An article in the Center for Health Journalism in March of 2020 reported that many psychotherapists are unable to sustain on the rates reimbursed by insurance companies for mental health treatment. Their research in California showed that “the average reimbursement for a therapy session from an insurance company is $60, a number that hasn’t increased in 10 to 20 years. Many psychotherapists say they can’t afford their overhead costs in addition to the extra time it takes to file paperwork and grapple with third-party payers compared to what insurance will reimburse.” (https://centerforhealthjournalism.org/2020/03/02/how-do-we-reach-mental-health-parity-if-therapists-don-t-take-insurance)

Many therapists decide to create cash-based businesses not because they don’t want to take insurance but because (in many cases) the low and unrealistic reimbursement rates. Unfortunately, this cash pay model creates a system that accommodates clients who can afford therapy when access to mental healthcare should be as mainstream as access to a primary care physician. 

This sheds some light on the reasons why consumers have a difficult time finding a therapist who takes their insurance. But it is only part of the picture.

The other part the consumer doesn’t see is how archaic the credentialing system is for therapists. I could write a dissertation on the steps involved with credentialing, but I won’t bore you. Its time consuming, confusing and must be repeated for every insurance company. And, once paneled with an insurance company, each company has different requirements for documentation (usually a provider manual); and, if your files are audited, ramifications for not following their prescribed protocols for documentation or treatment plans can lead to money being withdrawn from future payments—even if you’ve had successful outcomes from seeing the therapist.

So, though your employer or insurance agent may tout to you how great the mental health benefits are on your insurance plan, finding a therapist who takes the insurance becomes a tiring project for the reasons above.

That doesn’t mean you won’t find a therapist who takes your insurance. The good news is that some of the major health insurance companies are trying to make it easier to credential and some are even starting to pay their therapists living wages—but they are far and few between. In recent years, third party companies, like Headway.co, and others, have popped up to bring mental health to more consumers. They’ve managed to do what insurance companies couldn’t, get large numbers of mental health practitioners to sign up on the promise of higher wages without all the headaches that can come to us having to deal with insurers. It has been, largely, successful. Some providers in our industry are against this business model because the companies are likely data collection machines. But here is the reality: they are held to HIPAA standards, they are approved by insurers, and they make life easier for the providers to take your insurance. By doing so, we spend more time on what we love about this profession, helping you overcome terrible symptoms of your mental health challenges.

There is another side to this story though. Do you even use insurance, or do you pay privately for therapy (meaning pay the therapist’s cash rate)?

In my practice, I take some insurance policies, and I also work with Headway.co, and I also see clients who pay me privately and do not use insurance. I even have clients whose insurance I take, but they decide they would rather not use insurance.

You may be asking yourself: why would someone pay a therapist their full rate if their copay is only $25? There are a few reasons (and this list is not an exhaustive list): 1. Maybe the client has a family plan and doesn’t want their therapy disclosed to their spouse on their Explanation of Benefits (EOB); 2. Maybe they are concerned about confidentiality and want to make sure that a diagnosis does not become a part of their permanent medical record; or 3. Maybe they have an insurance company who scrutinizes their providers and dictates the time they can spend with the therapist; and, they want the freedom to see a therapist on their time and for as long as they need to.

Here is another reason you may pay for therapy out of your pocket: not all modalities are covered by all insurance companies. You may have an insurance company that, for example, doesn’t reimburse a therapist for Brainspotting therapy. Or maybe you are seeking a therapist who specializes in a niche that addresses exactly the problem you want to address in therapy, but they don’t take your insurance. Do you go to the local generalist and pay your copay for weeks on end and not get the results you need; or do you pay the niche specialist their rate and address your mental health challenges with the expert? No, you’d pay the niche provider, even if they don’t take your insurance.

I am obviously partial, but it is time for us to start looking at mental health therapy as part of our self-care. And if you don’t have insurance or cannot afford your co-pay or to pay privately, there are great options to consider. Most communities around the United States have community mental health centers. These can be tremendous options for finding affordable care. They usually get compensated by grants; so, usually most have programs to cover co-pays or even pay for therapy (sometimes on very affordable sliding fee scales). You can usually search on the web, “local community mental health agency”; or “local FQHC”; or “local behavioral health center.”

Finally, exhaust your insurance search first on popular therapist directories like, Psychology Today or Therapy Den. If you are a student, go to your student counseling center. They often have lists of therapists in your community. You can even ask your Primary Care Physician for referral. Usually if they take your insurance, they will have therapists on their referral roster who take the same insurance. Finally, look at your insurance company’s website.

If you cannot find anyone who takes your insurance, do not be afraid to ask the provider if they have a sliding scale. Some do and some don’t but you don’t know if you don’t ask.

If you are interested learning more about therapy in Washington DC, EMDR in Fort Lauderdale, EMDR in Virginia by Telehealth, EMDR or Brainspotting in Florida or Telehealth in Florida, reach out today. You can click here to contact us or call 754-946-6600.

Jordan Nodelman, LCSW, LICSW provides compassionate care in a judgment free zone. We are LGBTQI+ competent. We have worked with First Responders and do extensive work with C-Level Executives and professionals too.

Located in Wilton Manors, FL the office is safe and tucked away for confidentiality for peace of mind. I am an EMDR Certified Therapist in Fort Lauderdale and provide telehealth in Florida, telehealth in Washington DC and telehealth in Virginia.

Call today. Jordan looks forward to working with you.

This article is Copyrighted by Jordan Nodelman, LCSW. To reproduce please email jordan@jnodelmanlcsw.com