Dedicated therapists go through several years of education to be able to do this work well. Prerequisite courses, study materials and qualifying exams for licensure on top of graduate degrees leave most therapists with a significant amount of student debt.

Jessica ‘Gonji’ Lee, LCSW at Nokdu Therapy puts it well when they state “If you think about the amount people pay CPAs, paralegals, lawyers, and medical doctors for their time, the fee for a therapist may not come as much of a surprise. Therapy, however, is a feminized form of labor because it is associated with “talking about feelings”, which may cause us as a society to view it as a less valuable service. Of course in an ideal world, ALL of these services would be much more affordable and every person would have a right to these services regardless of their income. In the meantime, we resort to creative solutions to balance worker sustainability and consumer access. “

The best way to know if your insurance plan offers out of network coverage is to call the number on the back of your insurance or go to the website associated with your account and get a benefits report.

It may be helpful to ask your insurance the following questions:

• Does my plan include “out-of-network” coverage for mental health?

• Is there an annual deductible for out-of-network mental health benefits? If so, how much?

• Is there a limit on the number of sessions your plan will cover per year? If Yes, How many?

• Is there a limit on out of pocket expenses per year?

• What is my co-insurance percentage for mental health services?

• Does my plan require pre-authorization for psychotherapy?

• Does my plan require a referral for psychotherapy?

• How do I submit a claim for reimbursement?

• What is the reasonable and customary fee for my area?(Reasonable and customary fee the amount that your plan determines is the normal range of payment within a given geographic area)

In order to find out the reasonable and customary fee, the representative may ask for a Clinical Procedure Terminology (CPT) code for the service you plan to receive. Please note that the CPT codes for services are as follows:


90791 Initial Assessment:

90834 Ongoing psychotherapy:

90837 Psychotherapy:

90847 Couples/family psychotherapy:

90853 Group psychotherapy:

90785 Interactive psychotherapy:

To make care more accessible I offer a sliding scale payment option for individuals who are unable to afford the full fee. Please contact me for more information.

Insurance companies are part of broader systems that create barriers for holistic wellness. For example, one expectation is that all clients must have a mental health diagnosis to receive support. For some people a diagnosis can be a way to feel seen, understood and part of a community. For others however, diagnoses can create harm and pathologize normal human responses to abnormal systemic forces.

Insurance coverage is often limited in duration, or insurers may stop covering care when the diagnosis is in remission. This makes it hard for therapists to provide the long-term, consistent care that most clients need.

Insurance companies also tend to reimburse therapists a very low amount (as low as $30 per session), and it is difficult to sustain a practice with these rates. It is a well known fact that insurance companies will reimburse therapists significantly less than other health care professions like medical doctors. There’s also a mountain of paperwork and bureaucratic processes that require hours of additional labor on a therapist’s part. This limits how many clients a therapist can take on, or can require an additional staff person who would need to be paid to do this work.

The limited coverage offered by insurance companies is unfortunately a reflection of larger society’s view that mental health is not a basic right for every individual. Considering these structural barriers, I choose not to take insurance, and to instead offer sliding scale spots to meet people’s various financial needs.

The restricted insurance coverage reflects society's belief that mental health isn't a fundamental right for everyone. Because of these challenges, we opt not to accept insurance and instead provide discounted rates based on financial needs. Lowering my fees enables my to offer more affordable services without dealing with the burdensome requirements imposed by insurance companies.

**Information adapted from Nokdu Therapy