Yes, Indiana Medicaid does cover therapy. The Indiana Health Coverage Programs pay for individual psychotherapy, family therapy, group therapy, crisis intervention, psychiatric evaluations, substance use counseling, and Applied Behavior Analysis for autism, across every major Medicaid plan in the state. Most members pay either nothing or a $4 copay per outpatient visit, and you can see a therapist up to 20 times per provider in a rolling 12-month period before your provider has to request prior authorization to continue.
What Therapy Services Are Covered
Outpatient behavioral health coverage is broad. Individual psychotherapy is reimbursed in 30-, 45-, and 60-minute sessions. Family therapy is covered whether or not the patient is present, and group therapy is covered as well. Crisis intervention is included, including mobile crisis teams that provide on-scene triage, assessment, brief counseling, and safety planning.1Indiana Medicaid. Behavioral Health Services Codes
Beyond talk therapy, Indiana Medicaid covers psychiatric diagnostic evaluations, psychological and neuropsychological testing, intensive outpatient treatment, peer recovery services, tobacco dependence treatment, transcranial magnetic stimulation, and an annual depression screening. On the inpatient side, coverage includes acute psychiatric hospitalization, psychiatric residential treatment for people under 21, residential substance use treatment, and acute partial hospitalization.2State of Indiana. Behavioral Health Services Provider Reference Module
Session Limits and Prior Authorization
You can attend up to 20 psychotherapy sessions per provider within a rolling 12-month period before prior authorization kicks in. The 20-unit cap covers individual therapy, family therapy, crisis psychotherapy, and several related psychotherapy codes. Once you hit the limit, your therapist can keep treating you, but they’ll need to request prior authorization and show that continued care is medically necessary.1Indiana Medicaid. Behavioral Health Services Codes
The initial evaluation does not count against the cap and does not require prior authorization.3State of Indiana. Therapy Services Provider Reference Module For members in fee-for-service Medicaid, prior authorization goes through Acentra Health via the Atrezzo Provider Portal, or by mail, fax, or phone.4State of Indiana. Prior Authorization If you’re in a managed care plan, the plan has its own authorization process and your provider handles that with the plan directly.
The 20-session ceiling is not a behavioral-health-only restriction. Under Indiana’s parity compliance framework, all outpatient office visits are subject to a 30-visit rolling 12-month cap, and the state confirms no numerical limits, copays, or dollar caps apply exclusively to mental health services.5State of Indiana. Medicaid Mental Health Parity and Addiction Equity Act Compliance
What Therapy Will Cost You
What you pay depends on which Medicaid program you’re enrolled in. Members with Package A benefits pay nothing for therapy. That includes Hoosier Healthwise, Hoosier Care Connect, Traditional Medicaid, and Indiana PathWays for Aging.6State of Indiana. What Is Covered by Indiana Medicaid
For the Healthy Indiana Plan, copays split by tier. HIP Plus members, who make monthly POWER account contributions, pay nothing for outpatient or inpatient behavioral health; their only copay is $8 for a nonemergency ER visit. HIP Basic and HIP State Plan Basic members pay $4 per outpatient visit, including therapy, and $75 for inpatient stays. Copays stop for the rest of the quarter once you reach a 5% quarterly cost-sharing cap.7State of Indiana. Healthy Indiana Plan Provider Reference Module
Which Plan You’re On
Indiana runs several Medicaid programs, and each one covers therapy, but eligibility rules and copays differ.
- Healthy Indiana Plan (HIP): non-disabled adults ages 19 to 64 with household income up to 138% of the federal poverty level.8State of Indiana. Frequently Asked Questions About HIP
- Hoosier Healthwise: children up to age 19 and pregnant individuals, with children eligible up to 158% of the federal poverty level and CHIP coverage extending to 250%.9State of Indiana. Eligibility Guide
- Hoosier Care Connect: people age 59 and younger who are blind or disabled.
- Indiana PathWays for Aging: managed care for eligible individuals age 60 and older, launched July 2024.
