insurance and therapy costs
caring for your mental health
Investing in your mental health is just as important as caring for your physical health. Therapy can strengthen your relationships, reduce stress, and improve your overall well-being. Unfortunately, insurance coverage for therapy is often limited or confusing.
why many therapists don’t take insurance
People may wonder why so many therapists don’t take insurance. The reality is that using insurance often comes with trade-offs that affect your privacy and the quality of care you receive. To bill insurance, therapists must assign a mental health diagnosis—even if you’re seeking support for self-growth, relationship concerns, or navigating life changes. That diagnosis becomes part of your permanent health record. Insurance companies also require treatment notes and limit what methods therapists can use, meaning your care is shaped more by your plan than by your unique needs.
benefits of ‘private pay’ verses insurance
By working outside of insurance, therapy remains confidential, flexible, and tailored to you. For many clients, this leads to more personalized and effective support. Here are several reasons you may opt to pay for therapy out-of-pocket:
Confidentiality — Insurance requires sharing your diagnosis and sometimes treatment notes.
Flexibility — Insurance companies restrict which methods are covered, limiting your therapist’s ability to tailor care.
Personalized Care — Many people seek therapy for growth, relationships, or life transitions, which aren’t always covered by insurance.
Choice — Paying privately allows therapy to remain focused on your goals, not insurance requirements.
how insurance works in my practice
I don’t bill insurance directly, but I can provide a monthly statement (called a superbill) that you can submit to your insurance company for possible reimbursement.
If your insurance doesn’t provide coverage, or only covers part of the cost, you may be able to use a Health Savings Account (HSA) or Flexible Spending Account (FSA) through your employer.
how to determine if our sessions may be covered
Before starting, it’s a good idea to call your insurance provider and ask a few key questions to understand your coverage. See the sections below for the specific questions to ask your insurance carrier. Have a pen and paper handy to take notes. You may also want to ask for the name of the representative you speak with and a reference number for your call.
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for Individuals
Does my plan include coverage for outpatient mental health services?
Does it specifically include psychotherapy?
Provide these CPT codes to ensure they're covered: 90834 (50-minutes) and 90791 (initial intake).
Does my plan cover out-of-network providers
If yes, what is the reimbursement rate for out-of-network providers?
Is there a limit to the number of therapy sessions I can have per year?
Does my plan reimburse for longer individual therapy sessions?
Provide this CPT code 90837 (for 60 minutes)
Is there a deductible I must meet before coverage begins?
How much is it, and how much of it have I already met?
What is the "usual and customary rate" for psychotherapy sessions?
Many insurers only reimburse a portion of this rate, meaning you would pay the difference between the insurance reimbursement and the full fee.
Are there any exclusions I should be aware of?
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Does my plan include mental health services?
Does it specifically include couples counseling or family psychotherapy?
Provide these CPT codes to ensure they are covered: 90846, 90847, and 90791 (initial intake).
Does my plan cover out-of-network providers?
If yes, what is the reimbursement rate for out-of-network providers?
How many sessions are covered per year?
Are there limits I should know about?
Is there a deductible I must meet before coverage begins?
How much is it, and how much of it have I already met?
What is the "usual and customary rate" for family psychotherapy sessions?
This is the amount your insurance considers standard. They often only reimburse a portion, so you may pay the difference between their rate and my fee.
Are there any exclusions I should be aware of?
Important note: If you have chosen to have 75-minute or 90-minute sessions to support our work, your insurance will most likely reimburse you only up to the standard 50-minute session rate. You'd then pay the difference between that and the full fee.