Paying for therapy

Many people may want to try therapy, but aren’t sure if it’s affordable or not. In fact, cost is the number one reason people don’t get the mental health care they need. But there are many ways to make therapy more affordable, including choosing a therapist that’s in-network with your health insurance plan. Read on for the answers to common questions about how to pay for therapy.

What is the average cost of therapy?

One therapy session costs an average of $100-$200 in the US, but can be as high as $300 or more. This is the out-of-pocket cost before insurance, which can greatly reduce the cost to the patient. The cost of therapy varies based on factors like geography, therapist experience and specialization, and the type of therapy you’re considering.

Mental health care can be more expensive in areas with higher costs of living, such as New York City or Los Angeles. Therapists with distinct expertise in treating specific conditions, such as eating disorders or PTSD may charge higher fees. Similarly, more intensive therapies (such as EMDR for trauma), or treatment for multiple people (with, family or couples therapy) may be more expensive than individual therapy.

Is therapy covered by health insurance?

Yes, therapy is generally covered by health insurance. Thanks to the Affordable Care Act, mental and behavioral health services are considered essential health benefits and must be covered by most health plans.

This could include psychotherapy (also known as talk therapy, which includes cognitive behavioral therapy (CBT)), substance use and addiction treatment, and inpatient services. However, the extent of health insurance coverage for mental health services varies among different insurance plans. Many insurers offer coverage for therapy as a part of your plan, though co-pays, co-insurance, and deductibles may apply.

Is therapy covered by Medicare or Medicaid?

Yes, both Medicare and Medicaid provide therapy coverage to their eligible populations. If you’re covered by Medicare or Medicaid, you will have coverage for various types of inpatient and outpatient mental health care, preventive services, and numerous types of therapy, including CBT, family therapy, and substance use treatment.

Grow Therapy can help you find licensed therapists who accept Medicare and Medicaid. Learn more about Medicare therapy coverage and Medicaid therapy coverage.

How much does therapy cost with insurance?

Insurance coverage can significantly reduce the cost of therapy. By seeing a mental health care provider who’s in-network with your insurance plan, you can expect therapy sessions to cost as little as $0 to $30.

Depending on your insurance provider, you may be responsible for a copay per therapy session. Some insurance plans will reimburse part of your costs if you choose to see an out-of-network provider, but be sure to confirm details with your health plan. You will also want to consider your deductible and out-of-pocket maximum. Learn more about health insurance and how it works for therapy.

How much does therapy cost without insurance?

Individual sessions paid out-of-pocket typically cost an average of $100-$200, sometimes more. Depending on the mental health services needed, recovery may require 15-20 sessions, totaling over $4,000 without insurance coverage.

For individuals without health insurance, exploring therapists who offer sliding-scale fees and provide lower-cost therapy based on income is worthwhile. Open Path Collective is a good resource for finding sliding fee scale therapists.

What do terms like copay, deductible, and coinsurance mean?

Health insurance companies often use complex jargon, which can be confusing. Let’s break things down a bit more clearly:

• Deductible – A set amount of money that individuals pay for healthcare services before their insurance plan starts to pay
• Copay – A pre-set cost that you pay for healthcare services after paying the deductible (or immediately if the deductible is waived)
• Coinsurance – The percentage of a medical bill you pay after meeting your deductible
• In-network provider – Healthcare professionals who have contracts with your insurance company to offer services at reduced rates
• Out-of-network provider – Health care professionals who are not contracted with your insurance company. You will likely have to pay a higher amount than if you were to see an in-network provider.
• Reimbursement – If you see an out-of-network provider, you may be able to get a superbilll from your provider and submit it to your insurance company for reimbursement.

Learn more about health insurance here.

How much does couples therapy cost?

Couples therapy costs between $75 to $250 per session. Similar to individual therapy, couples therapy prices vary based on location, therapist qualification, session length, and type of therapy or modalities used. Insurance companies do not always cover couples or marriage counseling, as treatment for relationship issues is not classified as “medically necessary.”

However, instances where an insurance company may provide coverage for couples counseling are when there are underlying behavioral health problems or mental health diagnoses, including anxiety, depression, or adjustment disorders. Medicare has recently expanded mental health coverage to include marriage counseling.

Are some types of therapy less expensive than others?

With insurance, in-network providers are generally more affordable than out-of-network providers. Group therapy, typically costing $30-$80 per session, is also a budget-friendly option since the therapist’s time is shared. For those without insurance and paying out of pocket, low-cost therapy services, or therapists or clinics offering sliding-scale fees starting as low as $20, can be a good choice.

Seeing a provider who is still in training and under supervision can also be much more affordable. Costs vary by location, as areas with higher living expenses often have higher therapy rates. Lastly, short-term therapies, like solution-focused therapy, provide a cost-effective option, often lasting only six to eight sessions.

Can I pay for therapy out-of-pocket?

Yes. Paying out-of-pocket is common for individuals without insurance coverage, who are using an out-of-network provider, or are seeking a specialized mental health service that’s not covered by their plan. If you are insured, check with your insurance company to see if your plan allows for any reimbursement of out-of-pocket payments.

How can I get reimbursed for out-of-network therapy?

To get reimbursement for out-of-network therapy, insurance companies typically require you to submit a superbill within a specific timeframe, typically 90 days to six months. Keep in mind that out-of-network coverage varies across different insurance plans.

Reimbursement rates for out-of-network services are typically lower than those for in-network services. Members are responsible for a higher deductible, making the cost go up. Understanding your insurance plan’s out-of-network mental health treatment coverage can maximize your reimbursement.

Can I use my HSA or FSA to pay for therapy?

Yes, you can use a health savings account (HSA) or flexible spending account (FSA) to pay for mental health care expenses, including therapy. A HSA is a tax-advantaged savings account that can go towards paying for qualified medical expenses. Conversely, an FSA is an employee assistance benefit that gives employees a set amount of healthcare expenses through pre-tax income.

Both the HSA and FSA cover mental health treatment costs, including therapy (online and in-person), prescriptions, and inpatient psychiatric care. They also cover copays, deductibles, and direct therapy costs if insurance is limited. Keep in mind that both HSA and FSA cover any mental health condition recognized by DSM-5, with restrictions on marriage and couples counseling.

Why do only some therapists accept insurance?

The choice to accept insurance depends on the mental health professional or clinic. Factors such as reimbursement rates, paperwork, and administrative tasks come into play. Some providers accept Medicare, Medicaid, or private insurance, while others operate on a self-pay basis only. Platforms like Grow Therapy make it easy to filter providers by insurance type, helping you find a therapist covered by your plan, with both in-person and online options available.