Therapy in Virginia: Costs, Licensing & How to Find Help
A guide to therapy in Virginia — costs, licensing requirements, telehealth rules, insurance coverage, and how to find a therapist.
$185
Avg. session cost
#14
MH ranking (of 51)
270
Providers per 100K
7%
Uninsured rate
Therapist Licensing Requirements
Overseen by the Virginia Board of Counseling.
| Credential | Title | Supervised Hours | Required Exams |
|---|---|---|---|
| LPC | Licensed Professional Counselor | 3,400 | NCE |
| LCSW | Licensed Clinical Social Worker | 3,000 | ASWB Clinical |
| LMFT | Licensed Marriage and Family Therapist | 3,400 | MFT National Exam |
| Licensed Clinical Psychologist | Licensed Clinical Psychologist | 4,000 | EPPP |
Therapy Costs in Virginia
The average therapy session in Virginia costs $185 — $10 above the national average of $175. Online therapy is typically 15% less.
| Metro Area | Average | Range |
|---|---|---|
| Arlington | $210 | $160–$275 |
| Richmond | $175 | $135–$225 |
| Virginia Beach | $160 | $120–$205 |
Telehealth Rules in Virginia
PSYPACT Member (since 2020)
PSYPACT member state. Out-of-state psychologists may practice via APIT. Other providers must hold a Virginia license.
Audio-only therapy: Allowed
Medicaid telemental health: Covered
Consent: Informed consent required; must include explanation of telehealth services, technology requirements, and potential limitations.
Insurance & Parity in Virginia
Parity enforcement: moderate
Medicaid expanded: Yes (no session cap)
Typical in-network copay: $25–$50
Major insurers: Anthem Blue Cross Blue Shield, CareFirst, UnitedHealthcare, Aetna, Cigna
Crisis Resources in Virginia
Virginia Department of Behavioral Health and Developmental Services (DBHDS)
Crisis Lines
Warm Lines (Non-Crisis Support)
Notable Programs
- Virginia's 40 Community Services Boards (CSBs) provide comprehensive behavioral health services in every locality.
- Virginia's Marcus Alert system coordinates community crisis response teams as alternatives to law enforcement for behavioral health crises.
- The DBHDS STEP-VA initiative ensures every CSB offers same-day mental health screening and assessment.
Therapy Landscape in Virginia
Virginia's mental health landscape reflects the state's geographic and economic diversity. Northern Virginia, anchored by the DC metropolitan area, has one of the highest concentrations of therapists in the Southeast, with many practitioners specializing in high-stress professions, military and veteran issues, and government-related occupational stress. Average therapy costs in Northern Virginia range from $150 to $225 per session, while rates in central and southwestern Virginia are more moderate at $100 to $175.
The Virginia Board of Counseling licenses LPCs, and the Board of Social Work licenses LCSWs. Virginia also recognizes Licensed Marriage and Family Therapists and has specific requirements for supervisory hours that are among the more structured in the region. The state's community services boards (CSBs) — a network of 40 agencies — provide publicly funded mental health services and serve as a critical safety net for uninsured and underinsured residents.
Finding a Therapist in Virginia
If you have insurance, start with your carrier's provider directory. Major Virginia insurers include Anthem Blue Cross Blue Shield, Optima Health, and CareFirst. For those without coverage, Virginia's CSBs offer services on a sliding-scale basis regardless of ability to pay.
Consider what you need help with before searching. For anxiety or stress-related concerns, CBT is a well-supported option. Veterans and military families in the Hampton Roads and Northern Virginia areas can access specialized trauma care, including EMDR and prolonged exposure therapy.
Barriers to Care
The most significant barrier in Virginia is geographic disparity. While Northern Virginia and the Richmond metro area have ample providers, rural areas in the Shenandoah Valley, Southside, and far southwest face severe shortages. Some counties have no licensed psychologists at all.
Virginia has expanded Medicaid under the Affordable Care Act, which improved access for low-income adults, but provider participation in Medicaid remains uneven. Many private practitioners do not accept Medicaid due to low reimbursement rates, limiting options for those who rely on it. Telehealth has helped, and Virginia enacted permanent telehealth legislation that has increased access in underserved areas.
Out-of-pocket therapy in Virginia typically costs between $120 and $200 per session. Northern Virginia rates tend to be higher due to the cost of living. Community services boards offer sliding-scale options for those who qualify.
