The relationship you develop with your therapist is the primary tool with which you explore various questions and concerns that emerge in your life. And one of those concerns (among others) is your relationship to money. Therefore, we believe in setting a fee based on your particular financial circumstances. It is an important part of the psychotherapeutic relationship with your therapist and negotiating your fee with your therapist is an important beginning step of your treatment. During the initial consultation, your therapist will inform you of their fee rates, and based on that information you can explore what is possible or not possible for you. Perhaps, the fee your therapist mentions will be okay for you. Or you might discover that you have an unpleasant emotional reaction to it, which may prevent you from exploring the topic openly—that’s okay, your reaction will create an opportunity for both you and your therapist to learn about you. Generally speaking, our rate for individual therapy is between $150 and $350 per session, and couples therapy is between $200 to $400 per session.
If you and your therapist are not able to agree on your fee, then we will do our best to match you with someone else who is able to accommodate your needs. But in negotiating your fee, please honor your therapist's experience. You may really need a sliding scale, but the concept of haggling down to the most inexpensive level with your therapist is not appropriate. Please trust that your therapist is mindful of the expense of treatment, and has no intention of charging you a fee that would make you struggle financially. They also know that if the fee is set too low (or cheap) the benefit and outcome of the treatment suffers significantly because many people find it difficult to see its value as an investment you are making towards your future. Your fee is not set in stone. As your lifestyle changes, you will revisit the arrangement. In other words, the money and time (time issues will be explored in frequency of treatment, cancellation policy, and scheduling appointments) are two constants that do not go away from your life. Therefore, they are incorporated as an important part of your treatment.
photo by Angy Limare. Unsplash
What is our cancellation policy for session fees?
Once you set your schedule, your therapist blocks out your session time in their calendar. That time is always set out for you. You may be unable to attend that time for many reasons—work events, personal commitments, emergencies…And that is fully normal and understandable. However, we do not open up your hour to someone else because you are unable to make it to the session. So, when you are not able to come to your session, we require session fee. This arrangement might create strong reactions in you, and we understand that it is a difficult one to sit with. Think of this arrangement as similar to renting an apartment. You are responsible for your rent even when you are not using your space. Think of your place in your therapists as being like renting your therapist’s limited hours. We believe working this way is helpful based on many years of experience.
Why don’t we participate in insurance panels?
When looking for a therapist, the first thought that may come to your mind is the affordability of the treatment. You might think you would like to spend least amount for the treatment because you your insurance ought to pay for all your health-care needs. In this logic, the small copay that is required to see a psychotherapist might appear desirable. Then, you discover that there are very few psychotherapists who are in-network with your plan. ‘What is going on?’ you might wonder. Well, therapists who are in-network with insurance companies accept a copayment from the patient, typically ranging from $15 to $50. The rest of the payment is reimbursed by insurance company. The reason many therapists do not accept this in-network structure is simply because insurance companies do not reimburse the rate we deserve. Compared to the general psychotherapy rate, most in-network reimbursement is around $60 per session, which means if a therapist in New York City is on an insurance panel, they will struggle to pay their business and personal expenses. In addition, the in-network rate does not change even when the therapist has decades of experience. Insurance companies also do not take into account our expertise, years of post-graduate and post-doctoral trainings, psychoanalytic training and affiliation, and membership to professional groups. Let’s say that a therapist has all this background and over 20 years of experience, their rate will be the same as someone who has just received a license. And when the therapist requests a fee increase each year, insurance company works to deny this request, despite increasing costs of living year after year. As a reference, in New York and California, the average fee for psychotherapy with a clinician who has a post-graduate level of education $250 per session. This is one of the reasons why it is very difficult to find highly-trained therapists in NYC who are in-network with insurance companies.
However, one way you may be able to pass some of the cost of treatment to your insurance company is by using your out-of-network benefits if you insurance plan allows for it. What that means is that you may be able to receive reimbursement (money back) from your insurance company even if you are seeing a therapist who is not in-network with your insurance company. In a nutshell, “out-of-network” simply means that your therapist is not in-network with your insurance and “out-of-network” benefits means your insurance company will be able to reimburse psychotherapy treatment with a therapist who is not in-network with them. You might ask why an insurance company would agree to reimburse work carried out by an out-of-network therapist. This is because there is more demand for psychotherapists than their in-network database can accommodate, and there are not enough therapists who are able to accept new patients within in-network arrangement.
In utilizing your out-of-network benefits, you pay your therapist’s fee upfront, and your insurance company reimburses you a percentage of your fee. For example, if your fee is $250, your insurance company might provide reimbursement up to 80 percent, in which case your out-of-pocket responsibility would be $50 per session. The percentage of reimbursement depends on your specific plan. Also, if your plan has deductible amount, you must meet it before you begin receiving the reimbursement. In addition, sometimes your plan has a limit to how much your therapist can charge, which is called, “allowed amount.” For example, if your therapist charges you $250 and the plan has the allowed amount of $200, then the difference becomes your responsibility. In that case, the reimbursement will be calculate based on $200. If they are willing to reimburse 80%, then the fee that is used to calculate reimbursement rate is $200, not $250. You will end up paying $50 (after the reimbursement has been provided) and the additional $50 since your plan has “allowed amount.” In this case, your session fee will become $100 per session.
Here are some other reasons you may not want to use your in-network coverage:
Insurance companies can limit the number of sessions you are allowed to have.
To receive payment from insurance companies, therapists need to assign a diagnosis.
Having a diagnosis (for example, depression) on your record may prevent you from receiving other types of benefit and insurance, such as life insurance.
Your insurance plan may have a high deductible (more on what this means below), which means you would be paying fully out of pocket for a long time before your insurance benefits kick in.
Your insurance plan might change, and when that happens you might be forced to change your therapist with whom you’ve developed a therapeutic rapport.
