Cost and Insurance Coverage
How much therapy costs—and how it will be paid for—are important concerns for many people who consider seeing a therapist. If the price of therapy presents an obstacle, there are a number of ways to find treatment that is both effective and affordable. They include speaking with prospective therapists about ways to manage costs, consulting with therapists who use a sliding-scale fee structure, and determining whether a therapist’s fees can be covered (in part or in whole) by insurance.
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The cost of therapy depends on a number of variables, including the training and experience level of the therapist and the location of the therapy—the average fee in some regions is considerably higher than in others. In the U.S., the fee for a single session frequently falls between $100 and $200, but many providers will offer lower fees, while some charge more. The ultimate cost to a client also depends on whether health insurance is involved.
Many health insurance plans offer mental health care coverage, but not all therapists accept insurance—many require clients to pay the full fee “out of pocket.” When therapy is covered by insurance, the client will usually pay a “co-pay,” or portion of the fee. Psychology Today's Therapy Directory allows users to sort nearby therapists based on the types of insurance they accept.
Some insurance plans offer reimbursement for sessions with a therapist who is not on the insurance company’s list of in-network providers, which they reimburse at a higher rate than out of network providers. A client’s insurance company can provide information on whether this is the case. Insurers are likely to pay for a smaller portion of the fee for an out-of-network provider than they will for a provider who is in-network. But reimbursement can allow a client to see a preferred therapist who does not accept the client’s insurance—without having to cover the full cost.
Some therapy practices offer a sliding-scale fee, or a fee that can be higher or lower based on a client’s income. Finding a therapist who uses a sliding scale is one way for individuals who are concerned about the cost of therapy to access affordable treatment. Information on whether a therapist uses a sliding scale is included in the Finances section of listings in the Therapy Directory.
The primary reason that many therapists don’t accept insurance is economic: rates of reimbursement by insurance companies are deemed too low to sustain a private practice. For clients seeing a therapist who does not accept insurance, asking whether a therapist offers a slide-scale fee and seeking partial reimbursement from an insurance company for out-of-pocket expenses are two ways to reduce the cost of therapy.
Community mental health clinics, therapist training centers, local support groups, online therapy, and other forms of support for mental health concerns may be less costly than traditional talk therapy, but can still be helpful resources for those with concerns about affordability. Caution is warranted in determining that a relatively low-cost mental health professional has adequate clinical training (or is in the process of receiving it). In the U.S., the SAMHSA National Helpline (1-800-662-HELP) offers free referrals to help connect callers with state-funded treatment options.