Individual Psychotherapy - $200 per 50-minute session
If you are going to use your health insurance, call them (there may be a separate phone number for mental health or behavioral health) and ask:
Negotiating payment and insurance can be a confusing process, especially for someone in the middle of a crisis, so if at any time this information becomes too overwhelming, just give me a call as I have helped many previous clients through this process.
Benefits of the Self-Pay Model vs Managed Care Model
Limitations on length of treatment and type of treatment: Treatment is only authorized by insurance companies if a reviewer determines that the treatment conforms to the policies set by the company. This reviewer assesses the severity of your problem, your motivation for treatment, and whether treatment is necessary, and then determines whether you will be reimbursed. This reviewer need not have any mental health experience despite being responsible for making these very important decisions about your treatment. In addition, managed care companies encourage very brief treatment and favor the use of medication over psychotherapy.
Choosing your own therapist: Self-pay and out-of-network benefits allow you to choose a therapist that has the qualities and qualifications you are looking for.
Privacy issues: To justify treatment and determine reimbursement, insurance companies will require disclosure of information about a client's most dysfunctional behaviors. Treatment plans, progress notes, and a diagnosis may be required. Oftentimes, this information is put into a data bank and it is not always clear who has access to the information (some employers have been able to access information from their employees' insurance companies), how this information is protected, and how this may affect the client's future abilities to acquire insurance coverage in the future (health insurance, life insurance, disability).
Managed care is a business: Managed care companies will often make treatment decisions based on cost rather than the needs of the clients. Being a business, managed care companies also use profits for advertisements, executive salaries, political lobbying, and shareholders.
Labeling sickness: Managed care companies often require treatment to be "medically necessary" for it to be covered. This means that a psychiatric diagnosis is required regardless of your reason for seeking therapy. Many clients come to therapy for issues such as self-growth, stress-management, or habit change, which are issues that may not warrant a psychiatric diagnosis.
Cost-benefit analysis: All health insurance providers will be different but with in-network providers, insurance companies typically cover 80% of the fee set by the managed care company, which usually mean a cost of about $10-20 for the client. Thus, an in-network provider is the most cost-efficient choice. I am not on any insurance panels, and thus, am not an in-network provider for any insurance. If a client sees a therapist who is an out-of-network provider (as I would be), the insurance company usually covers the same 80% of the fee set by the managed care company, but because the therapist may charge more than that set fee, the client is left having to pay the difference. Thus, with an out-of-network provider, an insurance company may pay 80% of $100 (or whatever amount they set) but because my fee is $200, this means the cost to the client is still about $120. The savings of $100 can be significant for some, while others feel it is not worth using insurance for this purpose.