Yes. Virginia Medicaid covers outpatient therapy, psychiatric services, and substance use treatment. Coverage was significantly expanded in 2019, and most licensed mental health professionals can bill Medicaid if they are enrolled providers.
Yes. Virginia passed permanent telehealth legislation, and licensed therapists can provide services via video or audio. Insurance companies operating in Virginia are required to cover telehealth at the same rate as in-person sessions.
Community services boards (CSBs) are publicly funded agencies that provide mental health, substance use, and developmental disability services. Every region in Virginia has a CSB, and they serve residents regardless of insurance status or ability to pay.
Use the Virginia Department of Health Professions license lookup tool. You can search by the therapist's name, license type, or license number to verify their active status and check for any disciplinary history.
Licensing and Credentials in Virginia
The Virginia Board of Counseling licenses Licensed Professional Counselors (LPCs). The Board of Social Work licenses Licensed Clinical Social Workers (LCSWs). Licensed Marriage and Family Therapists (LMFTs) and Licensed Psychologists are also available. Virginia has specific supervisory hour requirements that are among the more structured in the region.
Pre-licensed professionals include Residents in Counseling and Supervisees in Social Work who practice under supervision. They can be a cost-effective option. Verify any provider through the Virginia Department of Health Professions license lookup tool.
Teletherapy Laws in Virginia
Virginia passed permanent telehealth legislation requiring insurers to cover virtual mental health sessions at the same rate as in-person visits. Both video and audio-only therapy are permitted. Licensed therapists can provide care to any Virginia resident via telehealth.
Virginia participates in PSYPACT, expanding telehealth options for psychologists. For counselors and social workers, providers must hold a Virginia license. Telehealth has been important for connecting rural residents in the Shenandoah Valley, Southside, and far southwest with Northern Virginia and Richmond specialists.
Medicaid and Insurance Coverage in Virginia
Virginia expanded Medicaid under the ACA in 2019, significantly improving access for low-income adults. Virginia Medicaid covers outpatient therapy, psychiatric services, and substance use treatment. Most licensed mental health professionals can bill Medicaid if they are enrolled providers, though provider participation is uneven.
Major private insurers include Anthem Blue Cross Blue Shield, Optima Health, CareFirst, and Aetna. Mental health parity laws apply to commercial plans. For more on managing therapy costs, see our how to pay for therapy guide.
Cost of Therapy in Virginia
Therapy costs in Virginia vary significantly by region. In Northern Virginia (DC suburbs), out-of-pocket sessions typically range from $150 to $225. In central and southwestern Virginia, rates are $100 to $175. Insurance copays generally fall between $20 to $50.
Community services boards offer sliding-scale options. University training clinics at UVA, VCU, and George Mason provide affordable sessions. For a nationwide comparison, see our therapy cost by state guide.
Crisis Resources in Virginia
If you or someone you know needs help:
- 988 Suicide and Crisis Lifeline — Call or text 988 for 24/7 support
- Virginia's Community Services Boards — 40 agencies provide crisis services across the state; contact the Virginia Department of Behavioral Health and Developmental Services to find your local CSB
- REACH (Regional Education Assessment Crisis Services and Habilitation) — Crisis services for individuals with developmental disabilities
- NAMI Virginia — 804-285-8264
Virginia's CSBs provide 24/7 crisis services and mobile crisis teams in many regions.
How to Get Started with Therapy in Virginia
Here is how to begin:
- Check your insurance — Anthem, Optima, and CareFirst maintain provider directories. If you have Virginia Medicaid, contact your managed care plan for behavioral health referrals.
- Contact your local CSB — Virginia's 40 community services boards provide mental health services regardless of insurance status. Find yours through the DBHDS website.
- Search directories — Psychology Today, Zencare, and the Virginia Psychological Association directory are useful tools.
- Use telehealth — Virtual sessions connect rural residents with Northern Virginia and Richmond specialists. PSYPACT also expands options to out-of-state psychologists.
- Know your coverage — Virginia's Medicaid expansion has made therapy accessible to many more adults. Check eligibility through Cover Virginia.
For more guidance, visit our how to find a therapist guide or our therapy for beginners guide.
Virginia offers a wide spectrum of therapy options, from world-class specialists in the DC suburbs to community-based services in rural areas. Taking the time to explore your options — and understanding what your insurance or local CSB covers — will help you find the right fit.