Payment for therapy

It is important that you ask the therapist how the finances are handled:

• What is the fee?
• How long is the session?
• What if a session is missed?
• When is payment due?
• How is insurance handled?

Don't be shy! It's a good idea to ask the therapist these questions.

Payment rules that many therapists follow

• Virtually all therapists ask for payment at the end of each visit.
• Therapists accept checks and some accept credit cards. Cash is often okay too.
• Some therapists will ask for a co-payment at the end of the visit if you are paying with insurance.
• Many therapists charge either half or full fee if you miss a session and did not let them know ahead of time that you needed to cancel.

What if you can't afford therapy?

There is no reason to be turned away because you are in a tight financial situation.

Some therapists will let you tell them about your financial situation, and they will adjust their fees according to your ability to pay. This is called a sliding scale.

Don't put off getting help because of lack of funds. Ask if the therapist has a sliding scale, and explain your circumstances. Many therapists will bend over backwards to work with someone in need, regardless of their current ability to pay.

Insurance payments for therapy

• Some therapists accept health insurance as full or partial payment for therapy.
• Some therapists will ask you for full payment at the end of each session, but will help you fill out your insurance forms so you can get reimbursed.
• Other therapists may accept a co-pay and will take care of the insurance paperwork themselves, so the health insurance company will pay the therapist whatever is due beyond the co-pay.
• For the first sessions, the co-pay is often unknown. Some therapists request a standard $25 or $20 co-pay until the insurance company has responded to the claim, which can often take weeks. After the insurance company has responded, the co-pay is adjusted to whatever the insurance company says it should be.
• Note that you are usually responsible for any shortfalls between what insurance pays and what the therapist charges you for.

Insurance is often quite limited

Health insurance commonly only covers a small number of visits and has other limitations. You should check with your health insurance company or employer benefits person for exact details.

You may be better off paying for therapy yourself, even if insurance doesn't cover much. You will get the benefits of the therapy and often these benefits far outweigh the costs.

Confidentiality and insurance

Sometimes, people pay their own therapy because they wish to keep the fact that they are seeking therapy confidential.

There is no stigma to therapy. But if you choose to not involve your insurance company, nobody will necessarily know that you are getting therapy. For some people this is important.

Therapists are under extremely strict legal and ethical obligations with regard to confidentiality. If you do not tell anyone you are in therapy, then probably nobody will know.