Care-First Auto Insurance for Therapists in Alberta 2027

On January 1, 2027, injuries from car collisions in Alberta move to a new auto insurance system called Care-First. If you see clients after a collision, the way you get approved, document and get paid is about to change.

The Government of Alberta has published resources for health care practitioners and a guidebook for insurers. They're thorough, but most of the detail is about physical injuries. So I've pulled together what therapists need to know about mental health care, and what still hasn't been decided.

The new rules apply to accidents on or after January 1, 2027. If your client was hurt before then, nothing changes for them.

Looking for something to share with clients? See Care-First Auto Insurance: Therapy After a Car Accident.

What's changing for mental health care

Right now, psychological treatment after a crash shares the $50,000 medical and rehabilitation limit with all other care, for up to 2 years. Under Care-First, there's no fixed cap.

Medical and rehabilitation benefits cover reasonable expenses until your client reaches maximum medical recovery, and potentially for life. The trade-off is that more of the process runs through the insurer: approvals, treatment plans and progress reports.

The three treatment streams

Care-First sorts care into three streams, depending on the injury: Program of Care, Customized Treatment and Catastrophic Treatment.

Stream 1: Program of Care

Program of Care is for common physical injuries, like neck, shoulder and back injuries, and concussion in adults. It follows set, evidence-based care pathways and is delivered by chiropractors, nurse practitioners, physicians and physiotherapists. If treatment starts within 12 weeks of the accident, no insurer approval is needed for the assessment or treatment.

Stream 2: Customized Treatment

Customized Treatment is for injuries with unique or more complex recovery needs, including mental health. Each person gets their own treatment plan, and treatment always needs insurer approval. The assessment sometimes needs approval too, depending on the injury. For mental health, the assessment always needs approval before the first appointment, and treatment is approved after you send your plan.

This is where therapy fits. Many of your clients will be in two streams at once: Program of Care for a physical injury like whiplash, and Customized Treatment for their mental health care with you.

Stream 3: Catastrophic Treatment

Catastrophic Treatment is for amputations, acquired brain injuries, spinal cord injuries and other catastrophic injuries. Acute hospital care doesn't need approval, but post-acute services may.

Mental health care, step by step

1. Your client gets insurer approval before the first appointment. This is the big difference from physical injuries. An initial mental health assessment always needs approval first, no matter how soon after the accident it happens.
2. You do the initial assessment. It has to be done by an authorized mental health practitioner, and Alberta hasn't said who that is yet (more on that below).
3. You send a treatment plan. After the assessment, you submit the Initial Assessment and Care and Treatment Request (Mental Health) form.
4. The insurer has five days to decide. Once the plan is approved and you and your client hear back, treatment goes ahead.
5. You report progress and invoice. Care-First expects you to report on recovery and outcomes, support requests for more treatment, and send invoices with the required information.

How insurers decide

Insurers have to weigh every treatment request against four questions, set out in section 8 of the Benefits, Treatment and Care Regulation. Will the treatment:

• be evidence-based?
• help your client recover from the injury, or address a decline in physical or mental function?
• be reasonable for the expected benefit?
• be the most appropriate and cost-effective option?

So write your treatment plans with those questions in mind. Name your evidence-based approach, the functional goals, and how you'll track progress. Alberta's Customized Treatment Guide has more on initial assessments and care and treatment requests.

Who counts as an authorized mental health practitioner?

It hasn't been announced yet. Alberta's guidebook for insurers says more information on who can do initial mental health assessments will be set out in future communications to support the implementation of the Care-First system.

Psychologists are named as an example in Alberta's public materials. Social workers, counsellors and psychotherapists haven't been mentioned either way. Keep an eye out for the announcement, and check with your college or professional association.

Grief counselling after a death

Grief counselling for families gets a lot more funding than before: up to $4,310 per person in 2025 dollars (about $4,426 in 2027), up from $500 per family.

It's for people who were close to someone who died in an accident: spouses and partners, parents, children, siblings, grandparents, grandchildren, and others with a family-like relationship.

The counselling can be provided by:

• a regulated professional authorized to perform psychosocial interventions
• clergy or a spiritual leader of the person's faith
• for Indigenous people, an Elder or spiritual leader of an Indigenous group

The counsellor can't be related to the person they're supporting. With prior insurer approval, travel can be covered when the round trip is more than 100 km.

The Care-First Health Care Practitioner Registry

The registry is a public directory, but for now it only lists clinics offering the Program of Care or Daily Living Assistance assessments.

Joining is voluntary, and you don't need to be listed to provide Care-First services. Alberta says the registry will grow to include more services. In the meantime, if you don't offer the Program of Care, the guidance asks you to point eligible clients to the registry so they can find someone for their physical injuries.

What to do now

• Watch for Alberta's announcement of who counts as an authorized mental health practitioner.
• Check what your college or professional association says about Care-First.
• Add the accident date, insurer and claim number to your intake for clients hurt in car accidents.
• Plan for the approval step, and let new clients know they need insurer approval before the first session.
• Get to know the Care-First forms, especially the Initial Assessment and Care and Treatment Request (Mental Health).
• Write treatment plans around functional goals and evidence-based approaches.
• Coordinate with your client's physiotherapist, chiropractor or physician when they're also in a Program of Care.

MVA Therapy in Alberta

More approvals and paperwork can feel like the opposite of trauma-sensitive care. They don't have to be.

MVA therapy offers a space to understand what the body and mind went through after a crash, and to feel safe on the road again.

Having an insurer in the picture can change how therapy feels, for you and for your client. But when you understand the process, you can support your client's sense of control. Explain the approval process early, so it feels predictable. And with no cap, care can follow your client's pace, as long as you show it's helping them recover.

Care-First changes the paperwork, not the heart of the work.

This article is general information for health care professionals, current as of November 2026. It isn't legal or billing advice. Care-First rules and guidance are still being released, so check alberta.ca/care-first-auto-insurance and your regulatory college for current requirements.

If you or someone you care about is in crisis or at risk of harm, please get help now. Call 911 or go to your nearest emergency department. You can also call or text 988 any time for suicide and crisis support. For more options, see our crisis support page.

About the Author

Carol Korenowski is a writer, speaker, and mental health advocate who created Therapy Alberta.