- Traditional Medicaid: members not in managed care, including dual-eligibles.9State of Indiana. Eligibility Guide
If you’re on HIP and you have a disabling mental disorder or chronic substance use disorder, you may be classified as “medically frail,” which gives you HIP State Plan benefits regardless of whether you’re in Plus or Basic. That upgrade adds Medicaid Rehabilitation Option services, vision, dental, and non-emergency transportation.8State of Indiana. Frequently Asked Questions About HIP
Telehealth Therapy
Indiana Medicaid covers therapy delivered by telehealth, as long as the service is on the official Telehealth and Virtual Services code set. Most therapy codes require both audio and video. Some codes are approved for audio-only delivery when billed with modifier 93.10State of Indiana. Telehealth and Virtual Services Provider Reference Module Clinical criteria and session limits are the same as for in-person visits.11Center for Connected Health Policy. Indiana Telehealth Policy
Providers must offer you the choice of an in-person appointment and document your consent to a telehealth visit. Intensive outpatient treatment requires video with cameras on for the full session; audio-only isn’t permitted for IOP. Some managed care plans layer on digital tools: MHS offers free online therapy through Brave Health for members 13 and older, UnitedHealthcare runs a 24/7 Doctor Chat for mental health, and CareSource offers a digital emotional health tool called myStrength.12State of Indiana. Health Plan Comparisons
Finding a Therapist
You don’t need a referral from a primary care doctor to see a therapist. Indiana Medicaid allows self-referral to any qualified in-network behavioral health provider.13National Academy for State Health Policy. Behavioral Health Fact Sheet
Where you search depends on your plan. If you have Traditional Medicaid, use the IHCP Provider Locator on the Indiana Medicaid website and filter by “Behavioral Health Provider” or “Therapist.” If you’re in HIP, Hoosier Healthwise, Hoosier Care Connect, or PathWays for Aging, use your health plan’s directory. Anthem, CareSource, MHS, UnitedHealthcare, and Humana each publish a searchable directory.14State of Indiana. Provider Directory Community mental health centers are another entry point and accept Medicaid on a self-referral basis.15State of Indiana. Certified Community Behavioral Health Clinic
Call the office before your first appointment to confirm they’re taking new patients with your specific Medicaid coverage. Directory listings aren’t always current.14State of Indiana. Provider Directory
The therapists who can bill Medicaid include psychiatrists, health service providers in psychology, licensed psychologists, licensed clinical social workers, licensed mental health counselors, licensed marriage and family therapists, licensed clinical addiction counselors, and advanced practice nurses or physician assistants.2State of Indiana. Behavioral Health Services Provider Reference Module
Extra Coverage for Children and Teens
Kids on Indiana Medicaid get broader therapy coverage than adults through the federal Early and Periodic Screening, Diagnostic and Treatment benefit. EPSDT applies from birth through age 20, and if a screening turns up a mental health condition, Medicaid has to pay for medically necessary treatment to correct or improve it, even for services that aren’t otherwise on Indiana’s benefit list.16State of Indiana. EPSDT Provider Reference Module
Children ages 6 through 17 with serious emotional disturbances may qualify for the Child Mental Health Wraparound program, which adds intensive home- and community-based services: wraparound facilitation, habilitation, respite care, and family support and training. Eligibility requires two or more qualifying diagnoses and a threshold score on a clinical assessment. Children whose primary diagnosis is ADHD, autism spectrum disorder, intellectual disability, or substance use disorder aren’t eligible for CMHW.17State of Indiana. Child Mental Health Wraparound Program
Substance Use Counseling and ABA
Substance use treatment follows the same 20-unit outpatient cap per provider per rolling 12 months, with more available through prior authorization. Medication-assisted treatment is a covered benefit, and opioid treatment programs bundle medication (methadone, buprenorphine, or naltrexone) with individual and group therapy, counseling, drug testing, and case management.1Indiana Medicaid. Behavioral Health Services Codes Under an 1115 waiver, Indiana also covers residential treatment in facilities classified as institutions for mental disease, up to 15 days per month for inpatient care and an average of 30 days for residential.18Indiana Medicaid. IHCP Bulletin BT201801
Applied Behavior Analysis therapy for autism is covered, but the rules changed on April 1, 2026. ABA is now limited to Medicaid members under age 21 and is accessed through EPSDT. Providers can continue billing for members over 21 during a transition period ending October 1, 2026, after which ABA will no longer be reimbursed for adults. Comprehensive ABA is subject to a 4,000-hour lifetime cap, with an additional 15 hours per week available beyond that if medically necessary. Weekly hour caps depend on the member’s autism severity level, and prior authorization is still required.19State of Indiana. Applied Behavioral Analysis Therapy