Does Medicaid Cover Therapy in Indiana? Limits, Costs, and Providers

Yes, Indiana Medicaid covers therapy. Every Indiana Medicaid plan — the Healthy Indiana Plan, Hoosier Healthwise, Hoosier Care Connect, Indiana PathWays for Aging, and Traditional Medicaid — pays for individual psychotherapy, family therapy, group therapy, crisis counseling, and psychiatric evaluations, and federal parity law prevents these benefits from being more restrictive than medical coverage.¹ You can see a therapist for up to 20 sessions per provider in a rolling 12-month period before anyone needs to ask the state for more, and most members pay either nothing or a small copay per visit.

What Therapy Is Covered

On the outpatient side, Indiana Medicaid pays for individual psychotherapy in 30-, 45-, and 60-minute sessions, family therapy with or without the patient present, group therapy, and crisis intervention, including mobile crisis teams that come to you for triage, brief counseling, and safety planning.² Also covered: psychiatric diagnostic evaluations, psychological and neuropsychological testing, intensive outpatient programs, peer recovery services, tobacco dependence treatment, transcranial magnetic stimulation, and an annual depression screening.³

When outpatient care is not enough, inpatient coverage includes acute psychiatric hospitalization, psychiatric residential treatment facilities for people under 21, residential substance use treatment, and partial hospitalization programs.³

The 20-Session Limit and Prior Authorization

Indiana Medicaid lets you have up to 20 psychotherapy sessions with a provider in a rolling 12-month period without any extra approval. That cap applies to individual therapy, family therapy, crisis psychotherapy, and several related codes. Once you reach it, your therapist can request prior authorization to continue, documenting that more sessions are medically necessary.² The initial evaluation does not count against this and does not need prior authorization.⁴

If you are in Traditional Medicaid, prior authorization requests go to Acentra Health through the Atrezzo Provider Portal or by mail, fax, or phone.⁵ If you are in a managed care plan, your health plan handles the request on its own terms, and your provider will coordinate with the plan directly.

The state’s parity review confirms this 20-session cap is not stricter than what Medicaid applies to medical office visits, which have their own 30-visit rolling 12-month limit. There are no copays, visit limits, or dollar caps that apply only to behavioral health.¹

What Therapy Costs

Your copay depends on which Medicaid plan you have.

Members with Package A benefits — Hoosier Healthwise, Hoosier Care Connect, Traditional Medicaid, and Indiana PathWays for Aging — have no cost-sharing for therapy at all.⁶

HIP Plus members, who make monthly contributions to a POWER account, also pay nothing for outpatient or inpatient behavioral health; the only HIP Plus copay is $8 for nonemergency use of an emergency department.⁷

HIP Basic and HIP State Plan Basic members pay $4 per outpatient therapy visit and $75 for an inpatient stay. If your total copays reach 5% of your household income in a quarter, you stop paying copays for the rest of that quarter.⁷

Members classified as “medically frail,” which includes people with a disabling mental disorder or chronic substance use disorder, get HIP State Plan benefits with Medicaid Rehabilitation Option services, vision, dental, and non-emergency transportation, no matter which HIP tier they are in.⁸

Who Can Provide Therapy

Indiana Medicaid reimburses a wide range of licensed providers, so you have real choice when picking a therapist. Covered provider types 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, Advanced Practice Registered Nurses, and physician assistants.³ You do not need a referral from a primary care doctor to see any of them; Indiana Medicaid allows self-referral to any qualified in-network behavioral health provider.⁹

Reimbursement rates differ by credential — psychologists at 100% of the fee schedule, APRNs and physician assistants at 85%, and LCSWs, LMHCs, LMFTs, and LCACs at 75%.³ For you as a patient the service is the same; the rate matters mainly for whether a given therapist chooses to accept Medicaid.

