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How Much Does Therapy Cost? Our Ultimate Guide
Therapy has a reputation for being expensive, but it doesn’t have to be. In fact, the costs of therapy vary widely.
You can pay as much as $200 an hour—or more—to see a private practice therapist who’s in high demand and who doesn’t accept insurance. But you can pay as little as $25 per session if you use insurance or find a community counseling center with low sliding-scale rates. Sometimes, you can even get therapy for free.
In this guide, we’ll give you a general idea of what you should expect to pay depending on where and how you get therapy. We’ll also share our tips and tricks for finding affordable therapy. Read on to learn how much therapy costs and why it doesn’t necessarily have to be expensive.
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- Can You Get Therapy for Free?
- How Much Does Therapy Cost If You Pay Out of Pocket?
- How Much Does Therapy Cost If You Use Insurance?
- Why Do Costs for Therapy Vary So Much?
- Why Do Some Therapists Charge So Much?
- How Much Does Medicare Pay for Mental Health Counseling?
- How Much Does Medicaid Pay for Mental Health Counseling?
- How Much Does TRICARE Pay for Mental Health Counseling?
- How Much Does Therapy Cost Without Insurance?
Can You Get Therapy for Free?
Some organizations offer free therapy as a service to members of their communities. You can use the OpenCounseling affordable counseling database and other online tools to research free or low-cost providers where you live.
Note that many programs listed as offering free therapy limit it to people from specific groups, such as veterans or trauma survivors.
Where You Can Sometimes Find Free Therapy
Depending on your area, any of the following programs or provider types may offer therapy for free or for significantly reduced costs:
- Free clinics
- Homeless shelters
- Domestic violence shelters
- Veterans’ groups and organizations
- Churches and other spiritual organizations
- Medical schools with psychiatry departments
- Community mental health centers and other public mental health programs
- Colleges or universities with psychology, social work, or counseling departments
- Non-profit or charitable organizations that are supported by grants and/or donations
There may be therapists in your area who participate in Give an Hour, a national organization that enlists therapists to provide pro bono sessions to veterans and trauma survivors.
Some therapists offer pro bono sessions independently through their own practices. However, they usually limit the number of free sessions they offer each month, and most only offer them to people who meet specific income or clinical criteria. You’ll need to call potential providers to ask if they currently have any pro bono slots open and if you would qualify for one.
How to Get Reduced Rates for Therapy
Many counselors and clinics offer sliding-scale fees based on your income and ability to pay. Many are also willing to negotiate fees even if they don’t already have a sliding scale in place. You’re more likely to be assessed a minimal fee or be able to get counseling for free at a local non-profit or public clinic if your income is at or below the Federal Poverty Level.
If you can’t find or don’t qualify for free therapy, you may still be able to find therapy for a more affordable price than the rates you see private practice therapists charging for your area.
For example, some specialized networks exist to help offset therapy costs. One of them, the Open Path Psychotherapy Collective, offers a lifetime membership for $59, after which you can see any therapist in their network for $30 to $60 per session.
How Much Does Therapy Cost If You Pay Out of Pocket?
On average, out-of-pocket costs for therapy range from $60 to $150 per session. Sites like Thervo and Thumbtack that list rates for local therapists agree on this range, though the true range is even wider.
While the average cost for therapists listed on Thervo is $60 to $120 per session, this means that people who find a therapist through the site pay anywhere from $20 to $250 per hour. The cost range for therapy on Thumbtack changes based on the zip code you enter and may be higher or lower than the national average.
How Low Do Private Practice Rates Really Go?
Note that national therapist directory TherapyDen reports that only 13 percent of private practice therapists charge $60 or less per session—even as a low fee on a sliding scale.
TherapyDen reports a national average low sliding-scale fee of $112 and a national high or full-cost fee of $157. The site acknowledges that these numbers may seem low or high depending on where you live.
A lot really does depend on your location. You’ll pay more for therapy in major metropolitan areas than you will in small towns. In some places, it’s unusual to find therapists charging less than $150 an hour, while in others, it’s unusual to see people charging more than $100.
How Much Does Therapy Cost If You Use Insurance?
For people who have insurance with mental health coverage, the cost of a therapy session with an in-network therapist is usually the same as the average co-pay to see a medical specialist, or about $30 to $50 per session.
Your Insurance Shouldn't Charge More for Therapy
Federal regulations including the Mental Health Parity and Addiction Equity Act (Parity Act) and the Affordable Care Act require insurance companies to charge equitable rates for mental health and medical services. This means they can’t assign higher co-pays to mental health specialists than they assign to medical specialists.
Some plans are exempt from these laws, and others simply don’t follow them. But in many cases, if you know your rights under the Parity Act, you can hold your insurance company accountable. Push back if you find you’re paying more out of pocket for therapy than you’d pay for the same level of medical care.
