Why
Publication 502 allows psychiatric care, fees paid to a psychologist for medical care, and therapy received as medical treatment.
The IRS FAQ draws the line by purpose: therapy for a diagnosed mental illness is a medical expense, and marital counseling isn't.
If a couples or family session is part of treating someone's diagnosed condition, document that connection. Without it, expect the session to be treated as marital counseling.
What to keep
- An invoice or superbill showing the date, provider, service and diagnosis code.
- Any written treatment plan.
Watch out for
- Life coaching and meditation apps aren't therapy received as medical treatment.
If you plan to reimburse yourself later
IRS Notice 2004-50, Q&A 39, sets no deadline, as long as the expense came after your HSA was established and your records show it wasn't paid by another source or deducted on a tax return. See what records the IRS expects and how long to keep them.