How Much Does Therapy Cost?

Key Takeaways

• Traditional mental health therapy sessions typically cost between $100–$200 in the United States. 
• Depending on your chosen platform and therapist, online therapy sessions typically cost between $70–$110.
• When using insurance to pay for therapy, the amount you pay per session (your copay) can be as low as $0–$30, depending on your specific plan. 
• More than 60 million adults in the United States receive outpatient mental health treatment, including in-person therapy and virtual therapy, each year. ^[1] Substance Abuse and Mental Health Services Administration. Results from the 2022 national survey on drug use and health. Found on the internet at https://www.samhsa.gov/data/sites/default/files/reports/rpt42728/NSDUHDetailedTabs2022/NSDUHDetailedTabs  

Your mental health is a vital piece of your overall well-being. Talking to a mental health professional—either through an online therapy platform or in person—can help you handle difficult emotions, overcome grief or trauma, and manage challenging life transitions. But therapy adds an extra expense to your budget, and one in four Americans needing mental health care report having to choose between getting treatment or paying for daily necessities. ^[2] National Council for Mental Wellbeing. Study reveals lack of access as root cause for mental health crisis in America. Found on the internet at https://www.thenationalcouncil.org/news/lack-of-access-root-cause-mental-health-crisis-in-america/ Knowing how much therapy costs and understanding how you can pay may help make therapy more accessible. Our Reviews Team talked to experts to help you understand the costs associated with therapy in the United States.   

What is therapy? 

Therapy, also called psychotherapy or talk therapy, refers to one-on-one sessions with a licensed mental health professional aimed at identifying and managing difficult feelings, behaviors, and beliefs, and as part of treatment for mental health conditions like depression, anxiety, and PTSD. According to the National Institute of Mental Health, therapy aims to “gain relief from symptoms, maintain or enhance daily functioning, and improve quality of life.” ^[3] National Institute of Mental Health. Psychotherapies. February 2024. Found on the internet at https://www.nimh.nih.gov/health/topics/psychotherapies

Chikeitha Owens, a licensed professional counselor (LPC), described therapy as “a safe space where you go to work out your mental health muscles.” In therapy, she said, you can “learn to work out past traumas and develop positive coping mechanisms while removing unhealthy defense mechanisms and setting healthy boundaries.” 

Therapy is generally regarded as effective, with 50% of people seeing a measurable improvement in symptoms after eight sessions and 75% seeing improvement after 26 sessions. ^[4] Howard KI, et al. The Dose-Effect Relationship in Psychotherapy. American Psychologist. 1986. 41(2), 159–164. Found on the internet at https://psycnet.apa.org/record/1986-17818-001 There are many types of therapy sessions, including individual, couples, and family therapy. You can attend in-person sessions in your provider’s office or virtual sessions from the comfort of your home. In recent years, audio and text-based therapy have become more popular. 

Who uses therapy?

Millions of American adults receive mental health treatment each year, including about 35 million who receive outpatient mental health treatment and 31 million who receive virtual mental health treatment. ^[5] Substance Abuse and Mental Health Services Administration. Table 6.1A – Any Mental Illness in Past Year: Among People Aged 18 or Older; by Gender and Detailed Age Category, Numbers in Thousands, 2021 and 2022. Found on the internet at https://www.sam According to the 2020 National Health Interview Survey, here’s how therapy was used across the population: 

• More women than men received mental health treatments. 
• Non-Hispanic white adults were more likely than Hispanic, non-Hispanic Black, and non-Hispanic Asian adults to receive mental health treatment. 
• Older adults age 65 and over were slightly less likely to receive mental health treatment than adults between the ages of 18–64. ^[6] Centers for Disease Control and Prevention. Mental health treatment among adults: United States, 2020. July 29, 2021. Found on the internet at https://www.cdc.gov/nchs/products/databriefs/db419.htm

