What Does Therapy Cost? (With Tips to Help You Pay Less)

It’s not always possible to find free therapy, but sometimes you can. Some organizations offer free therapy as a service to members of their communities.

Even if there are no free therapy providers where you live, you may be able to find organizations that offer therapy at a very low cost. 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 that offer free therapy offer it only to people from specific groups, such as veterans or trauma survivors.

It’s also possible to get free therapy from private-practice therapists. 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.

If you can’t find or don’t qualify for free therapy, you may still be able to find therapy for significantly less than the rates you see most private practice therapists charging for your area.

In addition to individual therapists who offer pro bono sessions or sliding-scale rates, some therapists participate in specialized networks that help offset therapy costs.

One of them, the Open Path Psychotherapy Collective, offers a lifetime membership for $65, after which you can see any therapist in their network for $30 to $70 per session.

Our sponsor, BetterHelp, offers income-based financial aid that can significantly reduce your per-session costs. Other online platforms offer these discounts, too.

On average, out-of-pocket costs for therapy range from $50 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 for 2023 is $50 to $150 per session, this means 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.

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 therapists charging more than $100.

If you have insurance with mental health coverage, the cost of a therapy session with an in-network therapist is usually the same as your co-pay to see a medical specialist. On average, specialist co-pays are about $30 to $50 per session.

Since they can’t simply assign higher co-pays, some insurers try to skirt around the requirements of healthcare law 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.

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. You have 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.

The biggest factor affecting the price of therapy is the cost of living where a therapist works.

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 also making sure more people can afford to see them.

Some therapists choose not to offer sliding-scale fees. 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’re 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.

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!

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 so much per hour?

Therapists in private practice have to shoulder similar costs as people who run small businesses. They have to cover rent for their offices and pay for their own insurance. They have to pay assistants or spend unpaid time doing 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.

Medicare Part B pays 20 percent of the Medicare-approved amount for therapy sessions after you meet your deductible ($226 in 2023). Medicare-approved amounts tend to be lower than the amount private insurers pay (80 percent lower, according to CNN).

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).

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.

The cost of therapy with TRICARE is the co-pay for a specialist visit, or about $35. 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 2023 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.

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.

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 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 even 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.

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 to find the therapy you need at a price you can afford, don’t give up—the help you need might just be a call or click away.