The first thing most people notice is the price.
$260 a session. No insurance. And for a lot of people, that's where the search ends — they close the tab and look for someone who takes their plan.
That's a reasonable response. Therapy isn't cheap, and insurance exists for a reason.
But if you're still here, you're probably weighing it. And that's worth thinking through clearly — not to sell you on anything, but because most people don't actually know what they're trading when they use insurance for mental health care.
What insurance actually controls
When you use insurance for therapy, your insurance company becomes a third party in your treatment. That's not a metaphor — it's how the system works.
Here's what that means practically:
You get a diagnosis whether you need one or not. Insurance requires a billable diagnosis code to authorize any session. That diagnosis goes on your record — potentially visible to future insurers, disability claims, and certain employers depending on your plan.
They decide how many sessions you get. Most plans authorize a set number of sessions at a time. When you hit that limit, your therapist submits for more. Sometimes it's approved. Sometimes it isn't. The decision is made by someone who has never met you.
They can limit what kind of therapy you receive. Certain modalities aren't covered under certain plans. If your therapist uses an approach your insurance doesn't recognize as reimbursable, that work either doesn't happen or you pay out of pocket for it anyway.
Your records aren't fully private. When a third party is paying, they have a right to some level of clinical information. That's not paranoia — it's the contract.
None of this means insurance therapy is bad. A lot of good work happens inside those constraints. But the constraints are real.
What private pay removes from the equation
When you pay out of pocket, the only people in the room are you and your therapist.
No diagnosis required unless it's clinically meaningful and you want one. No session limits set by a reviewer in another state. No restrictions on approach or modality. No third party with access to what happens in the room.
Your treatment is between you and the person doing the work. That's it.
For some people that doesn't matter much. For others — professionals with licensure concerns, people in industries where a mental health record could create complications, anyone doing sensitive personal work — it matters a lot.
The superbill option
Not taking insurance doesn't mean your insurance is useless.
I provide superbills — itemized receipts with the session details and codes you need to submit for out-of-network reimbursement. If you have a PPO plan, there's a real chance your insurance reimburses 50–80% of the session fee after your deductible.
Before you rule out working together based on cost, call your insurance and ask:
Do I have out-of-network mental health benefits?
What percentage do you reimburse per session?
What's my out-of-network deductible?
A lot of people find the effective out-of-pocket cost is lower than they expected. Some find it's not workable. Either way, it's worth knowing the actual number before you decide.
What you're actually paying for
This isn't a pitch for why private pay is inherently superior. It's an explanation of what the structure buys.
What $260 a session gets you here: a small caseload — which means full attention, not a packed schedule where you're one of thirty clients being managed. Sessions that go where they need to go, not where an authorization form says they should. A therapeutic relationship that isn't interrupted because a plan decided you've had enough sessions. And privacy that's structurally protected, not just promised.
That's the actual trade. It's not for everyone. But for the clients who are a fit for this kind of practice, it's usually exactly what they were looking for — they just didn't know how to ask for it.
If you've been on the fence about reaching out because of the cost, the consultation is free. Fifteen minutes, no commitment, a real conversation about where you are and whether this makes sense.