Fees & Insurance

Money is an emotionally charged topic, so perhaps it’s not a surprise that we’ll talk about it in therapy. We’ll probably have a lot of conversations about money and the role it’s played in your life; we’ll also talk about the role it plays in the therapeutic relationship, starting with the fee for therapy.

Negotiating the fee is important because it’ll bring up feelings. Whether my fee feels well within your means or beyond your reach, we will explore these feelings together.

In all discussions of the fee, we’ll discuss it as something that reflects my training and expertise and your commitment to the process. The fee—along with our discussions of the frequency of treatment (the number of times you’ll come each week), the cancelation policy, and re-scheduling matters—are all part of our therapeutic relationship, so we’ll likely discuss them more than once as circumstances in your life change.

I have some ability to negotiate a lower fee for people who cannot afford my full fee. When discussing the possibility of a sliding scale fee, please remember that negotiating the fee is not about haggling to push the fee as low as possible, nor is it about making you struggle financially. We’ll keep both of these ideas in mind as we set the fee. Ideally, we will settle on a fee that feels right for our therapeutic relationship. If we are not able to agree on a fee, I will do my best to help match you with another therapist.

Insurance

I do not accept insurance, and here are a few reasons why:

Insurance Companies are Money-Makers, Not Practitioners of Care

While it is understandable to be concerned about the affordability of therapy or wish that your health insurance would take care of your mental health needs, the truth is that insurance companies are out to make money, not to offer adequate care. For this reason, many therapists view insurance companies as an unwanted guest that intrudes in treatment, whether by artificially setting the fee, arbitrarily limiting the number of allowed sessions, or demanding notes about therapy sessions before processing reimbursements. In short, insurance companies play by their own rules, which are often at odds with therapeutic goals.

Low Reimbursement Rates

Unfortunately, most insurance companies do not reimburse therapists at a rate that allows them to sustain their business. Reimbursement rates to therapists are often around $60/session and remain unchanged for many years. The new online therapy platforms (like Betterhelp, Headway, Talkspace, etc.) are owned by venture capitalists who take a cut of what therapists would otherwise make for providing therapy—their reimbursement rates to therapists are as low as $30/session. Such low reimbursement rates often lead therapists to take on heavier caseloads to make ends meet, which can decrease the personalized attention they’re able to devote to each patient and increase their chances of burnout.

No Quality Control

Insurance companies do not differentiate among practitioners with many years of experience, specialized areas of expertise, or quality of time spent in session. For those of us who are committed to on-going professional development and advanced training, we invest significant time and money in our own growth and skillset. To my mind, these practices are essential to staying up to date on the research and techniques that allow us to provide the most effective therapy; however, insurance companies do not factor this into their reimbursement rates.

Interruptions to Continuity of Care

If your insurance plan changes, your therapist may not be in network with your new plan, which would lead to premature termination of treatment. If therapy is going well and you feel you have a good therapeutic rapport, this kind of interruption can be quite distressing.

Other Ways to Use Insurance: Out-of Network Benefits

Using out-of-network benefits is one way to lower the cost of therapy without the intrusion of insurance companies into your treatment. I can help you use your out-of-network benefits. After you pay your monthly bill, I will provide you with a Superbill for you to submit to your insurance company who will then send you a partial reimbursement. Reimbursement rates vary and I’m happy to explore this option with you further.

One way to start exploring out-of-network benefits is to contact your insurance company and ask the following questions.

• Ask your insurance representative what your yearly out-of-network deductible amount is. If you have a deductible, ask them how much of your yearly deductible has been met to date

• Then ask your insurance representative what the reimbursement rate is for Procedure Code 90834 (Psychotherapy, 45 minutes). If they require my license information, please tell them that I am a Licensed Psychoanalyst. If they require a diagnosis, we can discuss this during our session.

• If they ask who will be handing the insurance reimbursements, please tell them that you will be submitting superbills. (This practice protects your privacy and confidentiality.)

Cancelation Policy

Please email or text me at least 24-hours before you need to miss a session. All missed sessions must be made up within the same month or else you will be responsible for the missed session.

If you are facing an emergency, please call 911 or go to the nearest emergency room.