Are therapists expensive

How Much Does Therapy Cost, and How Do You Pay For It?

The demand for mental health services continues to grow, with the American Psychological Association reporting that treatments for anxiety and depression have increased since 2020. 

What hasn’t improved so much is accessibility, as costs continue to be a major barrier for many Americans: One study found that 58 percent of respondents worried about affording treatment or medication for their mental health, and 43 percent said they have skipped appointments to save money.  

But how much does therapy cost? Here’s what you can expect to pay for therapy, along with some helpful tips for bringing down your out-of-pocket costs. 

How much does therapy cost? 

Depending on where you live and the level of care you’re seeking, the cost of seeing a psychologist can vary. For most parts of the U.S., one session may cost about $100 to $200. If you live in a big metro area, expect to pay more, says Gray Otis, a licensed clinical mental health counselor in Utah. “If you’re in New York City, it can be anywhere from $150 to $250 or more." 

The cost will also depend on the type of practitioner you’re seeing. While a psychologist can help you work through various mental health concerns, a psychiatrist is a medical doctor who can diagnose and treat mental disorders and prescribe medication, so they will typically charge more. An initial visit with a psychiatrist can set you back about $300 to $500, with additional sessions around $100 to $200. 

Why does therapy cost so much? 

The cost of mental health therapy goes beyond treatment of patients. While the profession requires at least a master’s degree, many therapists go on to earn doctorates, medical degrees and other specialty certifications. “There are so many expenses associated with maintaining a license, including requirements for continuing education,” Otis says. 

“Of course, if you’re in practice by yourself or with others, you have business costs,” he adds, which can include things like renting an office, paying for insurance and compensating employees.  

How to pay for therapy 

Talk to your insurance company  

Most health insurance plans are required to cover mental health services, but it can be challenging to find in-network care. If going to an out-of-network provider is your only option, find out how much your insurance company will cover, as well as any copays, deductibles and other out-of-pocket costs so you know exactly how much you’ll have to pay. 

Ask about a sliding scale 

According to Otis, some therapists choose not to accept insurance to avoid the hassle of filing claims. “If an average counselor is charging $110 an hour, they’d be lucky to get $70 from seeing the same client but as an insurance reimbursement,” he says. 

If you’re planning to pay for your sessions on your own, see if your therapist works on a sliding scale. If they do, they might reduce your fee based on your income and expenses. Another option is to propose a per-session fee to try and find an arrangement that works for both you and your therapist.  

Look to your employer  

If you have a high-deductible health plan (HDHP), consider a health savings account (HSA) to help cover the cost of therapy. This type of account allows you to set aside pre-tax dollars that can be used to cover qualified medical expenses, which may include mental health services. Another option is an employer-sponsored flexible spending account (FSA), which can also reduce your out-of-pocket costs for therapy and lower your taxable income. Just remember that the funds in an FSA typically must be spent each year, whereas HSA money can stay in the account to grow over time (although you must have an HDHP to continue contributing to it).  

You may also want to contact your HR department to see if your company offers an Employee Assistance Plan (EAP), which provides confidential mental health counseling for employees. 

Consider online options 

Online therapy has grown in popularity, and some therapists offer a discount for virtual sessions. If not, a teletherapy platform can also be a more cost-effective solution. Some services offer monthly subscriptions that may be less than the cost of an in-office visit.  

Why is therapy so expensive???

Therapy is indeed very costly. The average price ranges from $80 to $300. This cost depends on the provider’s level of education, licensure status, specialized certifications and level of expertise. If you want to find out if your provider’s price is a fair market price go to the website and look under average psychotherapy cost for a 45-minute session or click here.

A therapist, similar to a lawyer, requires years of schooling. All therapists have masters and some even have a PhD. In order to receive a license; therapists have to go through a lot of training and years before they can actually work.

Lastly, counseling is expensive because there are many bills to pay:

  1. Rent and utilities.
  2. State licensure fees, each licensure requires annual fees to be paid.
  3. Continuing education courses; these are necessary in order to keep the licenses.
  4. Liability insurance.
  5. Marketing costs.
  6. Fees to maintain certifications and courses to keep them active.
  7. Books that counselors read to help them maintain.
  8. Yearly fees and courses to maintain different certification statuses active.
  9. Educational loans have to be paid off.

If you want a good counselor that has taken the time to learn and is on the forefront of their discipline, then you will prefer paying for one, rather than doubting if you are in the right hands. As always educate yourself and find one that is a good fit.

Why Does My Therapist Not Take Insurance?

Many of you probably have called your insurance company and talked to some of the therapists that are within your insurance network. You probably have found that they are either fully booked or not a good fit for you. A large portion of therapists do not accept insurance for various reasons. This however, does not mean that your insurance does not cover them. Some insurance providers reimburse clients for out of network mental health sessions. This means that the client/patient still has to pay out of pocket and then get reimbursed. Finding a good therapist that accepts insurance plans is very difficult. Out of all practicing medical professionals, those in the mental health field are the ones that are least likely to accept insurance. A study done by Bishop and her colleagues in 2014, showed that only 55 percent of psychiatrists use insurance plans, compared to a staggering 89 percent of other health care providers that do accept them.