According to NAMI, your state insurance division and the federal Center for Medicare and Medicaid Services can take action to enforce parity law.
Since they know they can’t simply assign higher co-pays, some insurers try to skirt around the requirements of the Parity Act and Affordable Care Act by finding other ways to limit the number of mental health claims they pay. For example, your insurance company may deny your therapy claims as “medically unnecessary.” When this happens, you have to appeal your denied claims to try to get your insurance provider to pay them. Many people simply give up instead of dealing with the headache.
Beware the Hidden Costs of High-Deductible Plans
If your plan is a grandfathered plan that’s exempt from parity requirements, you may have to pay higher co-pays for mental health care than you do for medical care. You’ll also have to pay more if you have a high deductible plan. Plans with high deductibles require you to pay the deductible before the plan will cover any costs. So, if your deductible is $5000, you’ll be paying a therapist’s standard per-session rate until you’ve paid $5000 toward your deductible for the plan year.
If your plan has out-of-network benefits, you don’t have to see an in-network provider to have your sessions covered by insurance. However, you’ll usually pay significantly more to see an out-of-network therapist than you would to see an in-network therapist.
If your plan doesn’t offer out-of-network coverage, it won’t pay for your therapy sessions unless you find an in-network therapist. Some people believe insurance companies are actively trying to limit the number of therapists in their networks so that people have to pay out-of-pocket or out-of-network rates.
For More Information
For more information on the hidden risks of using out-of-network benefits, you can read our article “Thinking of Seeing an Out-of-Network Therapist? Read This Before You Do.” In this article, you’ll also find tips for how to lower your risks and get the most out of your out-of network benefits.
Why Do Costs for Therapy Vary So Much?
Therapists who live in more expensive locations have to pay higher office rents and higher prices for other professional expenses. Therapists who live in more competitive areas have to invest more in marketing than therapists who live in less competitive locations. They may also have stricter requirements for licensure and have to pay higher licensing and continuing education fees.
Another reason for the wide cost range for therapy is that many therapists offer sliding-scale fees, or adjustable session rates based on clients’ incomes. The same therapist may charge some people $75 a session and others $200. This helps them cover their costs while making sure more people can afford to see them.
Where Can You Find Therapists Who Charge Less?
There are probably places to get low-cost therapy in your community that you don’t know about (yet). Let’s change that. Part of our mission is to increase awareness of these hidden gems of the therapy world.
You can often find therapy for less at the following places:
- Community counseling agencies
- The public mental health system
- Integrated primary care clinics
- University counseling clinics
- Faith-based counseling centers
- Employee assistance programs
You can read the linked articles for more information on how these providers work, who they’re for, and how to find them.
Some therapists choose not to offer sliding-scale fees out of concern some clients may not feel comfortable paying more or less than others. They may instead provide a certain number of pro bono sessions per week or find other ways to provide lower-cost sessions. For example, some therapists who want to serve clients from a wider range of socioeconomic backgrounds choose to offer some or all of their sessions through a local clinic.
Clinic-based therapists can often charge lower fees than therapists in private practice because they are not responsible for as many costs. Non-profit and public clinics may also receive money from state or federal grants or from charitable donations, which offsets their costs and allows them to charge clients less.
Why Do Some Therapists Charge So Much?
When you see that a local therapist charges $150, $200, or even more per session, it can seem unfair or greedy. A lot of people can’t afford to pay $600-$1000 per month to see a therapist!
However, most therapists don’t want to exclude clients based on income. This is why many choose to use a sliding scale, offer pro bono sessions, or spend some time each week providing therapy at an affordable local clinic.
Still, you might wonder why therapists don’t simply charge everyone less. If they’re so dedicated to helping everyone, why do they insist on charging more per hour than so many other kinds of professionals?
The main reason therapists charge so much is that it costs a lot to maintain a therapy practice.
Therapists in private practice have to shoulder similar costs as people who run small businesses. They have to cover rent for their offices as well as pay for their own insurance. They either have to pay assistants or spend unpaid time attending to various clerical and administrative tasks like filling out insurance paperwork.
After all of these costs are factored in, therapists take in significantly less per hour than what they charge per session.
Another reason therapy costs what it does is the degree of professional investment, training, and study required to become a therapist. Mental health is a demanding field and therapists want to make sure they’re fairly compensated.
Many therapists undergo a similar amount of education as medical doctors who charge even higher fees for their services. Then, for the rest of their careers, they have to pay for the continuing education they’re required to get to maintain a therapy license.
How Much Does Medicare Pay for Mental Health Counseling?
Participating vs. Non-Participating Providers
Therapists who accept Medicare assignment can’t charge more than the Medicare-approved amount, while providers who accept Medicare but don’t accept assignment can charge up to 15 percent more per session.
So while you’re only responsible for 20 percent of the Medicare-approved amount when you see participating providers, you’re responsible for 35 percent of the Medicare-approved amount for non-participating providers.
