Psychiatrist vs Psychologist vs Psychotherapist in Ontario: Who OHIP Covers

All five are regulated health professionals who can provide talk therapy. They differ in who regulates them, whether OHIP covers them, whether you need a referral, and whether they can diagnose or prescribe.

CPSO is the College of Physicians and Surgeons of Ontario; CPBAO is the College of Psychologists and Behaviour Analysts of Ontario; CRPO is the College of Registered Psychotherapists of Ontario; OCSWSSW is the Ontario College of Social Workers and Social Service Workers.

A psychiatrist is a medical doctor who has completed a residency in psychiatry. They are regulated by the College of Physicians and Surgeons of Ontario, the same college as every other physician.

OHIP covers them. Because a psychiatrist is a physician, their medically necessary services are insured and you are not billed. Psychiatrists both diagnose mental illnesses and prescribe medication, which is what sets them apart from the non-physician providers below.

You need a referral. The Schedule of Benefits pays a psychiatric consultation only when it follows a written request from a referring physician or nurse practitioner, so in practice someone has to refer you. That person does not have to be a family doctor. See how to see a psychiatrist in Ontario, and how to get a referral without a family doctor.

A family doctor is also a physician regulated by the College of Physicians and Surgeons of Ontario. Some family doctors provide psychotherapy or counselling themselves.

OHIP covers them. Psychotherapy delivered by a physician is an insured service under the Schedule of Benefits' psychotherapy, psychiatric and counselling section, so it is free to you. You do not need a referral to see your own family doctor.

This is the insured route most people do not know exists. We cover it in detail in medical psychotherapy: therapy delivered by a doctor.

A psychologist is registered with the College of Psychologists and Behaviour Analysts of Ontario, which was renamed from the College of Psychologists of Ontario in July 2024. Only College members may use the protected titles "Psychologist" and "Psychological Associate."

OHIP does not cover a psychologist in private practice. A psychologist is not a physician, and the Government of Ontario lists services from non-physician providers working outside a hospital as not covered. You would pay privately or through extended health benefits; what that costs is set out here. A psychologist working inside a hospital or a publicly funded program is free to you, because the hospital's public budget pays.

Psychologists can communicate a psychological diagnosis, which the College describes as a controlled act restricted to its qualified members. They do not prescribe medication.

A registered psychotherapist is registered with the College of Registered Psychotherapists of Ontario. Only its registrants may use the protected title "Registered Psychotherapist" and the designation "RP." Registration is based on master's-level training in psychotherapy, a registration exam and the College's practice requirements.

OHIP does not cover a registered psychotherapist. As a non-physician provider, their private-practice services are not insured; you pay privately or through benefits, unless you see them inside a hospital or public program.

An RP performs the controlled act of psychotherapy, which is the assessment and treatment of cognitive, emotional or behavioural disturbances. They do not communicate a diagnosis and do not prescribe.

A registered social worker is registered with the Ontario College of Social Workers and Social Service Workers. The titles "social worker" and "registered social worker (RSW)" are protected, and it is illegal to use them without registration. Registration is based on an accredited social-work degree.

OHIP does not cover a registered social worker in private practice, for the same reason: they are not a physician. Many social workers provide talk therapy, often addressing the social circumstances around a person's mental health. Seen inside a hospital, a Family Health Team or a community agency, their service is free to you. An RSW also performs the controlled act of psychotherapy, and does not diagnose or prescribe.

The rule running through the whole table is that OHIP pays for physicians, not for professions. The Government of Ontario's page on what OHIP covers insures doctors' medically necessary services and lists services from non-physician providers outside a hospital as not covered. So a psychiatrist and a family doctor are insured; a psychologist, a registered psychotherapist and a registered social worker are not, when you see them privately.

"Not covered by OHIP" is not the same as "not free." A psychologist, psychotherapist or social worker employed by a hospital, a Family Health Team or a publicly funded program costs you nothing, because that service is paid from a public budget rather than billed to OHIP. The full profession-by-profession breakdown, with the fee codes, is in our guide to what OHIP covers for therapy.

• You want insured therapy. Look for a physician who provides it, through medical psychotherapy, or ask your family doctor. A psychiatrist needs a referral; a family doctor does not.
• You want free therapy without a doctor. Ontario Structured Psychotherapy provides free cognitive behavioural therapy by self-referral, with no health card needed. See also the main free therapy routes in Ontario.
• You are ready to pay privately. A psychologist, registered psychotherapist or registered social worker can be seen directly. Check whether your extended health benefits cover their profession, since coverage often differs by title.