Therapy in South Dakota: Costs, Licensing & How to Find Help
A guide to therapy in South Dakota — costs, licensing, telehealth rules, and how to find a therapist.
$140
Avg. session cost
#23
MH ranking (of 51)
250
Providers per 100K
9.5%
Uninsured rate
Therapist Licensing Requirements
Overseen by the South Dakota Board of Examiners of Counselors and Marriage and Family Therapists.
| Credential | Title | Supervised Hours | Required Exams |
|---|---|---|---|
| LPC-MH | Licensed Professional Counselor - Mental Health | 3,000 | NCE, NCMHCE |
| LCSW-PIP | Licensed Clinical Social Worker - Private Independent Practice | 3,000 | ASWB Clinical |
| LMFT | Licensed Marriage and Family Therapist | 3,000 | MFT National Exam |
| Licensed Psychologist | Licensed Psychologist | 4,000 | EPPP |
Therapy Costs in South Dakota
The average therapy session in South Dakota costs $140 — $35 below the national average of $175. Online therapy is typically 20% less.
| Metro Area | Average | Range |
|---|---|---|
| Sioux Falls | $145 | $110–$185 |
| Rapid City | $135 | $100–$175 |
Telehealth Rules in South Dakota
PSYPACT Member (since 2022)
PSYPACT member state. Out-of-state psychologists may use APIT. Other providers must hold a South Dakota license. Medicaid expanded telehealth coverage for behavioral health and substance use disorder services.
Audio-only therapy: Allowed
Medicaid telemental health: Covered
Consent: Informed consent required; verbal consent acceptable when documented. Audio-only parameters have been clarified by the state.
Insurance & Parity in South Dakota
Parity enforcement: moderate
Medicaid expanded: Yes (no session cap)
Typical in-network copay: $25–$50
Major insurers: Avera Health Plans, Sanford Health Plan, DakotaCare
Crisis Resources in South Dakota
South Dakota Division of Behavioral Health
Notable Programs
- South Dakota's Community Mental Health Centers provide outpatient and crisis services across rural and urban regions.
- The South Dakota Suicide Prevention Program partners with tribal communities for culturally responsive prevention efforts.
- South Dakota's Behavioral Health Urgent Care Centers provide walk-in crisis stabilization in Sioux Falls and Rapid City.
Therapy Landscape in South Dakota
South Dakota's sparse population and vast geography make mental health access a persistent challenge. Sioux Falls and Rapid City are the primary hubs for behavioral health services, while many western counties and tribal reservation communities face critical provider shortages. South Dakota has high suicide rates, particularly among young people and Native American communities, making mental health outreach a state priority. The community mental health center network serves as the safety net for underserved areas. Out-of-pocket therapy costs typically range from $90 to $155 per session — among the more affordable in the nation. South Dakota did not expand Medicaid until recently, but the expansion has opened behavioral health coverage to many more residents.
Finding a Therapist in South Dakota
South Dakota licenses professional counselors (LPC-MHs), clinical social workers (CSW-PIPs), psychologists, and marriage and family therapists (LMFTs). The Board of Examiners of Counselors and Marriage and Family Therapists oversees counselor licensing. South Dakota participates in PSYPACT, and telehealth is a critical tool for connecting rural residents with providers. The state's Native American communities also have access to Indian Health Service behavioral health programs, though capacity varies.
Cognitive behavioral therapy (CBT) is widely available for anxiety and depression. For trauma and PTSD, specialized providers are concentrated in Sioux Falls and Rapid City but increasingly accessible via telehealth.
Out-of-pocket sessions typically cost $90 to $155. Insurance copays range from $15 to $40. Community mental health centers offer sliding-scale options based on income.
Yes. South Dakota Medicaid covers outpatient mental health services including individual therapy, crisis intervention, and substance use treatment. Recent Medicaid expansion has broadened eligibility.
Telehealth is typically the best option for rural residents. PSYPACT membership expands your options to psychologists in other states. Community mental health centers and federally qualified health centers also serve rural areas.
Yes. Indian Health Service facilities on South Dakota reservations provide behavioral health services. Great Plains Tribal Leaders' Health Board and other organizations also coordinate culturally specific programming.
Look for LPC-MH, CSW-PIP, licensed psychologist, or LMFT. All require graduate education, supervised clinical hours, and licensure through a South Dakota board.
South Dakota is working to expand mental health access through Medicaid expansion, telehealth, and community-based services. If you need support, the combination of local resources and virtual care means help is within reach, wherever you live in the state.