Claibourne Counseling Fees

Why Private Pay Therapy Can Be Better for You

It’s easy to assume that using insurance is always the best financial choice, but when it comes to mental health care, that’s not always the case. Private pay (sometimes called “self-pay”) gives you something that insurance simply can’t: privacy, choice, and control over your therapy experience.

Below are a few reasons many clients choose to pay privately, and why doing so can actually make your care more personal and effective. 

1. Your privacy stays 100% yours.

When you use insurance, your therapist is required to share certain information about you and your treatment with your insurance company, including a mental health diagnosis and more often than not, detailed case notes about your sessions.

Private pay keeps your therapy between you and your therapist. No one outside the room or treatment relationship needs to see your personal story, your diagnosis, or your progress notes.

(Real-world Example: A Claibourne client once submitted for out-of-network reimbursement, and the insurance company requested all of their private case notes before processing the claim.) 

2. You’re not limited by insurance rules.

Insurance companies often decide how many sessions you’re “allowed” to have, regardless of what you and your therapist believe is best. They can also dictate what types of therapy they’ll cover or stop coverage once symptoms are considered “managed.”

Private pay removes those limits. You and your therapist decide what’s best for your growth, mental health, and healing, not a claims department. 

3. Insurance puts pressure for a diagnosis on day one.

When you use insurance, your therapist must assign a mental health diagnosis during or shortly after your first session, even if it’s too soon to fully understand what’s going on.

With private pay, therapy can begin with curiosity and understanding rather than a label. Your therapist can take the time to get to know you and your goals before making any clinical determinations. 

4. You’re not defined by an “F code”.

Insurance companies require therapists to use what’s called an “F code” from the DSM…a list of mental health disorders like anxiety, depression, or PTSD. Even if you’re coming to therapy for stress, life transitions, or self-growth, insurance won’t cover it without an F code.

Private pay allows your therapist to use a “Z code” instead, which covers things like relationship issues, grief, or major life changes…situations that don’t necessarily mean something is wrong with you but you still deserve care and support. 

5. You get more time, attention, and flexibility. 

Therapists who work through insurance panels often face productivity quotas. This means they have to see a high number of clients each week to make a living. That can lead to burnout and less time for things like continuing education, consultation, or personalized care.

Private pay gives therapists the freedom to focus on quality over quantity. This allows the to spend more time preparing for your sessions, stay up to date on research, and offer more individualized treatment instead of rushing from client to client.

FEDERAL NO SURPRISES ACT NOTICE (#0938-1401)

You are entitled to receive a “Good Faith Estimate” of what the charges could be for psychotherapy services provided to you. While it is not possible for a psychotherapist to know, in advance, how many psychotherapy sessions may be necessary or appropriate for a given person, this provides an estimate of the cost of services provided.

Your total cost of services will depend upon the number of psychotherapy sessions you attend, your individual circumstances, and the type and amount of services that are provided to you. This estimate is not a contract and does not obligate you to obtain any services from the provider(s) listed, nor does it include any services rendered to you that are not identified here.

A Good Faith Estimate is not intended to serve as a recommendation for treatment or a prediction that you may need to attend a specified number of psychotherapy visits. The number of visits that are appropriate in your case, and the estimated cost for those services, depends on your needs and what you agree to in consultation with your therapist. You are entitled to disagree with any recommendations made to you concerning your treatment and you may discontinue treatment at any time.

The current psychotherapy pricing is listed in the Therapy Pricing section at the very top of this page. Most clients will attend one psychotherapy visit per week, but the frequency of psychotherapy visits that are appropriate in your case may be more or less than once per week, depending upon your needs.

You are encouraged to speak with your provider at any time about any questions you may have regarding your treatment plan, or the information provided to you in the full written Good Faith Estimate you will receive during your intake.

Disclaimers

A Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.

A Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, and your bill is $400 or more for any provider or facility than your Good Faith Estimate for that provider or facility, federal law allows you to dispute the bill.

You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available. You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days of the date on the original bill.

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises, email Fe******************@*****hs.gov, or call 800-985-3059.