Some people don’t seek mental health care treatment even though they need it due to a lack of insurance coverage or a lack of providers in the area where they live. ^[7] Reinert M, et al. The State of Mental Health in America 2023. Mental Health America. October 2022. Found on the internet at https://mhanational.org/sites/default/files/2023-State-of-Mental-Health-in-America-Report.pdf ^[8] National Alliance on Mental Illness. Mental health by the numbers. April 2023. Found on the internet at https://www.nami.org/about-mental-illness/mental-health-by-the-numbers/ The stigma associated with mental health challenges may also make people less likely to seek treatment. ^[9] Clement S, et al. What Is the Impact of Mental Health-Related Stigma on Help-Seeking? A Systematic Review of Quantitative and Qualitative Studies. Psychological Medicine. Feb. 21, 2014. Found on the internet at https://www.cambridge.org/core/journals  

Therapy in older adults

One in four older adults will experience mental illness, but it’s important to know that mental illness is not a normal part of aging. ^[10] National Institute of Mental Health. Mental illness. March 2023. Found on the internet at https://www.nimh.nih.gov/health/statistics/mental-illness Rather, symptoms of mental illness, like depression and anxiety, are signs that it’s time to get professional help. Still, two-thirds of older adults do not get the treatment they need. ^[11] Pan American Health Organization. Seniors and mental health. Found on the internet at https://www3.paho.org/hq/dmdocuments/2012/Mental-Health-Eng.pdf This is partially due to barriers such as mental illness stigma, negative beliefs about mental health services, and cost. ^[12] Elshaikh U, et al. Barriers and Facilitators of Older Adults for Professional Mental Health Help-Seeking: A Systematic Review. BMC Geriatrics. Aug. 25, 2023. Found on the internet at https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-023-04

If you’re an older adult seeking mental health care, Medicare will cover individual and group outpatient therapy as well as depression screenings, psychiatric evaluations, medication management, and more. ^[13] Medicare.gov. Mental health care (outpatient). Found on the internet at https://www.medicare.gov/coverage/mental-health-care-outpatient A law that went into effect Jan. 1, 2024, expands Medicare-approved mental health providers to include licensed mental health counselors (MHC) and licensed marriage and family therapists (LMFT).

How much does therapy cost?

The typical cost of a therapy session in the United States ranges from $100–$200, though some therapists charge more or less. Internal medicine physician and medical billing expert Virgie Bright Ellington shared that “therapists with more experience and who specialize in certain types of therapy, like post-traumatic stress disorder (PTSD) or eating disorders, tend to have the highest fees.” In these cases, per-session costs can be as high as $330.

“These rates are for therapists who are not on insurance panels,” Ellington said. “Meaning, they don’t accept insurance or are out-of-network and not a covered provider on your insurance plan.”  

Many factors influence the cost of therapy, like the type of therapy you’re receiving, the provider helping you, and your location. 

Type of therapy

The type of therapy you need will influence the cost you pay per session. Depending on your mental health condition, you may need any of the following types of therapy: 

• Individual therapy: You’ll meet one-on-one with a mental health provider to work through challenges and set treatment goals. Your provider may use a specific style, such as cognitive behavioral therapy (CBT), which focuses on changing unhelpful thinking patterns.
  
  The cost of individual therapy varies based on the type and frequency of treatment. Studies show that more frequent appointments lead to faster improvement of symptoms, so budgeting for weekly sessions may be ideal. ^[14] Bruijniks S, et al. Frequency and Change Mechanisms of Psychotherapy Among Depressed Patients: Study Protocol for a Multicenter Randomized Trial Comparing Twice-Weekly Versus Once-Weekly Sessions of CBT and IPT. BMC Psychiatry. June 30, 2015. Found o The reason you’re seeking therapy may also impact how much you pay. As Ellington shared, therapists who specialize in certain types of treatment, like eating disorders, may be more expensive. 
• Family or couples therapy: You and one or more family members work with a provider to resolve conflict and improve relationships. Because it involves treating more than one person, family or couples therapy can be more expensive than individual therapy. 

• In-person therapy: An in-person session occurs in your provider’s office and may incur additional fees like transportation and childcare. 

