Can You Deduct Psychiatric Care on Your Taxes?

Yes, psychiatric care is a deductible medical expense on your federal return, but only if you itemize deductions and only for the part of your total unreimbursed medical expenses that exceeds 7.5% of your adjusted gross income (AGI). IRS Publication 502 lists psychiatric care, payments to a psychologist for medical care, and therapy received as medical treatment as includible medical expenses. Amounts your insurer reimbursed, and amounts paid with tax-free HSA or reimbursed FSA money, do not count.

Because of the 7.5% floor and the standard deduction, many people with ordinary medical costs get no tax benefit. People paying out of pocket for ongoing psychiatry, therapy and related costs are more likely to cross the threshold, especially in a year with other large medical bills. This article is general information, not tax or legal advice; a tax professional can apply the rules to your return.

How the deduction works, step by step

1. Add up the qualifying medical and dental expenses you paid during the year for yourself, your spouse and your dependents.
2. Subtract anything reimbursed by insurance or other sources, including amounts paid directly to the provider on your behalf.
3. Subtract 7.5% of your AGI. Only the excess is deductible.
4. Add that excess to your other itemized deductions on Schedule A. You generally benefit only if your total itemized deductions are larger than your standard deduction.

A hypothetical example in percentages

These are invented, round figures to show the arithmetic, not anyone's actual costs or fees. Suppose your unreimbursed qualifying medical expenses for the year equal ten percent of your AGI.

That deduction helps only if it, together with your other itemized deductions such as state and local taxes, mortgage interest and charitable gifts, exceeds your standard deduction. If your expenses were five percent of AGI, the medical deduction would be zero no matter how you file.

What counts: psychiatry-related expenses

The test underneath all of these is the IRS definition of medical care: payments for the diagnosis, cure, mitigation, treatment or prevention of disease. A psychiatric evaluation for depression meets it. A program aimed at general well-being usually does not. When an expense is mixed, such as a visit that includes lab work and supplements, keep itemized records that separate the parts.

Travel adds up for people who attend weekly appointments in person. For 2025 the standard medical mileage rate in Publication 502 is 21 cents a mile, and you can add parking fees and tolls. The IRS sets the rate for each year, so use the edition of Publication 502 for the year you are filing. For 2026 the IRS set the medical rate at 20.5 cents a mile for January through June and 23.5 cents a mile from 1 July.

Larger costs Publication 502 addresses

Some mental health costs are much larger than office visits, and these are the ones most likely to push a household over the 7.5% floor in a given year.

• Hospital care. Inpatient care counts if a principal reason for being there is to receive medical care. Topic 502 lists inpatient hospital care among qualifying expenses.
• Specialized care for a dependent. Publication 502's psychiatric care entry includes the cost of supporting a mentally ill dependent at a specially equipped medical center where the dependent receives medical care.
• Special education. Tuition at a school for a child with learning disabilities can qualify when overcoming the learning disabilities is the primary reason for attending, under the conditions the publication sets out. This can be relevant for some children with ADHD-related learning difficulties; check the conditions carefully.
• A parent's travel. Transportation expenses of a parent who must go with a child who needs medical care are included.
• Lodging while away for care. Lodging can qualify only when it is primarily for and essential to medical care provided by a doctor in a licensed hospital or equivalent facility, is not lavish or extravagant, and involves no significant element of personal pleasure or vacation; Publication 502 also caps the amount per night.
• Medical conferences. Admission and travel for a conference about a chronic illness affecting you, your spouse or a dependent can qualify if most of the time is spent attending sessions on medical information.

Prepaying for care

Paying ahead does not move a deduction into the current year without limits. Publication 502 says you generally cannot include current payments for medical care, including medical insurance, to be provided substantially beyond the end of the year. If you are considering paying in advance for a program of care that runs into the next year, ask a tax professional how the payment should be treated before you count on it.

Who is most likely to benefit

The deduction tends to matter in a few situations, and rarely otherwise:

• You already itemize because your other deductions exceed the standard deduction, so every dollar of medical expense above the floor adds to the total.
• Your AGI is modest relative to your medical spending, so the 7.5% floor is a smaller hurdle.
• A year with a hospitalization, intensive treatment or a dependent's specialized care alongside ongoing out-of-pocket psychiatry.
• Large out-of-network costs that your insurer reimbursed only in part, since the unreimbursed remainder counts.

If none of these fits, the HSA or FSA route described below may be the more useful tax tool.

Whose expenses you can include

You can include medical expenses you paid for yourself, your spouse and your dependents. For a dependent, the person must have been your dependent either when the services were provided or when you paid. That matters for parents paying for a teenager's or college student's psychiatric care, and Publication 502 has special rules for some people who would be dependents except for their income or filing status.

Timing: the year you pay, and reimbursements that arrive later

You deduct expenses in the year you pay them, and a charge to a credit card counts in the year of the charge, not the year you pay the card bill. For out-of-network care this creates a timing issue: you pay the clinician, submit a superbill, and the insurer reimburses you weeks or months later, sometimes in the next tax year.

