How Much Does Therapy Cost?

Woman sitting in chair with notepad on her lap, looking into the distanceCost is one of the greatest barriers to mental health treatment. Although the Affordable Care Act and other regulatory reforms sought to improve access to behavioral and mental health services, many people worry about the costs of therapy. While the cost of therapy is a very real concern, it is often possible for people to access free or low-cost therapy, especially if they live in large metropolitan areas or near a teaching university.

Average Cost of Therapy

Therapy generally ranges from $65 per hour to $250 or more. In most areas of the country, a person can expect to pay $100-$200 per session. Some factors that can affect the price of therapy include:

  • The therapist’s training. Highly trained and very experienced therapists typically charge more.
  • The location of therapy. Therapists in large metropolitan areas and regions with high costs of living must charge more to pay their bills.
  • The therapist’s reputation. Well-known therapists who are highly in demand often charge more.
  • Insurance coverage. People whose therapy is covered by insurance tend to pay less.
  • Length of the therapy session. The longer the session is, the more a client typically will pay.
  • Specialization. Therapy tends to be more expensive when the therapist is an expert in a highly specialized field or treats an unusual or challenging condition.

Some therapists also charge more for a longer initial consultation.

How Much Does Therapy Cost With Insurance?

Under the Affordable Care Act, all insurance plans must cover mental health care. Additionally, plans must not impose different rules on mental health clients or fund mental health care at lower rates.

This means people with insurance usually have some coverage for therapy. In most cases, they must choose a therapist within their network. They may also have to meet other criteria, such as having a mental health diagnosis, meeting a deductible, or getting a referral for treatment. Consequently, even people with insurance may opt to pay for their therapy out of pocket.

When people pay for therapy through insurance, they typically must pay a co-pay. Insurance co-pays vary widely, from just a few dollars to $50 or more.

How to Pay for Therapy

For many people, insurance offers the best option for funding therapy. Try calling your insurer to ask about mental health coverage and to get a list of in-network providers.

If you don’t have insurance, you may be eligible for insurance through your state’s Medicaid program or through the Healthcare.gov marketplace.

Some employee assistance and benefit programs also offer help paying for therapy.

Many universities offer free or sliding-scale therapy programs to people pursuing training as therapists. Try calling schools near you to ask about access to low-cost therapy.

Additionally, some therapists offer therapy on a sliding-scale basis. Consider asking about this option when you interview therapists. Some therapists may also offer payment plans that allow you to pay for therapy over time.

Many therapy practices also employ novice therapists who need experience. These interns or apprentices may offer free or low-cost mental health care.

Telehealth services, which offer counseling online or on the phone, may also be more affordable.

Is There a Way to Get Free Therapy?

A number of clinics are working to expand access to health care services, including mental health services, by offering free or discounted treatment. The National Association for Free and Charitable Clinics, for example, offers free and low-cost care.

Some other options for finding free therapy in your area include:

  • Contacting your state’s department of public or community health. Many offer community mental health clinics or referrals to free or low-cost services.
  • Enrolling in studies for mental health conditions. If you have a specific diagnosis, your local college or university may be researching your diagnosis. You can often get free care, including medication and therapy, by enrolling in such a study.
  • Seeking care at a college or university clinic. If you are a student, you may be eligible for free care at your college or university. If you are not a student but are located near a university that has a mental health care program, students in that program may offer free treatment to meet licensure requirements.

What Therapists Say About the Costs of Therapy

Vallejos-Lisa
Lisa M. Vallejos, MA, LPC, NCC
: Therapy costs have an extremely wide range. I know clinics that charge as little at $5 per session and others that charge $300 per session. It really is dependent on the therapist, your location, and the going rate for therapy in your area. There are many things to consider in addition to the cost that I would like to address.

Another factor to consider is whether you plan on using your insurance for therapy. In that case, you will likely be limited to however many sessions your insurance will pay for, which can vary. Also to consider if you are using your insurance, is whether there are only certain types of therapy that are covered, such as cognitive behavioral therapy. If you are paying for therapy with insurance, also consider that to be covered by insurance you must have a “covered” diagnosis. Your therapist will diagnose you and will list that diagnosis on your reimbursement paperwork. You will likely have a co-pay to pay when you seek insurance-reimbursed therapy, so be sure to find out how much that is as well.

Many therapists elect not to take insurance to avoid having to diagnose and the challenges that come with working with insurance companies, so it may be worth your while to ask the potential therapist to work with you on a fee that you can afford to bypass insurance.

