Is therapy tax deductible?

The entries that apply

Pub 502 does not have one section called mental health. Four entries cover most situations. Therapy says you can include amounts you pay for therapy received as medical treatment. Psychologist says you can include amounts you pay to a psychologist for medical care. Psychiatric Care says you can include amounts you pay for psychiatric care, including the cost of supporting a mentally ill dependent at a specially equipped medical center where the dependent receives medical care. Psychoanalysis says you can include payments for psychoanalysis.

The key words are “as medical treatment” and “for medical care.” The publication defines medical expenses as costs of diagnosis, cure, mitigation, treatment or prevention of disease and for the purpose of affecting any part or function of the body, and says the care must be primarily to alleviate or prevent a physical or mental disability or illness. Costs that are merely beneficial to general health do not count.

What does not count

Psychoanalysis has one stated exception: you cannot include payments for psychoanalysis that is part of required training to be a psychoanalyst. More broadly, the publication warns against costs aimed at general well-being. Health club dues, and amounts paid to improve general health or to relieve physical or mental discomfort not related to a particular medical condition, are excluded. Dancing and swimming lessons are excluded when they are only for the improvement of general health, even if a doctor recommends them.

Legal fees are narrow too. You can include legal fees that are necessary to authorize treatment for mental illness, but not fees for the management of a guardianship estate, for conducting the affairs of the person being treated, or other fees that are not necessary for medical care.

Related costs and travel

Treatment programs have their own entries. Inpatient treatment at a therapeutic center for alcohol or drug addiction counts, including meals and lodging provided by the center. Transportation to and from alcohol recovery support meetings in your community counts when attendance follows competent medical advice that membership is necessary for treating a disease involving excessive use of alcohol. Transportation expenses for regular visits to a mentally ill dependent count if the visits are recommended as part of treatment.

Driving to appointments is covered by the Transportation rules: actual out-of-pocket car costs, or for 2025 returns the standard medical mileage rate of 21 cents a mile, plus parking and tolls. You cannot include commuting to work.

Reimbursements and who can claim

Reduce your costs by any insurance reimbursement, which Pub 502 says includes Medicare. Most people with therapy coverage pay only a copay or a deductible, and those are the amounts that count. You can include expenses you paid for yourself, your spouse and your dependents, and you include them in the year you paid.

Illustration, not from the publication: with AGI of $70,000 the floor is $5,250. If you paid $4,800 for sessions after insurance and $2,100 of other qualifying costs, your total is $6,900 and the deduction is $1,650. Alone, the sessions would not have cleared the floor. The calculator above lets you test your own numbers, and the standard-versus-itemized calculator tells you whether itemizing is worth it at all.

How the floor, timing and itemizing apply here

For therapy, the same three rules from Publication 502 decide the final number. First, the deduction is only the part of your total medical and dental expenses that is more than 7.5% of your adjusted gross income, so a $1,000 cost does nothing until the year’s total passes the floor. Second, you include only what you paid during the tax year and were not reimbursed for, and you may include costs for yourself, your spouse and your dependents. Third, the deduction is claimed on Schedule A (Form 1040), so it helps only if your itemized deductions add up to more than your standard deduction. Amounts paid with a tax-free health savings account distribution cannot be counted again, and pre-tax flexible spending arrangement reimbursements are excluded.

Related medical expense topics

More from the same IRS publication: Is acupuncture tax deductible?, Is medical marijuana tax deductible?, Is a home health aide tax deductible?. For a full calculation across all your expenses, use the medical expense deduction calculator.

Sources

• IRS Publication 502, Medical and Dental Expenses (2025): the “Therapy” entries, the 7.5% of AGI rule, the reimbursement rules and the transportation rules. Read November 2, 2026.

Edition read: Publication 502 (2025), for use in preparing 2025 returns. Dollar limits and rates in this publication are for 2025; the publication notes that later legislation (P.L. 119-21) may affect federal deductions, so check the current publication and the Schedule A instructions for your tax year. This page summarizes the publication and does not replace it. Marked for human review.