The short answer

Gambling disorder is a diagnosis in the DSM-5 with its own billing code (ICD-10 F63.0). That means it can be billed like other mental health conditions, and major insurers increasingly cover counseling and therapy for it. Coverage for residential treatment is more variable and usually requires prior authorization and a showing of medical necessity.

What affects whether you are covered

• Your plan. Employer plans, marketplace plans, Medicaid and Medicare all differ. Some states have moved to require coverage; New York added problem gambling treatment to required insurance coverage in its 2026 budget.
• Level of care. Outpatient therapy is covered more often than residential treatment.
• Co-occurring conditions. Depression, anxiety or substance use alongside gambling often strengthens a medical necessity case.
• Network. Whether the provider is in your plan's network changes what you pay.

Questions to ask your insurer

1. Is treatment for gambling disorder (F63.0) a covered benefit on my plan?
2. Which levels of care are covered: outpatient, intensive outpatient, residential?
3. Is prior authorization required, and what documentation do you need?
4. What are my deductible, copay and out-of-pocket maximum for behavioral health?
5. Do you cover out-of-network behavioral health providers, and at what rate?

If insurance does not cover it

Options include private pay with a payment plan, employer assistance programs (EAPs), and in Arizona, the state's Treatment Assistance Program, which subsidizes counseling with approved providers. See our Arizona resources page.

How Outpost will handle it

Outpost Recovery plans to accept most major insurance carriers. Once we open, our team will verify your benefits at no cost and explain your options before you commit to anything. Request a confidential consultation if you have questions in the meantime.

Frequently asked questions