Finally, many therapists will work on a sliding fee scale, but they do not always advertise that. A sliding scale is a payment structure that is based on your income. You can ask your potential therapist if they do, and if they do not, would they consider doing it for you.

Cohen-MarlaMarla B. Cohen, PsyD: The price of therapy varies. Many insurance plans cover psychotherapy, and if you choose to work with a provider within your network, you will only need to pay your typical co-payment. Should you choose to see a therapist outside of your insurance network, you will find that therapists charge different rates depending on their office location, level of education, and degree of expertise in their field.

Some therapists may charge as much as $200 or more per session, but most will charge $75-$150 a session. Many therapists work with a sliding scale fee schedule, which means their fee will depend on your income level. If you have out-of-network benefits with your insurance plan, you may be reimbursed for the majority of what you pay the therapist. Your therapist’s office can create a ledger for you to submit to your insurance company for reimbursement. If costs are an issue, many areas have community mental health agencies that provide therapy at a reduced fee.

fuller-staceyStacey Fuller, LMFT: When it comes to the cost of therapy, there is no set industry standard. The cost of therapy can vary widely depending on a number of factors.

Some therapists are part of a panel of providers who accept a particular insurance. In this case, the cost of therapy may only be a co-pay and/or deductible payment determined by the insurance company. Typically, insurance companies will limit the number of sessions they pay for in a calendar year so it is important to check with your insurance provider prior to initiating therapy to determine how much of the cost of treatment will be covered.

Some therapists choose to not accept insurance and instead offer fee-for-service (otherwise known as private pay) only. How private pay therapists set their rates is dependent on a number of factors: area, specialization and specialized training, number of years of experience, how in demand they are in the community, etc. In my area private pay therapists are typically priced anywhere from $65 on up to $250 a session. In other areas of the country, the prices may be quite different. Checking out some GoodTherapy therapist profiles in your area will give you a general sense of the cost of private pay therapy.

Free or low-cost therapy is often available for people with limited financial means through local clinics, hospitals, and community agencies. Frequently these providers are students in training or mental health interns who provide therapy at a low rate or free of charge in exchange for experience hours towards licensure.

Getting Help

Therapy can be expensive, particularly when you look only at the price tag and not the total value. Yet therapy can also confer significant benefits, including an improved financial outlook or better career prospects. People who are less productive because of depression, who suffer from creative blocks, who struggle to identify the right career path, who engage in compulsive shopping or gambling, and who experience problems at work may ultimately have more money as a result of therapy. Even when therapy does not offer a direct economic benefit, it can greatly and permanently improve a person’s life.

People considering therapy should consider the overall value of therapy, not just the cost. To find a therapist who can bring real value to your life, click here.

References:

  1. Gold, J. (2017, November 30). Health insurers are still skimping on mental health coverage. Retrieved from https://www.npr.org/sections/health-shots/2017/11/29/567264925/health-insurers-are-still-skimping-on-mental-health-coverage
  2. Mental health and substance abuse health coverage options. (n.d.). Retrieved from https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage
  3. Rowan, K., Mcalpine, D. D., & Blewett, L. A. (2013). Access and cost barriers to mental health care by insurance status, 1999-2010. Health Affairs, 32(10), 1723-1730. doi: 10.1377/hlthaff.2013.0133

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • 16 comments
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  • John

    John

    October 31st, 2014 at 10:11 PM

    I am glad that I am getting good help at 59, but I went the route of low-cost therapy for people with limited financial means through a local church ministry with students in training or mental health interns who provide therapy at a low rate or free of charge in exchange for experience hours towards licensure. For me,it was all I could afford and looking back, the quality was lacking. I then paid $80/hr to a psychologist for 2 years and felt it was a waste of $$$$. Bottom line, except for my current therapy with an excellent retired MSW, I find that most therapists are in it for the $$$$$ and only want YAVIS customers. Young Affluent Verbal Intelligent and Successful. In other words, my ideal client is someone who can pay my top rate and who doesn’t demand a lot of me. My anger towards past therapy and many therapists will never go away, I am more compassionate with interns — but NOT for so-called professionals. BE GOOD OR BE GONE!

