How Much Does Therapy Cost?

Figuring out the cost of therapy can feel like a maze you can’t solve: confusing, overwhelming, and exhausting. One site says $50 per session, another says $200, and your friend says they only paid $25. Add insurance into the mix, and your questions multiply. Does insurance cover therapy? What does my plan include?

You’re not alone. Research shows that only half of people with a mental illness get treatment. A common reason is simply not knowing what therapy costs or how health insurance works for mental health care.

Here’s what you need to know: Insurance covers therapy thanks to the Mental Health Parity Act, which requires insurance to cover mental health visits the same as medical visits, and the Affordable Care Act, which requires mental health as an essential benefit. Most insured people pay between $20 and $50 per therapy session. Without insurance, sessions range from $90 to $300+ per session.

Let’s break down exactly what you can expect to pay and how to find care that works for you.

Insurance terms to know

New to insurance? These definitions will help you understand your benefits and the costs below. Already understand your copay from your coinsurance? You can skip ahead to the cost breakdowns.

• Out-of-pocket costs: Any expenses that you pay yourself, instead of being covered by insurance. This includes, copays, deductibles, or paying full price for a therapy session.

• Copay: A fixed amount you pay for each mental health visit (e.g., $20 copay for each therapy session).

• Coinsurance: A percentage of the cost you pay after meeting your deductible (e.g., if a $120 therapy session has 20% coinsurance, you pay $24 and insurance covers $96).

• Deductible: The total amount you pay out-of-pocket each year before insurance starts covering most mental health services. Before meeting your deductible, you may pay full session costs. After meeting it, you typically pay only copays or coinsurance.

How much does therapy cost with insurance?

• Copayments: Typically $20-$50 per session

• Coinsurance: You pay 10%-30% after meeting your deductible

• Medicaid: Usually free or very low cost ($0-$5 per session)

Of course, not all insurance is the same. Your actual costs will vary based on your specific plan and provider.

Insurance coverage by plan type

What insurance typically covers

• Individual, group, and family therapy sessions

• Psychiatric evaluations and medication management

• Substance use disorder treatment

• Crisis intervention services

• Telehealth mental health appointments

Private insurance

Most private insurance companies cover therapy under the Mental Health Parity Act. Coverage varies, but major carriers such as Aetna, Cigna, Blue Cross Blue Shield, and UnitedHealthcare all offer mental health benefits.

Before your first appointment, it’s important to know what your insurance plan covers. Ask if your plan includes therapy and which providers are covered. You should also check your financial responsibilities, including copay per session, deductible, and any coinsurance after the deductible is met. 

It’s also helpful to ask if there are any limits on the number of sessions covered per year and whether you need a referral from your primary care doctor before getting started. If you’re considering seeing someone not within your insurance network, ask if your plan reimburses for those visits and at what rate.

Having these answers upfront can help you avoid surprise bills and give you peace of mind.

Medicaid

Medicaid covers mental health care for low-income families and people with disabilities, usually for free or at a low cost. Each state runs its program differently, so check your state’s Medicaid website for details.

Important things to know:

• You may need permission for certain services first (called preauthorization)

• You must use doctors or therapists in your insurance plan’s network for full coverage

• Most services cost little to nothing, though some may have small fees

• Some states may limit the number of sessions per year 

To verify your Medicaid coverage:

• Check your Medicaid card or plan materials

• Look at your state’s Medicaid website 

• Call providers to confirm they take your plan

• Ask about telehealth and crisis support options

Medicare

Medicare covers mental health care for people 65 and older, and some people with disabilities. You’ll likely still pay some copays or meet a deductible first.

Important things to know:

• Coverage depends on which Medicare plan you have. For example, Part A includes inpatient behavioral health care and substance use services, and Part B includes outpatient services, psychiatric evaluations, and preventative services 

• Medicare Advantage plans may require referrals or have network restrictions

• Typical costs include copays or coinsurance (usually 20% for outpatient visits)

To verify your Medicare coverage:

• Review your Medicare handbook 

• Use the Medicare website to find covered providers

• Confirm providers accept Medicare or your specific plan

Insurance cost examples

Several factors affect therapy rates, including the type of therapy and mental health treatment you need, your therapist's training and experience, session length, and your location.

Example with insurance deductible

To better understand how therapy costs might play out over time, let’s walk through an example. Imagine you have an insurance plan that has a $1,500 annual deductible, a 20% coinsurance rate after that deductible is met, and a $2,000 out-of-pocket maximum. You find an in-network therapist who charges $150 per session.

At first, you’ll be paying the full amount out of pocket. For the first 10 sessions, you would pay $150 each time, totaling $1,500. Once you’ve reached $1,500 (your deductible) at around session 11, your insurance kicks in, and you start paying only 20% of the session cost. That brings your out-of-pocket costs down to $30 per session, while insurance covers the remaining $120.

If your total spending on healthcare reaches the $2,000 out-of-pocket maximum, your insurance will begin covering 100% of the session cost. That means any therapy you receive for the rest of the year would be completely covered, and you wouldn’t owe anything more.

Therapy may feel expensive at first, especially before you meet your deductible. But over time, it usually becomes more affordable or could even be free once you reach your out-of-pocket maximum, depending on your plan. 

Example with Medicaid

If you’re covered by Medicaid, therapy sessions are often covered at no cost (in many states) or a low fee ($0-$25 per session). This makes ongoing support much more accessible, especially for those managing mental health needs on a tighter budget.