A simple habit helps: keep a running list of each visit date, the amount paid, the date you submitted the claim and the amount the insurer reimbursed. At tax time you then know the true unreimbursed total. The claim process is described in superbills and out-of-network claims, and why reimbursement is often lower than what you paid is explained in allowed amounts and UCR.

HSAs and FSAs: no double benefit

You cannot include amounts you contribute to a health savings account, and you cannot include expenses paid with a tax-free HSA distribution. Likewise, expenses fully reimbursed by a flexible spending arrangement funded with pre-tax income cannot be included. Premiums and other medical expenses paid through an employer's cafeteria plan are not deductible unless they are included in box 1 of your Form W-2.

The practical choice is usually between the two routes, not both. HSA contributions can be deducted or excluded from income even if you do not itemize, and HSA distributions and FSA reimbursements may be tax free when used for qualified medical expenses. The itemized deduction, by contrast, only helps above the 7.5% floor and only if you itemize. For many people the account is the better tool, and the deduction becomes useful only in years with unusually high costs. Contribution limits, eligibility and documentation are covered in using an HSA or FSA for psychiatry.

Records to keep

The IRS says to keep records of your medical expenses to support the deduction, and not to send them with a paper return.

• Itemized receipts or superbills showing the provider, date, service and amount paid.
• Explanations of benefits showing what your insurer reimbursed.
• Pharmacy receipts for prescribed medications.
• Itemized lab invoices, kept separate from any supplement purchases.
• For supplements, a clinician's written recommendation naming the diagnosed condition, if you intend to claim them.
• A mileage log for trips to appointments, with dates and destinations.
• Records of any HSA or FSA payments, so you do not count those expenses twice.

State returns and other considerations

Federal Schedule A has a box to check if you elect to itemize for state tax or other purposes even when your itemized deductions are less than your standard deduction. State rules differ from federal rules, so ask your preparer how New York or your state treats medical expenses.

Two other points are worth checking with a professional. If you are self-employed, you may be able to deduct health insurance premiums as an adjustment to income rather than as an itemized medical expense, subject to limits. And if a large, one-time medical cost is coming, timing payments within one tax year can sometimes push total expenses over the floor; that is a planning question for a tax professional, not a reason to delay care.

Prescription costs are often part of the total; ways to lower psychiatric prescription costs covers options before tax time. For the full picture of what out-of-pocket care may cost, see whether out-of-pocket integrative psychiatry is worth it.

How Dr. Lewis's practice can help with your records

The practice provides a superbill, an itemized statement, in its patient portal after each session. Many patients pay for psychiatric care with an HSA or FSA, and the practice notes that eligibility rules vary between plans and change from year to year, so confirm coverage with your plan administrator. Lab and supplement costs are separate from visit fees, which makes it easier to separate items with different tax treatment. The practice also offers a Good Faith Estimate of expected costs before care starts, which can help with planning. Payment details are on the insurance and payment page and in the practice FAQ. More guides are in the Choosing Psychiatric Care guide, and the IRS's own summaries are Publication 502 and Topic 502.

Frequently asked questions

Is therapy with a licensed clinical social worker deductible, or only with a psychiatrist or psychologist?

Publication 502 allows amounts paid for therapy received as medical treatment, not only care from psychiatrists and psychologists. What matters is that the therapy treats a medical or mental health condition. Keep the superbill showing the service and diagnosis.

Can I deduct telehealth psychiatry visits?

Publication 502 does not distinguish by format. A psychiatric visit is psychiatric care whether it happens in person or by video. Keep the same records you would for an office visit.

My insurer reimbursed me in January for visits I paid for in December. What do I do?

If you deducted those December payments on the prior year's return, the reimbursement is generally reported as income up to the amount you deducted. If you did not deduct them because you did not itemize or did not exceed the floor, you generally do not include the reimbursement, up to the amount of the expense, in income. A tax professional can confirm for your situation.

Can I deduct psychiatric care I paid for my adult child?

Only if your child qualifies as your dependent for this purpose at the time of the service or payment, under the rules in Publication 502. Some people who are not dependents because of income or a joint return can still qualify. Check the publication or ask a tax professional.

Are online mental health courses deductible?

Publication 502 does not list educational courses, and expenses that are merely beneficial to general health do not qualify. A course is unlikely to count unless it is part of treatment for a diagnosed condition; ask a tax professional before relying on it.

Does the 7.5% threshold apply to the 2026 tax year?

IRS Topic 502, updated in October 2026, describes the deduction for expenses that exceed 7.5% of AGI. Check the 2026 edition of Publication 502 and the Schedule A instructions when they are released before you file.

Sources

1. Publication 502 (2025), Medical and Dental Expenses. Internal Revenue Service, 2025. irs.gov
2. Topic No. 502, Medical and Dental Expenses. Internal Revenue Service, 2026. irs.gov
3. Instructions for Schedule A (Form 1040) (2025). Internal Revenue Service, 2025. irs.gov
4. Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans. Internal Revenue Service, 2025. irs.gov
5. Standard mileage rates. Internal Revenue Service, 2026. irs.gov

Educational information, not medical, tax or legal advice. Decisions about diagnosis, medication and treatment belong with a clinician who knows your history.