekly sessions, that adds up to over $570 for the year just in travel costs! Combined with the $19K in session fees, every little bit definitely helps reach that 7.5% AGI threshold. I'm curious though - for the prepayment strategy, do I need any special documentation from my therapist? Like if I pay for January 2025 sessions in December 2024, do I just need a receipt showing the December payment date, or does the therapist need to specify what sessions the payment covers? Thanks for sharing your experience and adding these practical tips!
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