The out-of-pocket cost will vary depending on whether you use insurance and what your individual insurance plan requires of you. It is best to contact your insurance company before you schedule an appointment and find out what your mental health benefits are. Below are helpful questions to ask: 

• Is the therapist I want to see In-Network (in my health insurance network)?

• What is my deductible (what I have to pay before my insurance starts paying) for in-network mental health benefits?

• How much is my co-payment (my cost-sharing portion of the bill) for mental health services?

• Does my plan limit how many therapy sessions are allowed per year?

• What is the policy year (i.e., Jan 1 – Dec 31)?

• Does my policy cover 60-minute sessions? 

• Does my policy cover telehealth (if this is a service you would prefer)?

If the therapist you want to see is not in your insurance network, you may want to find out if  they are an “Out-Of-Network” provider for you. Some insurance companies will still allow you to see this therapist, but they may require you to pay a higher co-insurance/portion of the bill. In this case, you will want to ask:

• Does my insurance company allow Out-Of-Network (OON) Mental Health Benefits?

• If so, how much does my insurance pay for an OON provider? This is usually a percent (i.e., 70%). 

• Does my OON payment count toward my deductible? If so, what is my OON deductible? Is it different than my in-network deductible?

• Does my OON payment count toward my deductible?

• Is approval required from my primary care physician (i.e., pre-authorization)? 

If you decide to see an Out-Of-Network therapist, you will be responsible for the portion of the bill the insurance company does not pay. The process works like this: you have a therapy session and pay for the session in full at the end of the session. Your therapist gives you a SuperBill as a receipt for your payment. You send the SuperBill to your insurance company and they reimburse you according to their Out-Of-Network rate. For example, if you have Out-Of-Network benefits at 70%, you will pay for 100% of the therapy session cost and get reimbursed 70% of that payment by your insurance company.

Note: Whether you use in-network or out-of-network benefits, any cost not covered by your insurance is your responsibility. 

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Some people choose not to use insurance at all, using a direct pay option. In this case, you would pay for the session with HSA, cash, check or credit card. Your therapist may offer a reduced day-of-service rate

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Good Faith Estimate: If you are not enrolled in a plan or coverage or a Federal health care program (uninsured individuals), or are enrolled but not seeking to file a claim with your plan or coverage (self-pay individuals), you may request a good faith estimate of the expected charges you may be billed for.

A good faith estimate will be provided within 3 business days upon request. Information regarding scheduled items and services will be furnished within 1 business day of scheduling a service to be provided in 3 business days; and within 3 business days of scheduling a service to be provided in at least 10 business days.