• Virtual therapy: A virtual session can be done from your home on a phone, tablet, or computer. Virtual therapy, which is as effective as in-person therapy for those not experiencing severe mental illness, eliminates potential transportation and childcare costs. ^[15] Greenwood H, et al. Telehealth Versus Face-to-Face Psychotherapy for Less Common Mental Health Conditions: Systematic Review and Meta-Analysis of Randomized Controlled Trials. JMIR Mental Health. July 21, 2021. Found on the internet at https://mental  

Type and experience of therapist

Generally, the more specialization a provider obtains and the more years of experience under their belt, the more expensive their fee will be. You may hear the word therapist refer to a range of providers, including the following: 

• Psychiatrist: A psychiatrist typically has a medical degree, such as an MD or DO, official clinical experience, and a license or certification. They can prescribe medications. Psychiatry fees are usually higher than those of other mental health care providers. 

• Psychologist: A psychologist has a doctoral degree (PhD or PsyD) but is not a medical doctor. They will also have official clinical experience and a license. Most psychologists cannot prescribe medications. 

• Therapist: A qualified therapist typically has a bachelor’s degree in psychology or a related field, a master’s degree (counseling, psychology, or social work), official clinical experience, and a license or certification. Licensed clinical social workers (LCSWs), licensed marriage and family therapists (LMFT), and licensed professional counselors (LPCs) often have more affordable rates than psychiatrists and psychologists. They cannot prescribe medications.

Seeing a therapist with a doctoral degree doesn’t guarantee a more positive outcome. The therapeutic alliance—or the relationship between a therapist and patient—is a more likely predictor of therapy’s success than the type of therapist you see. ^[16] Ardito R, Rabellino D. Therapeutic Alliance and Outcome of Psychotherapy: Historical Excursus, Measurements, and Prospects for Research. Frontiers in Psychology. Oct. 17, 2011. Found on the internet at https://www.frontiersin.org/journals/psychology/ Depending on your needs, you may prefer to see a more experienced provider. While you will likely benefit from your therapist’s experience, their fee may be higher than someone with fewer years of training and experience. 

Geographic area 

The cost of therapy will vary depending on where you live. Therapy often costs more in large metropolitan areas where the cost of living is higher, such as New York City or Los Angeles.  

A study of 31,836 ZIP codes found that the lowest-income communities were less likely to have office-based private practices with access to mental health practitioners. ^[17] Cummings JR, et al. Geographic Access to Specialty Mental Health Care Across High-and-Low-Income US Communities. JAMA Psychiatry. May 2017. Found on the internet at https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2616167 These same areas were more likely to have community-based outpatient mental health treatment facilities. While lower-income communities may have more free or low-cost mental health services, access to those services may be limited by high demand and long wait times.

Because virtual therapy expands the geographic area where you can search for a therapist, finding one you can afford may be easier. The only constraint on virtual therapy in terms of geographic area is based on state licenses. For instance, it doesn’t matter if you are in Buffalo, New York, or New York City to see a provider who is licensed in the state of New York, but that same provider will not be able to treat you if you are a resident in Hoboken, New Jersey, unless they are also licensed in New Jersey. 

Insurance coverage

Mental health parity laws require health insurance companies to treat mental health or substance abuse disorders the same way they treat medical or surgical needs in terms of benefits and coverage. ^[18] Centers for Medicare & Medicaid Services. Sept. 6, 2023. The Mental Health Parity and Addiction Equity Act (MHPAEA). Found on the internet at https://www.cms.gov/marketplace/private-health-insurance/mental-health-parity-addiction-equity Still, Ellington shared that reimbursement rates for psychotherapy providers remain “substantially lower than reimbursement for medical services,” and “more experienced, senior therapists may stop accepting insurance.” This may also be true for some junior-level therapists. As a result, a lack of in-network providers in your area can sometimes make it hard to get help when you need it. 

If you have health insurance and can find a provider who accepts your plan, you should be able to attend a therapy session for the cost of your copay. According to Ellington, therapy session copays for those with insurance typically range between $15–$30. So, if you’re attending weekly therapy sessions, your out-of-pocket responsibility would be $60–$120 per month. If you’re seeing a specialist or a psychiatrist, your copay may be higher.