  • Joseph

    Joseph

    November 3rd, 2015 at 2:55 PM

    This article should explain why therapy is so expensive and account for all the costs that go into it. I think $75-150 seems to be the average, but that varies depending on your city. talkspace.com/blog/2015/10/how-much-does-therapy-cost-and-why-is-it-crazy-expensive/

  • Workerbee

    Workerbee

    March 11th, 2018 at 12:42 PM

    Having been a counseling client in the past and a licensed counselor by training, the reason that counseling costs what it does is simple: a) the therapist is usually an independent contractor/business owner. As such, they don’t get paid time off as they would in a traditional full-time job. If the therapist doesn’t work, they don’t get paid. b) most therapists will have a no-show or late cancellation policy, meaning they may charge some fee for to the client who is a no-show as that time had been reserved for them that couldn’t then be spent with another client; c) the therapist most likely has to pay office space and/or office staff to answer phones, help with billing insurance, etc., d) a qualified therapist must be licensed by the state in which the practice, and all licensing boards require on-going continuing education for licensees; e) liability insurance, f) testing instruments (such as MMPI-2, etc.), g) documentation that a client may request for family court or for an employer, insurer, etc. and h) probably the biggest reason that therapy costs what it does is that insurance companies only pay a fraction of what the therapist may charge (so when a therapist charges $150/hour, your insurance may only allow their contracted providers to charge $75/hour. Of that $75/hour, you may have only a $35 co-pay per visit, and the insurance would pay the therapist the other $40. The therapist basically writes off or ‘eats’ the rest.

  • Tass

    Tass

    January 17th, 2016 at 1:29 PM

    Watch out for clinics that advertise “sliding scale fees”. One of them said they would work with me, then decided not to. They said I had to pay $100 an hour no matter what. When they found out my insurance would not cover counseling, they dropped me altogether and wouldn’t negotiate any type of fee that would be more affordable. I would have been able to continue on at $75 an hour, but they were not willing to negotiate. If a clinic advertises sliding scale fees and then refuses to honor that or work anything out, it should be reported as fraud.

  • eg

    eg

    February 16th, 2017 at 12:11 PM

    Keep in mind a few things. First it depends on the area you seeking therapy in. I know that the price of 100 or 150 seems like so much but therapists usually are paying for the office space, all costs of keeping the lights on, they have no benefits like health insurance for themselves, expensive malpractice insurance, retirement, sick day, etc… Then when you are self employed you get hit with a big self employment social security tax, you basically pay your share and the share that a employer would typically pay. Now while some therapists can see a lot patients a week, many can not, think about it.. there is no way to see 40 patients a week and do good work… I find that 20 is the max for me personally. There is enormous work that is done beside the actual clinical hour. Note writing, insurance billing, scheduling, pt crisis calls… these things take up easily 5-10 hours a week depending on the practice… it is not nearly 100-150 when all is said and done that the therapist is after expenses income. Overhead can run in up to well over 2K a month so they are not making 100-150 an hour… it just seems like it

  • Andrea

    Andrea

    May 9th, 2017 at 4:35 PM

    Thank you.

  • Mary

    Mary

    April 24th, 2016 at 11:08 AM

    I’m thinking currently in a battle with Alta California Regional Center and I have to warn parents of them… When they intake your child the child becomes there property; it’s in are Lanterman Act but not disclosed to you… I’ve since fired them hence the battle for not supplying my son with previously approved CBT and other illegal moves on there part… I kept there psychiatrist because he is good and is on my sons side not there’s… My son finally has the right diagnosis of Autism and Schizophrenia… But it’s been rough in finding him a therapist… We have another intake on Monday with someone who said they have a sliding pay scale; but come to find out we’re at the top of his scale at $150.00 per session… We are low income and have had the experience of being BEACON clients and the therapist was not doing her job… No one explained he would be rediagnosed and I expressly told her I want no such thing done… She assured me she is a therapist and would never over ride a Developmental Pediatrician from the MIND Institute; she lied… She coded under another doctor…. Same with Yolo Family Services there therapist tried the same and failed because I turned them down flat also… My son is Schizophrenic and developmental I agree, but just because it’s the cheapest way to go doesn’t make it right and I’m speaking of ABA… We have gone that route twice and through school also the last time he went to Sutter for a danger to himself and others, he was a complete mess… I am dual diagnosis also and I finally kicked the psychotropics and am able too live a happy life as a loving mother of three kids two on both spectrums and one on the Autism only… But I reached this through seeing a psychologist every Monday and a psychiatrist every Friday with classes in between with the help of Kaiser… I’m a firm believer in medication in the interim and therapy always… But how do you find the right therapist it’s very hard out of network

  • Kathleen M

    Kathleen M

    May 20th, 2016 at 6:42 AM

    I am sorry for all the poor experiences people have had with therapy. That’s shameful. I am a clinical psychologist and truly believe in the power of therapy. You must find a good one! Don’t give up…they exist!

