Using insurance in-network
If a therapist is in-network with your plan, you pay a copay or coinsurance and the therapist bills your insurer. Before your first session, call the member services number on your card and ask:
- Is this therapist in-network for outpatient mental health?
- What's my copay or coinsurance per session, and have I met my deductible?
- Do I need a referral or pre-authorization?
- Is there a limit on the number of sessions?
Federal parity law generally requires plans to cover mental health on terms comparable to medical care, so if something seems off, it's worth asking.
Out-of-network and superbills
Many therapists don't take insurance directly. If your plan has out-of-network benefits, you pay the therapist in full and they give you a superbill, a receipt with the codes your insurer needs. You submit it and get part of the fee back. Ask your insurer what percentage they reimburse and whether a deductible applies first.
Paying out of pocket
Fees vary a lot by location and license type. Master's-level therapists often charge less than psychologists, and psychiatric visits cost more. If you're paying yourself or not using insurance, U.S. law gives you the right to a written Good Faith Estimate of what your care will cost before you start.
Sliding scale fees
Some therapists lower their rate based on income. They may not advertise it, so it's fine to ask. Open Path Collective is a nonprofit network of therapists who offer reduced fees.
Lower-cost options
- Medicaid and Medicare cover mental health care. Provider profiles on Tendwell show when a provider is registered with a state Medicaid program.
- Employee assistance programs (EAPs) often include a few free counseling sessions. Check with HR.
- Community mental health centers offer care on a sliding scale, often regardless of ability to pay.
- University training clinics have supervised graduate students who see clients at reduced rates.
- Associate-level clinicians working toward full licensure often charge less.
- Group therapy usually costs much less than individual sessions.