Find a Highmark Therapist

How Highmark Mental-Health Coverage Works

Highmark covers therapy and psychiatry across Medicare, Medicaid, Marketplace, and employer plans, though your costs will depend on the plan you’re enrolled in.

If you have a Highmark Medicare Advantage plan (such as Complete Blue PPO), you’ll typically pay about $40 per visit, whether it’s for therapy or medication management.

Members in Wholecare Dual Special Needs Plans (D-SNP) have $0 out-of-pocket costs for outpatient mental health visits. That’s because Medicaid picks up anything Medicare doesn’t cover.

With a Marketplace Silver PPO or HMO, therapy and psychiatry visits usually cost $20–$40 after your deductible, though some urgent mental health visits are available at no cost. There’s no annual cap on sessions.

If you’re covered under an employer-sponsored Highmark PPO or HMO, most plans charge a $20–$40 copay per visit, though some employers waive copays for telehealth sessions. It’s always best to check your Summary of Benefits and Coverage (SBC) to see what applies to you.

For those in a High-Deductible or HSA-eligible plan, you’ll pay 20% coinsurance after meeting your deductible, then the standard copay. Many members use their Health Savings Account to cover costs early in the year.

Tip: Every Highmark plan is a little different, so always review your Summary of Benefits to confirm your exact mental health coverage.

Plan highlights

• Unlimited sessions. If the clinician says they’re medically necessary, Highmark keeps paying.
  
• No referral. You can schedule directly with a mental-health specialist.
  
• Telehealth costs the same—or less. Virtual visits run under your “Outpatient Mental Health” benefit, so whatever you’d owe in the office applies online as well. Many Marketplace and employer plans drop the copay entirely for Well360 Virtual Health.
  
• Nation-wide Blues network. Moving or traveling? Use BlueCard to see in-network therapists in any state.

Highmark’s in Network Mental-Health Provider Types 

Highmark’s network includes a full range of licensed mental health professionals, so you can find the right type of care for your needs.

• Therapists and counselors (LCSWs, LMFTs, LPCs): These providers offer weekly talk therapy, teach coping skills, and can support both individuals and families dealing with stress, anxiety, depression, or life transitions.
• Psychologists (PhD or PsyD): In addition to therapy, psychologists specialize in psychological testing and trauma-focused approaches. They’re often the go-to choice if you need evaluations for ADHD, learning issues, or more intensive therapeutic modalities.
• Psychiatrists (MD/DO): As medical doctors, psychiatrists focus on diagnosis and medication management, making them especially important for conditions that require prescriptions or complex treatment planning.

No matter which clinician you choose, all three provider types bill under the same outpatient mental health benefit, meaning your copay—or $0, depending on your plan—will be identical.

Real-Life Use Case: How Jordan Found a Highmark Therapist in 3 Days — and Paid $0

Day 1: Jordan (34, Pittsburgh) logs into highmark.com → Find Care & Costs → Behavioral Health. He sees nine in-network therapists within 10 miles. He applies filters: Telehealth, CBT, and Evening hours. Three therapists remain—all accepting new patients.

Day 2: Jordan uses the cost estimator:

• $0 for Well360 video sessions
• $25 for in-person visits (Marketplace Silver Plan)

Day 3: He books a Thursday 7 p.m. virtual session with Devon Lee, LCSW, a Highmark in-network therapist. Copay: $0

Day 10: After two sessions, Devon recommends exploring medication.

Day 12: Jordan schedules a 30-minute psychiatry consult via Well360 for the next morning.
Copay: $0

Total time from search to first session: three days. Out-of-pocket so far: $0.

Step-by-Step: Booking Therapy Through Highmark

1. Sign in or call. Open highmark.com (or the Sydney Health app) or dial Member Services; say “Behavioral Health.”
   
   
2. Search the directory. Filter by ZIP, telehealth vs. office, specialty, language, and evening/weekend hours.
   
   
3. Confirm network status. Look for “In Network – UnitedHealthcare Choice Plus” or the local Blues phrase—your cue you’ve found a covered Highmark therapist.
   
   
4. Check your cost. Click Estimate Cost; you’ll see the exact copay/coinsurance before you book.
   
   
5. Choose speed or locality. Telehealth (Well360/Amwell or Teladoc) often offers next-day slots; office visits may take a week or two.
   
   
6. Complete intake forms. Online questionnaires speed insurance verification.

Telehealth Options

Highmark makes it simple to connect with mental health professionals virtually, giving you more flexibility and faster access to care.

Through Well360 Virtual Health (powered by Amwell), members can schedule video visits for both therapy and psychiatry between 7 a.m. and 9 p.m. Costs are typically the same as an office visit, though many plans now waive the copay entirely for virtual sessions.

Some Medicare Advantage and D-SNP members also have access to Teladoc, where therapy and psychiatry visits are often covered at $0 per session.

In states like Delaware, New York, and West Virginia, Highmark also permits phone-only sessions if broadband access is unavailable. These calls are billed at the same rate as a video or office visit.

Tip: Just like in-person appointments, all virtual sessions count toward your deductible and out-of-pocket maximum. Choosing telehealth won’t change your costs—it simply makes care more convenient.

Cost estimates 

What you’ll pay for therapy or psychiatry with Highmark depends on your plan type, but most options keep care affordable.

If you’re on a Highmark Medicare Advantage plan, in-office therapy visits usually run about $40 per session, and Well360 video therapy costs between $0 and $40, depending on your plan. Psychiatric evaluations follow the same pricing as therapy sessions.

For members in a Wholecare Dual Special Needs Plan (D-SNP), all outpatient mental health visits—including therapy, psychiatry, and telehealth—are covered at $0. Medicare and Medicaid share the bill, leaving you with no out-of-pocket cost.

With a Marketplace Silver plan, in-office therapy typically costs $20–$40 after your deductible, and many plans now offer Well360 video therapy at $0. Psychiatric evaluations bill at the same rate as therapy.

If you’re covered through an employer-sponsored PPO, expect to pay about $20–$40 per session, with virtual visits often coming in at $0 depending on your employer’s design.

Tip: Highmark applies the same copay or coinsurance for psychiatric evaluations as therapy sessions, so your first appointment won’t cost more than a regular visit.

What to do if you cant find an appointment within 10 days: 

• Document every call. Write the date, name, and “next available” date.
• Ask for Behavioral Health Care Management. Highmark reps can hunt cancellations across ZIP codes.
• Request a network-adequacy waiver. If no in-network slot within 10 business days, Highmark can green-light an outside provider at in-network rates.
• File a grievance online. The plan must answer in 30 days—often sooner. 

Frequently Asked Questions

Does Highmark cover therapy?
Yes. All commercial, Marketplace, Medicaid, and Medicare Advantage options include outpatient therapy and psychiatric visits with no session cap. Copays range from $0 to $40 depending on your plan.

How do I find therapists that take Highmark near me?
Sign in → Find Care & Costs → Behavioral Health → filter by ZIP, telehealth, and availability.

What’s the difference between a Highmark therapist and a Highmark psychologist?
Therapists (LCSW, LMFT, LPC) provide counseling; psychologists (PhD/PsyD) can also perform psychological testing. Both bill under the same outpatient mental-health benefit.

Are Highmark psychiatrists accepting new patients?
Many are—especially through Well360 Virtual Health. Use the telehealth filter and “Accepting patients” tag.

Will my virtual visit count toward my deductible?
Yes. Telehealth sessions apply to the same deductible and out-of-pocket max as office visits.