How Much Does Therapy Cost Without Insurance?

Mental health has recently become a popular topic throughout America, as more educational institutions, government officials, and health experts label it an essential form of healthcare for the general public. Mental illness can negatively affect people at their jobs, in school, and at home. Due to the relatively new acknowledgment of the benefits that come from a healthy mindstate, more people are considering going to therapy.

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Mental healthcare is a range of services that can help people improve relationships with themselves and those around them. Personal and professional issues can be solved through counseling, and the overall outlook someone has on life can transform when they meet the right therapist. 

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One of the main reservations people have about seeking treatment is the cost of therapy. Although therapy sessions can be expensive, and sometimes difficult to get covered by health insurance, we at Nirvana see mental health services as a necessary resource that should be available to everyone in our community. This article will explain how people can help pay for therapy with out-of-network benefits, how they can find affordable therapy, and what Nirvana can do to help them.

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How much does therapy cost a month?

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The cost of therapy can vary depending on a number of factors. A few things worth considering when looking for counseling include the type of therapy being offered, the length of each session; the therapist’s training and experience, their reputation and if they are in high-demand, and the location in which therapy will take place. 

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For example, someone searching for three-hour sessions of specialized Cognitive Behavioral Therapy (CBT) from a highly-coveted therapist in New York City will be paying significantly more than someone seeking one hour of general talk therapy from a local therapist in rural or suburban Kentucky. 

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That being said, the pricing for therapy across the country ranges from $100-$200 per session, or $400-800 a month. However, this scale is relative and can drastically change based on location. In New York City, the average monthly therapy costs comes out to a little over $830, while the monthly average in Kentucky is $300. This can be attributed to the high overhead costs therapists based in NYC have when factoring in rent and other steep expenses therapists in Kentucky might not have to incorporate into their business plan. In addition, the tenure of a therapist can impact the amount they charge. Therapists with more experience typically charge more than those starting up their practice.

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Clearly there are many factors that go into how much someone will pay for mental health services and the variety in therapy costs throughout the country can be confusing. It’s important to research multiple therapists before making a decision on who to work with, so there is a solid understanding of how much one should expect to pay for their sessions. 

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What is the average therapy session cost?

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As mentioned before, the costs of therapy fluctuate based on a number of factors including the type of therapy, the availability of therapists, and the location of the sessions. In addition, due to the ongoing COVID-19 pandemic, the use of virtual therapy has skyrocketed, which has a few similarities and differences to in-person counseling.

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Online therapy charges by the hour, while in-person charges by session, so virtual therapy sessions tend to be shorter than in-person meetings. It is also easier to schedule and attend online therapy since it can be conducted using a phone or computer. Similar to in-person counseling, virtual sessions normally take place once a week. 

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On average, online therapy costs throughout the country range from $60 to $90 per week (billed every four weeks). This changes based on location, the type of treatment being received, and the availability of the therapist. So, after a client finds a virtual therapist that meets their needs, it will be up to that therapist to determine if they’ll work together. As of late, the amount of therapists offering in-person therapy is limited compared to those offering it online. Furthermore, therapists offering in-person sessions are less common, but more expensive. Prices for in-person therapy average out to $75-$150 per session across the country. 

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People that have health insurance will be able to pay less for both virtual and in-person therapy. Under the Affordable Care Act, all insurance plans are mandated to cover mental healthcare. Additionally, insurers cannot lower their rate for mental health services, or place different rules on members treating mental illness. Normally, health insurance companies will cover a significant amount of therapy costs if a client meets certain criteria, such as receiving a mental health diagnosis, meeting a deductible, or getting a referral for treatment. Insurance companies may also adjust their mental health coverage rate based on whether the client works with a therapist that is in or out-of-network. This means, people with insurance should be able to receive some type of coverage for therapy, and not have to pay entirely out-of-pocket for their treatment. 

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In order to help those looking to get coverage for therapy, Nirvana has created a Peace Of Mind Insurance Coverage Calculator that makes this process fast and simple. The calculator takes in information (like the client’s health insurance provider and the therapist they are working with), and determines whether they’ll be able to receive any coverage for their therapy, and how much they could be reimbursed. Nirvana uses our relationships with insurance providers and therapists to create accurate estimations of how much a client will end up paying for therapy.

What does “sliding scale” mean in therapy?

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For people who receive minimal mental health coverage (or none at all) from their provider, therapists may offer a sliding scale. This is a payment structure based on a client’s income that will allow them to pay a certain percentage of the therapist’s original fee. Establishing a sliding scale requires an honest dialogue between therapist and client to find a comfortable price that will work for both parties. Many therapists offer sliding scales, even if they do not advertise it. More often than not, therapists are willing to work with their clients if the requests are reasonable. 

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If a therapist does not offer a sliding scale option, clients can either look for local low-cost or free community mental health services, or contact the Open Path Psychotherapy Collective. The organization is a nationwide nonprofit network of mental health professionals dedicated to providing in-office and online mental healthcare to people at a significantly reduced rate.

Open Path provides access to transformative and affordable mental and holistic healthcare, striving for a day where all people across the globe can easily access the treatment they need. Through partnerships with licensed mental health clinicians in private practice throughout the US and Canada, Open Path has matched more than 85,000 clients across the country to affordable therapy. 

Between therapists offering sliding scales, and organizations like OpenPath, there are many ways for people to find mental healthcare at an affordable rate. 

How to check out-of-network insurance benefits for therapy? 

