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 FairHealthConsumer.org 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:


  • Rent and utilities, office supplies, internet, etc..
  • State licensure fees, each licensure requires annual fees to be paid.
  • Continuing education courses; these are necessary in order to keep the licenses
  • Liability insurance
  • Costs of City Certificates of Use
  • Marketing costs (Website maintenance, domain costs, and directory costs)
  • Fees to maintain certifications and courses to keep them active
  • Books that counselors read to help them maintain
  • Yearly fees and courses to maintain different certification statuses active and
  • Some counselors have loans to pay


Why Are Many Therapists Not on Insurance Panels?

Many of you probably have called your insurance company and talk to some of the therapists on the 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.


Why are my Therapy Sessions Not Covered By Insurance?

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 Individual 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.

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.


There are many good therapists out there. Finding a good therapist takes time.  Read ‘How to choose a good therapist’ on tips that can help you navigate this unfamiliar terrain. Therapy is an investment in yourself. If you have not found a good fit with a therapist that is covered by your insurance panel, then you may want to explore other options. Do your research and understand that most therapists are not in the business of making money, they do what they do because they love to help.