I don’t bill insurance directly, but most PPO plans pay you back for a good share of therapy with an out-of-network provider. Two numbers decide what that looks like for you.
How it works
1. We check your coverage on the consult call.
Bring your insurance card to your free 15-minute consultation and I’ll look up your out-of-network benefits while we talk — your deductible, how much of it you’ve already met, and what percentage your plan pays. It takes seconds, and it means you know your real numbers before you decide anything.
2. You set up payment once, before we start.
I’ll send you a link to Thrizer, the service I use for billing and claims. You add your own card and insurance details — about two minutes. That is the only admin you ever do.
3. After that it runs on its own.
Following each session I charge your card for the session fee, and the claim goes to your insurer at the same moment with everything they need. No superbill to mail, nothing for you to submit. Your insurer reimburses you directly, on your plan’s terms — which for most people means once the out-of-network deductible has been met.
Please note that insurance companies require a diagnosis for reimbursement. I will input a previous diagnosis, or assess for one myself during the intake.
You don’t have to submit anything
Most people never claim their out-of-network benefits. Not because they’re denied — because submitting the paperwork is homework, and it quietly stops happening after a month or two.
I use a service called Thrizer that files your claims for you. You add your insurance details once at the start. After each session the claim goes to your insurer automatically, and your reimbursement comes back to you directly. There is nothing for you to fill in, mail, or chase.
If you would rather handle it yourself, I’m glad to provide superbills at no charge. Some people prefer to keep their own records, and that is completely fine.
What you’ll actually pay
Your deductible comes first
Most plans have a separate out-of-network deductible — often between $1,000 and $3,500. Until you reach it you’re billed the full session fee and your insurer reimburses nothing. Your sessions still count toward the deductible.
Your other out-of-network care counts too
The deductible isn’t just for therapy. Every out-of-network service you use in the same plan year goes toward the same number — a specialist, lab work, imaging, physical therapy, a procedure. If you’ve already seen an out-of-network provider this year, you may be closer to reimbursement than you think.
It works both ways: the sessions you pay for also count toward your deductible for other out-of-network care.
Then your insurer starts paying you after each session
You’re initially billed the full session fee every time. Once you’ve met your deductible, your insurer reimburses you directly — usually 50–70% out of network.
One thing to know up front: that percentage applies to what your plan decides a session is worth, roughly $167, not to the full session fee. So “60%” means your insurer reimburses about $100, not $120.
If your plan has a $1,500 deductible and pays 60%
| Session cost | Insurer reimburses | Your net cost | |
|---|---|---|---|
| Sessions 1–9 meeting your deductible |
$200 | $0 | $200 |
| Session 10 onward deductible met |
$200 | $100 60% of $167 |
$100 |
You’re billed the same $200 at every session. What changes is how much your insurer reimburses afterward — a better plan reimburses more, and the calculator below will show you yours.
So what it feels like
You pay full price for the first stretch and see nothing. Then your insurer starts paying you after each session, and keeps doing that for the rest of the year. Every January the deductible resets and the cycle begins again.
If your deductible is on the higher end, it might take several months to reach it. I’m glad to check your benefits before we begin — and if your plan isn’t going to help much, I’d rather tell you that now than have you find out in month three.
What your own plan would do
Enter three numbers from your plan and you’ll see what reimbursement actually works out to. Nothing you type is saved or sent — the arithmetic happens in your browser.
Your plan
Where to find these numbers
- Log in to your insurer’s member portal and look for “out-of-network deductible” and “coinsurance” under behavioral or mental health.
- Or call the number on the back of your card and ask: “What are my out-of-network outpatient mental health benefits? What’s my deductible, how much have I met, and what percentage do you cover after that?”
- Your Summary of Benefits and Coverage document lists both.
Don’t know these numbers? Bring your insurance card to your free 15-minute consult and I’ll look them up for you.
Looking into this for a partner, a friend, or your adult child? That’s common — send me a question and I’ll help you think it through.
Why doesn’t my plan reimburse a percentage of the full fee?
Insurers reimburse a percentage of what they decide a session is worth — often around $167 for a 53-minute session — rather than a percentage of the fee itself. So a plan that pays 60% reimburses about $100, not $120. The difference isn’t covered by anyone, and I’d rather you know that now than be surprised later.
I’m looking for someone else — can I use this?
Yes, though you’ll need their plan details, which they’d have to look up themselves. If you don’t have those, don’t worry about the numbers — just send me a question. People often reach out on behalf of a partner, a friend, or an adult child, and I’m glad to talk through whether I’d be a good fit and how the cost works.
One thing to know: I work with adults, so at some point they’ll need to be the one to reach out. But there’s a lot I can answer before that, and it’s often easier for someone to take the first step when the groundwork is already done.
Does my deductible reset?
Yes, almost always on January 1st. If we begin in the autumn you may work through it twice within a few months. Not a reason to wait — just worth planning around.
This is an estimate based on the numbers you entered, not a quote or a guarantee of coverage. Your plan’s actual allowed amount and benefits may differ. Nothing you type here is saved, sent, or shared — the calculation happens entirely in your browser.
Details worth knowing
Paying with an HSA or FSA
You can pay with a credit or debit card, or with a health savings account (HSA) or flexible spending account (FSA) card. For out-of-network therapy, an HSA or FSA is often the most direct way to put pre-tax money toward the cost.
If you would prefer nothing reported to your insurer at all, paying by HSA or FSA without filing a claim is also an option. Just tell me.
Zelle, Venmo, PayPal and check all remain fine as well.
Once you’ve met your deductible
After your deductible is met and a claim has been paid, you may be able to pay only your share at each session rather than the full fee and waiting for reimbursement. Whether that’s available depends on your plan. I’ll tell you when it applies to you.
Your right to a Good Faith Estimate
If you don’t have insurance, or you choose not to use it, you have the right to a written estimate of what your care will cost before we begin. I’ll give you one automatically, and you can ask for one at any time. If you’re ever billed for substantially more than the estimate, you have the right to dispute it. Just ask, and I’ll put it in writing.
Ready to talk it through?
A free 15-minute consultation is the easiest way to find out whether this is a fit — and I’m happy to look at your benefits with you.
Book a free 15-minute consult Ask me a question
Looking into this for a partner, a friend, or your adult child? That question is answered here — a great deal can be sorted out before they’re ready to make contact themselves.