  • denise

    denise

    May 23rd, 2016 at 5:03 PM

    Hey i was in a car accident and my back hurt 27 7 im in pain all day please let me no something

  • Milagros

    Milagros

    May 22nd, 2017 at 8:09 AM

    My daughter had a stroke need therapy but her insurance is limited. Cant afford. Where can I find help. Please help. Thank you.

  • Olive

    Olive

    July 8th, 2017 at 8:52 AM

    Fantastic blog! Do you have any helpful hints for aspiring
    writers? I’m hoping to start my own site soon but I’m a
    little lost on everything. Would you recommend starting with a free platform like WordPress or
    go for a paid option? There are so many options out there
    that I’m totally overwhelmed .. Any suggestions?

    Thank you!

  • John

    John

    October 2nd, 2017 at 11:48 PM

    Hi, I was just referred to psychologist for a 1 hr. Session and I gave Regence Blue Shield. My deductible was $391. I feel ripped off. I am on a limited retirement income.I am going to find another Clinic or maybe go without a Doctor. It appears they can charge whatever they want at the moment. Do I have any recourse? Thank You

  • Arsen

    Arsen

    January 15th, 2019 at 8:57 PM

    What the “session means” how much time it takes and how many of them people need??

  • Ana S.

    Ana S.

    February 19th, 2019 at 4:14 AM

    The public obviously doesn’t recognize the sacrifice it requires to go into extensive debt for one’s education and training. Most therapists in recent years must also pay for their own post-degree supervision hours, which runs into thousands of hours for which they pay for out-of-pocket because there are so few funded training sites. In the old days hospitals and government institutions were more than happy to provide training spots and many of these positions were funded by the federal government albeit at very low cost. Since insurance cos. refused to reimburse hospitals and clinics for services performed by residents about 20 years ago, the training spots have dwindled. Also, in spite of incurring 5-6 figure student loan debt, psychotherapists do not make a lot of money. There is substantial overhead attached to running a practice and insurance reimbursement rates have not kept up with inflation or COLAs. In fact, over the last 30 years, insurance reimbursement rates have declined by over 50 percent with rates averaging less than a dollar increase annually. In contrast the salaries of members of Congress have risen by by over 55% during the same time range and incomes of insurance executives and their employees have also risen handsomely. Yet many MH professionals in private practice do not provide themselves with benefits because they cannot afford to do so unless they have a partner or spouse who is covered. There is a Mental Health Parity Act that was passed in 2008 and was supposed to put mental health coverage on par in every respect with other medical coverage. That still has not been the case. There are other laws that have prevented MH professionals (and also primary care physicians) from negotiating equitable rates and the laws enacted during the mid to late 1990s prevent these professionals from bargaining collectively and gives insurance companies control over determining the rates. In effect, running a mental health practice in many, if not most, parts of the country is not sustainable. As health insurance companies persist in not granting COLAs and keeping reimbursement rates up with inflation, MH professionals will vote with their feet so that they may also meet their obligations and live a sustainable life as well as repay student loan debt. I hope that MH professionals continue to fight for MH Parity and Equity and that the public advocates as well.

  • Barbara

    Barbara

    July 22nd, 2019 at 3:40 AM

    Thank you for taking the time to write your comment. I strongly agree with you. I am a licensed mental health counselor and feel frustrated with how difficult it is to keep explaining why mental health is important and why getting services from a provider costs what it costs. I see it often, clients don’t fully understand the value of this service and hold unrealistic expectations as to how much or even why they should have to pay our fees. Yes, it is true that there are unethical therapists out there. It is also true that most therapists are hard working, well trained professional who have done their homework and paid their dues, who deserve to be paid and have a profitable practice that can allow them to also have a good quality of life and provide for their families as every other business owner does. Besides, who in their right mind would want to underpay for any service? Most of the time I believe, it is a matter of priorities clients may have. Some clients would not think twice about spending $100 eating out of buying things they don’t necessarily need, but think twice before paying their therapist. I find that clients who value our service are less resentful about paying for a therapy session and are more invested in the process. Again, thank you.

  • S-Chan

    S-Chan

    August 25th, 2019 at 9:41 PM

    People can buy those things as a cry for help or to help them feel better for themselves while harsh stipulations in the United States healthcare lets its citizens suffer and are imposed on them. Just because they may buy something for them once in a while (and as a therapist, you should know that self care comes from a variety of mind sets, even if it’s not what you or I would do) is important. Please don’t act holier than thou just because someone decided to buy something nice for themselves while they wait for therapists and insurances do their jobs. Also, there are people who genuinely can’t afford either a $100 meal or a therapist, so please reconsider your argument.

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