If you have health insurance through the Affordable Care Act’s Health Insurance Marketplace, your plan should cover mental and behavioral health services, though you may still have a copay. ^[19] U.S. Department of Health and Human Services. Does the Affordable Care Act cover individuals with mental health problems? April 20, 2023. Found on the internet at https://www.hhs.gov/answers/health-insurance-reform/does-the-aca-cover-individuals-with  

Your employer may provide other means of gaining access to affordable mental health care. Employee assistance programs (EAPs) often provide referrals to treatment and short-term counseling services to address issues like stress or grief. ^[20] Substance Abuse and Mental Health Services Administration. Provide support. Oct. 3, 2023. Found on the internet at https://www.samhsa.gov/workplace/employer-resources/provide-support “Because the services are short term,” Ellington said, “they may lack the ability to provide substantive therapy.” Still, these programs can “provide bridges of support between the time when therapy is needed and finding availability of therapy in the community.” 

You can also usually pay for therapy using a flexible spending account (FSA) or health savings account (HSA), which sets aside pre-tax money from your paycheck to use for health care expenses. 

How to pay for therapy 

It can be a challenge to build the cost of therapy into your budget, but there are ways to make mental health care more affordable. Consider these tips: 

1. Explore virtual therapy options. Virtual therapy can be more affordable than in-person options because it eliminates secondary costs like transportation and childcare. You may be able to save money on therapy by using an online therapy platform, many of which offer sliding scale rates or financial aid, discounts, and promo codes. 

2. Choose a provider appropriate for your needs. If you could benefit from medication such as an antidepressant, a primary care physician (PCP) may be an appropriate choice for medication management. But PCPs don’t offer therapy and often do not have the expertise and experience to prescribe medications for complex mental health conditions. In this case, a psychiatrist will be a more  appropriate choice even if it comes at a higher cost.  
   
   To save money, consider scheduling periodic medication check-ins with a psychiatrist or PCP in addition to seeing a more affordable therapist for weekly talk therapy sessions. An online psychiatrist can be an easy-to-access, affordable option for medication management. Also, there are masters-level prescribers, such as advanced practice registered nurses (APRNs), who could be more affordable, and some offer therapy. 

3. Use insurance. Call your insurance company to ask about your copay for mental health services. You can also ask for a list of in-network providers in your area. The NCOA BenefitsCheckUp tool can connect you to benefits programs that may help pay for mental health care.

4. Look into other employer options for mental health care. Ask your employer about setting up a pre-tax FSA or HSA account to help pay for mental health care. Your company may also have an EAP with counseling services for employees. 

5. Ask about sliding scale fees. If you don’t have insurance or can’t find an in-network provider for your insurance plan, ask therapists in your area about sliding scale fees. “Often therapists will charge patients without insurance the same reimbursed rate they receive from insurance,” Ellington said. 

6. Seek help in the community. Find a Certified Community Behavioral Health Clinic (CCBHC) in your area or contact your region’s Department of Health and Human Services to ask about community mental health services. 

Bottom line

With a typical per-session cost of $100–$200, paying for therapy can be challenging. But there are ways to reduce costs and get the help you need. If you have health insurance, look for an in-network provider who offers therapy for the cost of your copay. If you can’t find an in-network therapist or don’t have insurance, ask mental health care providers about sliding scale fees. Keep in mind that specialists, including psychiatrists, may be more expensive than psychologists or therapists. You may want to consider virtual therapy to save money on secondary costs like transportation or childcare. 

We all need mental health support at different stages in our lives. You deserve to get the help you need when you need it. If you’re having trouble accessing affordable therapy, talk to your primary care physician or call local 211 to find free mental health services in your community.  

Have questions about this article? Email us at reviewsteam@ncoa.org.

