Does Blue Cross Blue Shield Cover EMDR?
How BCBS covers EMDR across its 35 independent companies — billed as standard psychotherapy, typical costs, and using BlueCard to find EMDR-trained providers.
The Short Answer
Yes, BCBS covers EMDR. Eye Movement Desensitization and Reprocessing is an evidence-based treatment for PTSD recognized by the American Psychological Association. All BCBS plans cover EMDR under outpatient mental health benefits per federal parity.
Sessions are billed as standard psychotherapy (90834 or 90837). The specific copay and network rules depend on your state Blue (Anthem, CareFirst, Highmark, Florida Blue, Blue Shield of California, etc.) — not on "BCBS" as a single entity.
Key Takeaways
- All BCBS plans cover EMDR under outpatient mental health benefits.
- EMDR is billed as standard psychotherapy; no EMDR-specific code.
- In-network copays typically $20–$60 per session across Blues.
- BlueCard lets you see in-network EMDR providers across state lines — useful because EMDR-trained providers are unevenly distributed.
- Prior authorization is not required for outpatient EMDR.
What BCBS Covers for EMDR
CPT codes
Standard across Blues:
| CPT Code | Description |
|---|---|
| 90791 | Intake / diagnostic evaluation |
| 90834 | 45-minute psychotherapy |
| 90837 | 60-minute psychotherapy (common for EMDR) |
Covered conditions
EMDR is typically billed for PTSD, complex PTSD, trauma-related anxiety, depression, and adjustment disorders.
Session count
Single-incident EMDR: 6–12 sessions. Complex or chronic presentations run longer. Most Blues do not impose a fixed session cap.
In-Network vs. Out-of-Network EMDR
In-network
- Use your state Blue's provider directory (start at your state-specific website, not "bcbs.com")
- Cross-reference with the EMDRIA directory to confirm EMDR training
- BlueCard advantage: EMDR training is concentrated in certain metros — BlueCard lets you see in-network providers in other states for telehealth
Out-of-network
- Cash-pay rates: $150–$300 per session
- PPO Blues reimburse 50–80% of allowed amount after OON deductible
- HMO Blues: no OON coverage
Prior Authorization
Not required for standard outpatient EMDR on any Blue plan.
How to Verify Your BCBS EMDR Coverage
Call the member services number on the back of your ID card.
Script
- "What is my copay for individual psychotherapy CPT 90834?"
- "Is 90837 reimbursed at the same rate?"
- "Is prior authorization required for outpatient therapy?"
- "Do I have out-of-network benefits, and what is the allowed amount for 90834?"
- "Does BlueCard apply to behavioral health providers in other states for in-network reimbursement?"
- "Are telehealth EMDR sessions reimbursed at the same rate as in-person?"
Note the reference number and the name of your state Blue.
Typical Out-of-Pocket Costs for an 8-Session EMDR Course
| Scenario | Per Session | 8-Session Course |
|---|---|---|
| In-network, $30 copay | $30 | $240 |
| In-network, $50 copay | $50 | $400 |
| HDHP before deductible | ~$100–$150 | $800–$1,200 |
| OON PPO, 70% reimbursement | ~$60–$120 post-reimbursement | $2,500+ (year 1 OON deductible) |
| Cash pay | $150–$300 | $1,200–$2,400 |
See EMDR therapy cost for the private-pay view.
What to Do If BCBS Denies an EMDR Claim
- Get the denial EOB in writing.
- Ask your provider to peer-review with your state Blue.
- File a first-level appeal within the deadline listed on your denial letter.
- Cite MHPAEA parity if the denial appears modality-specific.
- External review is available after internal appeals.
Frequently Asked Questions
Does BCBS cover EMDR for conditions other than PTSD? Yes. EMDR for anxiety, depression, phobias, and adjustment disorders is covered when billed by a licensed provider for a diagnosed condition.
Does BCBS cover online EMDR? Telehealth EMDR is typically covered at the same rate as in-person across Blues. See can you do EMDR online?
Why does my BCBS plan cost differently than my friend's? Because you are likely on different state Blues — each independent company sets its own copays, deductibles, and network.
Can I use my home-state BCBS plan to see a provider licensed in another state? Yes, via BlueCard. This is especially useful for EMDR because trained providers are concentrated in certain metros.