This means that if the Medicare-approved amount for a therapy session where you live is $150, you’ll pay $30 coinsurance to see a participating provider and $52.50 to see a non-participating provider.
You can search for the Medicare-approved amount for therapy in your area by using the CMS Physician Fee Schedule Look-Up Tool (the HCPCS code for 60 minutes of individual therapy is 90837).
How Much Does Medicaid Pay for Mental Health Counseling?
Medicaid co-pays for therapy are $4.00 or less if your income is at or below the Federal Poverty Level (FPL) and are a little more if your income is up to 150 percent of the FPL. Per Medicaid cost-sharing requirements, Medicaid co-pays aren’t allowed to exceed 5 percent of your individual or family income.
Clinics Are More Likely to Accept Medicaid
Because Medicaid reimbursement rates are relatively low, it’s rare for private practice therapists to accept Medicaid. Clinics, especially those run by non-profit agencies or the public mental health system, are more likely to accept Medicaid than therapists in private practice.
How Much Does TRICARE Pay for Mental Health Counseling?
The cost of therapy with TRICARE is the co-pay for a specialist visit, or about $30. There are some variations in co-pays, deductibles, and premiums based on what type of TRICARE plan you have.
TRICARE publishes a fact sheet listing its costs and fees annually. You can find the 2022 fact sheet here. TRICARE also provides an interactive tool you can use to figure out your co-pay on their “Compare Costs” page.
Note that TRICARE only covers therapy for the treatment of a diagnosed mental health or substance use disorder.
How Much Does Therapy Cost Without Insurance?
In summary, there are many factors that determine how much you’ll pay to see a therapist if you don’t have insurance or if you choose not to use insurance. These are:
- The average cost of therapy in the surrounding area
- The cost of living where the therapist’s office is located
- Whether the therapist you want to see offers a sliding scale
- Whether you’re eligible for therapy through the public mental health system
- Whether there are mental health clinics in your area that offer therapy and whether you’re willing to get therapy at a clinic
- Whether you’re open to receiving pastoral counseling and whether it’s available at your church or another location in the community
- Whether you have integrated healthcare clinics where you live that allow you to receive medical and mental health care at the same location
- Whether your state offers financial assistance for mental health services for people who are uninsured and whether you qualify for that assistance
In other words, what you pay depends on the average cost of private practice therapy where you live and whether you have affordable alternatives to private practice therapy. For example, while you might have to pay $115 a session to see a private practice therapist in your area, you may find that you can pay $65 at a local non-profit clinic and $50 at a community mental health center in your state’s public mental health system.
Federally Qualified Health Centers
Federally qualified health centers (FQHCs) often provide affordable therapy alongside affordable primary care. These integrated healthcare clinics are specifically designed to help people in underserved areas access affordable healthcare.
They accept a wide range of insurance plans. One special thing about FQHCs is that they always accept Medicare and Medicaid, while few private practice therapists do.
Even if you don’t have insurance, you can sometimes pay a single fee for all the care you receive each month at an FQHC instead of paying a fee for every service you receive. (This is also true of some other types of integrated clinics.)
You can use the online search tool on the U.S. Department of Health and Human Services website to find out if you have a FQHC near you.
In some areas, costs for therapy may not vary that much between these different care settings, but it’s always worth looking into a wide range of local therapy providers to see if there’s a low-cost option available to you. You can also call therapists you’re researching to find out if they offer sliding-scale fees or other cost-saving methods. You can often negotiate rates with a therapist.
At OpenCounseling, we recognize that our mental health system has serious gaps and that cost is a real and significant barrier to therapy for many Americans. However, we also know that there are more options for affordable therapy than many people realize, and our mission is to make it easier for you to find those options.
Check If You Can Save Online
BetterHelp (a sponsor of OpenCounseling) currently charges $320 a month to see a therapist online through their platform. They also offer financial aid between 10% and 40% for those who qualify. The weekly charge includes live phone or video sessions as well as messaging services. If you’re getting a weekly live session, this may mean that at $80 per session, BetterHelp is more affordable than other out-of-pocket options where you live.
In addition to participating in BetterHelp or other online platforms, some therapists offer online video sessions independently. In many cases, they offer sliding-scale rates for both online and offline sessions. This means you may be able to find a therapist who’s licensed to practice in your state whose sliding-scale rates for online sessions are lower than in-person rates for therapists within driving distance of where you live.
We hope this article has sparked some ideas and helped you locate potential resources for affordable mental health support where you live. Even if it takes a while, don’t give up—you may be closer to finding the help you need than you think.
Stephanie Hairston is a freelance mental health writer who spent several years in the field of adult mental health before transitioning to professional writing and editing. As a clinical social worker, she provided group and individual therapy, crisis intervention services, and psychological assessments.