Is couples therapy covered by insurance? CPT code 90847 guide
When considering the average cost of a psychotherapy session by state, you might think a session is most expensive in California or New York.
Think again.
Our deep dive into SimplePractice exclusive data* on the average cost of psychotherapy sessions by state reveals pricing patterns that may defy conventional wisdom.
As therapists build their private practices and client lists, they may feel uncomfortable as they ask a key question—how much should they charge for therapy? And, what data points can they consider when setting their rates?
Clinicians navigate a profound ethical tension—balancing the commitment to accessible care that drew many to the profession against the financial realities of running a sustainable practice.
This balancing act plays out in every rate-setting decision.
To find the average cost of a psychotherapy session, we analyzed nearly 105 million therapy sessions (both self-pay and insurance) conducted in 2023-2024 using SimplePractice data on CPT codes for psychotherapy.
This unprecedented dataset from nearly 204,000 behavioral health therapists located in all 50 states and the District of Columbia, shows the average cost of psychotherapy sessions by state today.
Is therapy getting more expensive?
According to SimplePractice internal data, the cost of therapy has risen almost 13% over the past five years.
Download our free 24-page white paper to learn more about the rising cost of therapy in America—as well as to find out expert insights on how insurance plays into the average rates.
In 2019, therapists charged an average of $123 for therapy sessions (both private pay and insurance).
The data reveals a consistent pattern of cost acceleration, with therapy rates climbing approximately 4% annually since 2021, outpacing general inflation during several years and suggesting structural factors driving mental health care costs upward.
In 2024, the average cost of a psychotherapy session has risen to roughly $139—a $16 increase.
Furthermore, in 2017, SimplePractice published research showing that the nationwide median rate for therapy that year was $120.
Taking this additional data into account demonstrates a continual increase in the cost of therapy over the past seven years.
What is the market rate for therapy?
The market rate, also known as the going rate for a therapy session, refers to the range of rates which vary by city and state.
While this information is just one of many data points therapists consider when setting their rates, it’s arguably one of the most important.
If a therapist sets their rate too high, they may not be delivering the access to care that drew them to behavioral health in the first place.
However, if a therapist sets their rate too low, perhaps they will be perceived as offering less value to their clients.
And insurance reimbursement rates and therapy costs can even significantly vary between cities and towns in the same states that are just miles away from each other. How much a therapy session costs with insurance can vary significantly between cities and towns in the same state, even when they're just miles apart.
That said, the U.S. states with the highest and lowest average cost of a psychotherapy session may surprise you.
Which states have the highest therapy costs?
In 2023-2024, the average cost of a psychotherapy session by state varied from as low as $122, to as high as $227, according to SimplePractice data.
The cost disparity is particularly evident at the top of our list, where two states stand out with average psychotherapy session costs exceeding $200.
1. North Dakota: $227
2. Alaska: $212
3. South Dakota: $192
4. Washington D.C.: $189
5. Arkansas: $184
6. Oregon: $182
7. Nebraska: $180
8. Mississippi: $179
9. Minnesota: $176
10. New York: $176
Mental health access gaps—and their impact on the cost of therapy
The geographic distribution of psychotherapy session costs by state challenges simplistic cost-of-living explanations.
While metropolitan hubs with higher costs of living—like Washington D.C., New York City, and Portland, Oregon—contribute to their states ranking among those with the highest rates for therapy sessions, the presence of rural states like North and South Dakota at the very top of our rankings reveals a more complex reality: the critical variable appears to be provider scarcity, rather than regional affluence.
When you consider the lower number of mental health clinicians practicing in North Dakota, Alaska, South Dakota, Arkansas, and Nebraska compared to the number of state residents, it becomes clear that there are fewer mental health providers per capita in many of those states.
For example, South Dakota reported only 150 clinical and counseling psychologists in 2023, and North Dakota reported 160, according to the U.S. Bureau of Labor Statistics. Based on their current populations, South Dakota has approximately one psychologist for every 6,130 citizens and North Dakota has approximately one psychologist per 4,900 citizens.
In comparison, the state of New York reported 7,290 clinical and counseling psychologists—which is one psychologist per 2,690 citizens.
Our findings illuminate a classic economic principle in action: in states where mental health professionals are scarce—with some regions showing one therapist per 5,000+ citizens—session rates climb substantially, creating therapy deserts where care exists, but only at premium prices.
What states have the lowest therapy costs?
Based on SimplePractice data, in 2023-2024, only six U.S. states had rates of therapy under $130 per session: Oklahoma, Tennessee, Vermont, South Carolina, Louisiana, and Missouri.
The 10 states with the lowest average cost of a psychotherapy session include:
1. Missouri: $122
2. Louisiana: $123
3. South Carolina: $123
4. Vermont: $126
5. Tennessee: $126
6. Oklahoma: $129
7. Texas: $131
8. Indiana: $132
9. Nevada: $134
10. Florida: $134.80
Download the free 24-page white paper to find out more about how much therapy costs in the U.S., and to get expert tips from clinicians nationwide.
*NOTE: All data used in this analysis is completely anonymous. SimplePractice does not sell therapist data at any time for any reason.
The data included in this white paper reflect actual session rate data billed by SimplePractice customers in the U.S. from 2019 to 2024 for both self pay and insurance pay sessions.
This report also includes data from 104,679,056 session fees (self pay and insurance pay) collected in 2023-2024, from nearly 204,000 behavioral therapists located in all 50 states and the District of Columbia, who use the SimplePractice EHR platform and reported treatments using CPT codes 90832, 90833, 90834, 90836, 90837, and 90838.
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