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Due to the limited number of therapists that are typically in an insurance company’s network, many people can find themselves looking to receive counseling from someone who is out-of-network. In fact, many people can find therapy that’s closer to them, more specific to their issues, or with a therapist they prefer, when they go out of their insurer’s network. 

When looking to find the type of out-of-network benefits a health insurance plan provides, a good place to start is their company’s website under the “Summary of Benefits” title. Look for the term “out-of-network deductible,” which refers to the amount of money one must pay for therapy before they can be eligible for reimbursement. These deductibles will reset each year, so it’s important to keep the plan’s rollover date in mind when scheduling appointments.

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After visiting the website, clients should call their insurance company to confirm that they understood the information on their website. Their phone number should be available on their website, or their insurance card. Insurers can answer questions about deductibles for in-network and out-of-network mental healthcare, and how to submit claim forms for reimbursement. 

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Thankfully, Nirvana Health offers services that will help clients maximize their out-of-network coverage. We give clients and therapists access to our Insurance Coverage Calculator, which allows them to check their insurance policy to see approximately how much they will have to pay once their insurance coverage is factored in. Nirvana can also provide access to software that automatically files and tracks insurance claims on the client’s behalf, making sure they get reimbursed as soon as possible. 

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How to use out-of-network insurance to get reimbursed for therapy? 

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Another tip when finding a therapist who is out-of-network is to see if they are willing to submit reimbursement claims to an insurance company on the client’s behalf. Some therapists offer this, but typically an out-of-network therapist will require clients to submit their own mental health insurance claims.

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In this case, the therapist will give a client a document known as a Superbill once a month. The superbill functions as a receipt for the treatment received that month, and includes details about the number of sessions and total costs of the care. Clients can mail or electronically submit the superbill directly to the insurance company, who will determine whether they are eligible for any coverage. Clients will pay for the total cost of their session up front, and wait for their health insurance company to mail them a check to reimburse a portion of the costs.

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The Superbill process can be long and confusing. A few issues people face include the tedious process of submitting a superbill, understanding the unclear policies many insurance companies have for out of-network coverage, and needing to pay for treatment up-front and having to wait weeks, or even months, for their insurance company’s reimbursement.

Alternatives to therapy without insurance

Even when maximizing their out-of-network coverage, people may still find going to a private practice therapist too expensive, or inconvenient for their schedules. That being said, people can still find ways to engage in meaningful talk therapy to deal with their struggles or mental illness. In addition to the Open Path Psychotherapy Collective. described above, a few alternatives include group therapy, support groups, and Employee Assistance Programs.

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Group Therapy 

One alternative to individual therapy is group therapy. Individual therapy occurs when one or more therapists work with a single individual in the same session, while group therapy is defined by one or more therapists working with one or more individuals in the same session. Normally, group therapy involves one or two therapists working with a group of individuals who have some type of relation to each other (family, partners, or similar issues). For example, marriage counseling (a type of group therapy for spouses) typically consist of two clients, while group therapy for substance use disorders may consist of 10 or more people. 

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A few benefits of group therapy are individuals being able to see they are not alone, and that other people are dealing with similar issues. This can help relieve some stress and anxiety about therapy, and also give clients a sense of belongingness. People in group therapy may also offer and receive support to and from their group members, creating a broader therapeutic alliance between therapists and clients. Finally, group therapy costs tend to be less than individual therapy, since the costs are divided by how many clients participate in the session.

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Support Groups

A support group can take on many forms, but it is generally a space that allows a number of people to come together and discuss their shared experiences. Discussions are normally centered around a certain topic and everyone's relationship to it such as loss, anxiety, or depression. Support groups can be led by anyone, including licensed psychologists and social workers, or someone who has a similar experience to their group members. 

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Support groups typically occur once a week for about an hour, normally in a relaxed environment where people can take comfort in knowing they are surrounded by those going through similar struggles. Conversations are open, and everyone is given a chance to speak if they want to, but verbal participation is not required. Many people will come to support groups simply to sit, listen, and relate. In addition, attendance at support group sessions is not mandatory, as it is simply providing a space where people can express their feelings and relate to others. This also means different people can attend a session each time, allowing participants to meet a wide range of individuals who are dealing with something similar to them. 

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It is important to note there are different ethical standards between therapy and support groups, primarily the confidentiality of the discussions. Although all support group members are asked not to disclose anything discussed in their group, they are not legally and ethically bound to keep discussions confidential the same way a licensed professional would be. That being said, the costs of support groups are noticeably less expensive than those of therapy. Support group costs can vary, but most have a small fee, or are completely free.

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Employee Assistance Program (EAP)

An Employer Assistance Program (EAP) is a separate benefit offered by an employer to help their employees receive treatment for short-term issues that may distract them from work. Many of these programs offer free or low-cost resources to address a wide variety of issues. A few resources EAPs can cover include:

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Short-term counseling – Counseling with a licensed professional for a limited number of sessions, usually between three and ten, to help address stressful or traumatic events. 

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Substance abuse referral services – Individual and group counseling resources for those struggling with substance abuse.

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Financial counseling – Resources that help employees manage their money responsibly, and learn about investing.

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Workplace trauma counseling – Support for employees who experienced a traumatic event in the workplace that normally involves some type of violence.

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These are only a few of the resources Employee Assistance Programs can offer, normally at no cost to their workers for a limited number of sessions. If the issue is not resolved in the limited sessions, people can transition to their own health plan benefits to continue their treatment. 

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Overall, there are many alternatives to individual therapy for those who may not be able to afford it. If a client is unable to find a suitable therapist match through Nirvana’s extensive network, or its countless tools that simplify paying for therapy, there are still many options they can pursue to find the help they need. 

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