Sources

1. Substance Abuse and Mental Health Services Administration. Results from the 2022 national survey on drug use and health. Found on the internet at https://www.samhsa.gov/data/sites/default/files/reports/rpt42728/NSDUHDetailedTabs2022/NSDUHDetailedTabs2022/NSDUHDetTabsSect6pe2022.htm
2. National Council for Mental Wellbeing. Study reveals lack of access as root cause for mental health crisis in America. Found on the internet at https://www.thenationalcouncil.org/news/lack-of-access-root-cause-mental-health-crisis-in-america/
3. National Institute of Mental Health. Psychotherapies. February 2024. Found on the internet at https://www.nimh.nih.gov/health/topics/psychotherapies
4. Howard KI, et al. The Dose-Effect Relationship in Psychotherapy. American Psychologist. February 1986. Found on the internet at https://psycnet.apa.org/record/1986-17818-001
5. Substance Abuse and Mental Health Services Administration. Table 6.1A – Any Mental Illness in Past Year: Among People Aged 18 or Older; by Gender and Detailed Age Category, Numbers in Thousands, 2021 and 2022. Found on the internet at https://www.samhsa.gov/data/sites/default/files/reports/rpt42728/NSDUHDetailedTabs2022/NSDUHDetailedTabs2022/NSDUHDetTabsSect6pe2022.htm
6. Centers for Disease Control and Prevention. Mental health treatment among adults: United States, 2020. July 29, 2021. Found on the internet at https://www.cdc.gov/nchs/products/databriefs/db419.htm
7. Reinert M, et al. The State of Mental Health in America 2023. Mental Health America. October 2022. Found on the internet at https://mhanational.org/sites/default/files/2023-State-of-Mental-Health-in-America-Report.pdf
8. National Alliance on Mental Illness. Mental health by the numbers. April 2023. Found on the internet at https://www.nami.org/about-mental-illness/mental-health-by-the-numbers/
9. Clement S, et al. What Is the Impact of Mental Health-Related Stigma on Help-Seeking? A Systematic Review of Quantitative and Qualitative Studies. Psychological Medicine. Feb. 21, 2014. Found on the internet at https://www.cambridge.org/core/journals/psychological-medicine/article/what-is-the-impact-of-mental-healthrelated-stigma-on-helpseeking-a-systematic-review-of-quantitative-and-qualitative-studies/E3FD6B42EE9815C4E26A6B84ED7BD3AE
10. National Institute of Mental Health. Mental illness. March 2023. Found on the internet at https://www.nimh.nih.gov/health/statistics/mental-illness
11. Pan American Health Organization. Seniors and mental health. Found on the internet at https://www3.paho.org/hq/dmdocuments/2012/Mental-Health-Eng.pdf
12. Elshaikh U, et al. Barriers and Facilitators of Older Adults for Professional Mental Health Help-Seeking: A Systematic Review. BMC Geriatrics. Aug. 25, 2023. Found on the internet at https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-023-04229-x
13. Medicare.gov. Mental health care (outpatient). Found on the internet at https://www.medicare.gov/coverage/mental-health-care-outpatient
14. Bruijniks S, et al. Frequency and Change Mechanisms of Psychotherapy Among Depressed Patients: Study Protocol for a Multicenter Randomized Trial Comparing Twice-Weekly Versus Once-Weekly Sessions of CBT and IPT. BMC Psychiatry. June 30, 2015. Found on the internet at https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-015-0532-8
15. Greenwood H, et al. Telehealth Versus Face-to-Face Psychotherapy for Less Common Mental Health Conditions: Systematic Review and Meta-Analysis of Randomized Controlled Trials. JMIR Mental Health. July 21, 2021. Found on the internet at https://mental.jmir.org/2022/3/e31780
16. Ardito R, Rabellino D. Therapeutic Alliance and Outcome of Psychotherapy: Historical Excursus, Measurements, and Prospects for Research. Frontiers in Psychology. Oct. 17, 2011. Found on the internet at https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2011.00270/full
17. Cummings JR, et al. Geographic Access to Specialty Mental Health Care Across High-and-Low-Income US Communities. JAMA Psychiatry. May 2017. Found on the internet at https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2616167 
18. Centers for Medicare & Medicaid Services. Sept. 6, 2023. The Mental Health Parity and Addiction Equity Act (MHPAEA). Found on the internet at https://www.cms.gov/marketplace/private-health-insurance/mental-health-parity-addiction-equity
19. U.S. Department of Health and Human Services. Does the Affordable Care Act cover individuals with mental health problems? April 20, 2023. Found on the internet at https://www.hhs.gov/answers/health-insurance-reform/does-the-aca-cover-individuals-with-mental-health-problems/index.html
20. Substance Abuse and Mental Health Services Administration. Provide support. Oct. 3, 2023. Found on the internet at https://www.samhsa.gov/workplace/employer-resources/provide-support