There are many reasons to this. One is that insurance plans do not accept certain diagnosis. Insurance companies work from a medical perspective and want to have a diagnosis and a time-frame to which this diagnosis will be ‘cured’. For example, when someone goes to the doctor for a broken toe, the diagnosis is a broken toe and there is a set type of treatment that the patient undergoes. Unfortunately, for mental health insurance companies see this comparable to a pre-existing condition, were the treatment protocol is not specific. Additionally, they don’t see preventative care as a reason for treatment, and therapists have a very hard time justifying treatment and their claims get denied.

Accepting Insurance Can Be Time Consuming and Expensive for Therapists
  • The amount of paperwork and time that is needed to discuss each patient with the insurance company, means time taken away from the clients to actually be able to do therapy.
  • When any health care provider accepts insurance they have to call the insurance each time the client comes to make sure they are still insured and that their session will be covered by the health insurance.
  • Each time a client steps in the door, paperwork has to be filled out after the session to justify that the client received therapy.
  • Additionally, insurance companies have to be called for payment reimbursement. All this can take more than an hour per client. This means that this hour cannot be used to see any other client, cannot be used for client preparation or to read and continually educate oneself to be a better therapist.

Why Does My Therapist Not Hire Extra Help

Many would say, to hire an assistant that can do the job for them. That is a good idea in theory, but that also means that a therapist has to work double the amount to make half of what they would be making in private practice. This is because the reimbursement rates by insurances is very low, so therapists have to take twice to three times as many clients as they would if clients pay out-of-pocket. Therapists are only human and if you want your therapist to be 100% there for you, then it is better that they are not over saturated with client sessions, so they can offer their private clients better service.

Unlike other medical providers, that have a full staff, that help them with intake, diagnosis, blood work, paperwork etc. many therapists are on their own, this ensures the maximum amount of confidentiality.  Many clients are people who do not want a mental health diagnosis to come out in their insurance plans so they prefer paying out-of-pocket. It allows them to keep their mental health diagnosis private.

Finding a good therapist takes time. Read ‘How to find a good therapist’ on tips that can help you navigate this unfamiliar terrain.


Dr. Kreinberg is a dually licensed therapist, with a specialization in sexology, issues related to depression, anxiety and trauma. She is the founder of the Mind Wellness Center, a center that focuses on creating change in the life of the clients.





Izhevsk doctor told why he prescribes expensive medicines 8 February 2016 12:57

My story

A therapist at one of the state clinics told why imported drugs are better than domestic ones.

Patients who come to the hospital can be conditionally divided into two groups: diligent and doubters. The former strictly follow medical instructions without asking questions. The second - cast doubt on everything that the doctor says. Why, instead of inexpensive and “working” medicines, I was prescribed expensive medicines? Is it necessary to take 6-7 drugs at the same time? Why is a different pill prescribed every year to treat a cold or flu?

As a rule, they are looking for answers to these questions not in the doctor's office, but on the Internet, on pseudo-medical sites and forums. And there - tips for every "taste and color." For example, that some medicines do not save you from a cold and therefore you can not drink them. Or that expensive imported drugs can be replaced with cheap domestic counterparts - they help just as well, so why overpay for a brand and a beautiful box?

Imbued with "online wisdom", patients decide that doctors prescribe expensive drugs "on order" from pharmaceutical companies. Therefore, they are treated with other drugs and ignore the advice of the attending physician.

The first - indeed, representatives of pharmaceutical companies often visit therapists. They acquaint physicians with the research conducted by their companies, offer new drugs. However, pharmaceutical representatives cannot force a doctor to prescribe them. After all, there are strict rules and standards for which drugs to prescribe.

But! These same standards do change regularly. All thanks to medical discoveries. Therefore, instead of old drugs, doctors are trying to prescribe more effective, modern drugs. Often these include expensive drugs with a long list of contraindications and possible complications.

Second - do not be afraid of the list of contraindications. After all, the longer it is, the more serious the studies that were carried out on the medicine. For comparison, domestic medicines are practically not checked - therefore, there is no list of side effects in the packages. This does not indicate the effectiveness of drugs, but only that they were poorly tested.

And finally, the third - according to the medical standard, several drugs can be prescribed simultaneously: antiviral (they destroy the virus-cause of the disease), antipyretic (they destroy the symptoms) and antihistamines (anti-allergic - they destroy the consequences). But there are practically no drugs that would safely combine all three actions for the body. That is why it turns out that the doctor gives the patient a long list of medicines, most of which are imported. And not at all because of the desire to capitalize on his illness.

Friends, do you trust your doctor? Are you taking all the medications prescribed for you?

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