Telehealth Therapy

Therapy by video is covered on the same terms as an in-person session, provided the service appears in the state’s Telehealth and Virtual Services code set. Most telehealth therapy needs both audio and video. A smaller set of codes can be done audio-only with a specific billing modifier. Your provider has to offer you a choice between an in-person visit and a telehealth one and document your consent and location.¹⁰

Intensive outpatient treatment is an exception: cameras must stay on for the full session, and audio-only is not allowed. The same clinical criteria and session limits that govern in-person therapy apply to telehealth.¹¹

Several managed care plans add extras on top of standard telehealth. MHS offers free online therapy through Brave Health for members 13 and older, UnitedHealthcare has a 24/7 Doctor Chat for mental health, and CareSource offers a digital emotional health tool called myStrength.¹²

Therapy for Children

Kids and teens on Indiana Medicaid are covered more broadly than adults. Through the federal Early and Periodic Screening, Diagnostic and Treatment benefit, anyone from birth through age 20 is entitled to medically necessary treatment for a mental health condition found during a screening, even when the specific service is not otherwise in Indiana’s state plan.¹³

For children with serious emotional disturbances, the Child Mental Health Wraparound program adds intensive home- and community-based services beyond standard therapy. It serves youth ages 6 through 17 who have two or more qualifying diagnoses and meet a threshold on a clinical assessment, and it provides wraparound facilitation, habilitation, respite care, and family support and training. Children whose primary diagnosis is ADHD, autism spectrum disorder, intellectual disability, or substance use disorder are not eligible. Families can refer through the CMHW access site or by contacting the Division of Mental Health and Addiction.¹⁴

Applied Behavior Analysis for autism is also covered, but under new rules effective April 1, 2026, ABA is limited to Medicaid members under age 21 through EPSDT. Adult coverage ends after a transition period on October 1, 2026. Comprehensive ABA has a 4,000-hour lifetime cap, with up to 15 additional hours per week available if medically necessary, and prior authorization is required.¹⁵

Counseling for Substance Use

Counseling for alcohol or drug use is covered the same way as other therapy: up to 20 units per provider in a rolling 12-month period, with more available through prior authorization. Intensive outpatient programs — typically three hours of structured treatment three days a week — are covered through community mental health centers, with the state expanding availability to additional providers.¹⁶

Medication-assisted treatment is covered too. Opioid treatment programs bundle medication (methadone, buprenorphine, or naltrexone) with individual and group therapy, counseling, drug testing, and case management.² State law specifically requires Medicaid to cover treatment for opioid and alcohol dependence, including counseling and FDA-approved medications, and prohibits step therapy for mental health medications under Medicaid.¹⁷

How to Find a Medicaid Therapist

Where you start 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.”¹⁸

If you have HIP, Hoosier Healthwise, Hoosier Care Connect, or Indiana PathWays for Aging, use the directory for your managed care plan. Anthem, CareSource, MHS, UnitedHealthcare, and Humana each run their own searchable directory.¹⁸ Managed care contracts require plans to keep at least two psychiatrists within 60 miles of each member and allow plans to pay out-of-network behavioral health providers at 98% of the normal rate, which can expand your options.⁹

Community mental health centers are another good starting point. The Indiana Council of Community Mental Health Centers has a Find a Center search tool, and CMHCs accept Medicaid on a self-referral basis for counseling, crisis services, medication-assisted treatment, peer recovery, and psychiatric care.¹⁹

However you find a provider, call the office before you schedule to confirm they are taking new patients with your specific type of Medicaid. Directory listings are not always current.¹⁸

1
State of Indiana. Medicaid Mental Health Parity and Addiction Equity Act Compliance
2
Indiana Medicaid. Behavioral Health Services Codes
3
State of Indiana. Behavioral Health Services Provider Reference Module
4
State of Indiana. Therapy Services Provider Reference Module
5
State of Indiana. Prior Authorization
6
State of Indiana. What Is Covered by Indiana Medicaid
7
State of Indiana. Healthy Indiana Plan Provider Reference Module
8
State of Indiana. Frequently Asked Questions About HIP
9
National Academy for State Health Policy. Behavioral Health Fact Sheet
10
State of Indiana. Telehealth and Virtual Services Provider Reference Module
11
Center for Connected Health Policy. Indiana Telehealth Policy
12
State of Indiana. Health Plan Comparisons
13
State of Indiana. EPSDT Provider Reference Module
14
State of Indiana. Child Mental Health Wraparound Program
15
State of Indiana. Applied Behavioral Analysis Therapy
16
Medicaid.gov. Indiana Healthy Indiana Plan SUD Implementation Protocol
17
ParityTrack. Indiana Statutes
18
State of Indiana. Provider Directory
19
State of Indiana. Certified Community Behavioral Health Clinic