In addition to therapy, psychiatric evaluations are generally included in your coverage at no extra charge. These evaluations can be an important first step if you’re exploring medication or trying to get a clearer understanding of your symptoms.

And if you’re ever facing a mental health crisis, Medicaid ensures you won’t have to worry about the cost of care. Crisis services are always fully covered, providing immediate support when you need it most. 

Other things to know for insurance

In-network vs. out-of-network providers

• In-network: Providers who have contracts with your insurance plan. You’ll typically pay less because they’ve agreed to lower rates. 

• Out-of-network: Providers without contracts with your insurance plan. You’ll typically pay more, and some plans might not cover them at all.

Eden Katz, LCSW, suggests, “If possible, stick to in-network therapists. Providers who are in your insurance network have pre-negotiated rates, which means you’ll pay less out of pocket compared to seeing someone out of network.”

“If there are no therapists with the right fit of speciality, availability, or geography who are in-network with your insurance, you can appeal to have an out-of-network provider covered at the reimbursement rate as if they were in-network,” recommends Laura Goldstein, LCMFT. “You can ask for a single case agreement, network exception request, or gap coverage request.”

Other things to consider:

• Doctoral-level providers (PhD, PsyD, MD) typically charge higher fees than master's-level therapists due to additional education and training requirements.

• Some experienced therapists choose to work out-of-network because they can maintain full practices through referrals and prefer to avoid insurance paperwork. You can find excellent therapists both in- and out-of-network.

• Consider the results you get, not just the price per session. For example, going to fewer sessions with a therapist who is a good fit for your specific needs may be more helpful and cost-effective than going to more sessions with someone who isn’t the right match.

Special accounts

Two types of accounts can help reduce your therapy costs using pre-tax dollars (money taken from your paycheck before taxes are calculated):

• HSA (Health Savings Account): Available for people with high-deductible health insurance plans. You can use pre-tax dollars to pay for therapy, counseling, psychiatry visits, medications, and other eligible mental health services.

• FSA (Flexible Spending Account): Money from your paycheck (before taxes) that you can use for healthcare expenses, including therapy. The catch is that you usually have to spend it all by the end of the year or you lose it, so plan accordingly.

Understanding insurance paperwork

When reviewing an Explanation of Benefits (the summary from your insurance that shows what was covered and what you may owe), you may see codes next to each service. These are billing codes therapists use to describe the type of session you had.

Understanding these codes can help you make sense of what your therapist charged for, how long the session was, and what kind of therapy it involved. These codes can also help explain why your insurance covers a certain amount (insurance companies use these codes to decide how much they’ll pay—not all codes are treated the same). For example, your plan might fully cover a 45-minute session, but only partially cover a 60-minute one.

Common therapy billing codes:

• 90834 — Individual psychotherapy for 45 minutes

• 90837 — Individual psychotherapy for 60 minutes

• 90847 — Family psychotherapy for 50 minutes

• 90853 — Group psychotherapy

How much does therapy cost without insurance?

• National average cost: $100-$200 per session

• Major cities (NYC, LA, San Francisco): $200-$350+ per session

• Smaller towns and rural areas: $80-$150 per session

Cost example without insurance

Without insurance, therapy costs can add up quickly. For example, if you attend therapy twice a month for a year (24 weeks) at $200 per session, you would pay $4,800 annually. However, there are more affordable options if you are paying out-of-pocket:

• Group therapy and support groups

• Community mental health centers 

• Nonprofits and faith-based counseling

• University training clinics

• Crisis hotlines and chat support

Check out our article on finding affordable therapy to learn more about this topic. 

Ashley Goodwin, MSW, LCSW, also suggests a proactive approach: “Identify therapists in multiple provider directories like Psychology Today, Therapy for Black Girls, Monarch, Open Path Collective, and request consultations to inquire about pro bono and sliding scale fees. Many private practice owners offer interns under close supervision who provide low-cost services.” For example, a therapist might charge $60 per session instead of $100 to accommodate your financial situation.

What’s the difference between a $20 and $300 therapy session?

Understanding these price differences can help you budget and find the right fit for your needs and budget.

Lower cost options ($20-$100 without insurance)

What to expect: You may work with graduate students or newer mental health professionals who are working under licensed supervision, as well as licensed therapists at community centers. Sessions may be in higher demand with less flexible scheduling, but you’ll still get quality care at more accessible prices.

Where you’ll find them:

• Community mental health clinics

• Nonprofit organizations

• University counseling centers

• Graduate training programs

• Sliding scale fee providers

• Group therapy sessions

Higher cost options ($150-$350+ without insurance)

What to expect: Licensed therapists with years of experience and specialized training. You may get standard to longer sessions (50-90 minutes), flexible scheduling, and expertise in specific areas. This option could be ideal for people who are seeking specialized treatment or want a long-term therapeutic relationship.

Where you’ll find them:

• Private practice therapists

• Specialties in trauma, couples therapy, or specific disorders

• Major cities or metropolitan areas

Important note: Neither option is better or worse — it just depends on your budget, the type of help you need, and your treatment goals. The most expensive therapist isn’t automatically the best fit, nor is the least expensive necessarily the most cost-effective choice if they’re not helping you reach your therapy goals.

Your mental health investment

Therapy can be an investment, both emotionally and financially. Now that you know what to expect in terms of cost and coverage, you’re better equipped to make the decision that’s right for you. 

Ready to find a therapist? Explore the Project Healthy Minds directory to find services available online or near you. Taking that first step toward mental health support is a powerful act of self-care. Help is within reach.