Navigating the Intersection of Work and Mental Health

Private Pay


Some clients choose to pay for therapy using cash, check, credit card, or pretax (FSA/HSA) dollars. Why do some people make this choice, given that mental health conditions are covered by most insurers?

Security and privacy

Some clients prefer to keep their counseling work highly private. When third-party payers are involved (such as insurance companies, EAPs, and alternative third party payers), some information must be released to that payer to facilitate payment. Despite significant privacy laws in the United States, some clients still prefer that the fact they are in therapy stays between themselves and their therapist. 

Lack of coverage

Despite parity laws that should require insurers to pay for mental health no differently than any other health condition, some individuals find their mental health benefits unusable and simply choose to pay out of pocket rather than try to find an in-network provider with their insurance company or do the work to get out of network reimbursement. 

Secondly, some issues clients want to address in counseling are not diagnosable medical conditions and are therefore, not billable to health insurance. 




Insurance companies require that services are delivered in 30, 45, or 60-minute increments either in our offices or via secure video conference. Private-pay counseling that is not medically necessary and/or that does not result in a diagnosis can be delivered via phone, in our offices, at your home or office, via video conference, via chat, or via email, so long as client and counselor agree the delivery method is appropriate.  Paying privately means clients and their counselors choose how services are delivered, which makes counseling more accessible to some.