How much does therapy cost? (Free white paper)
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Written by Kristen Garafano
In an initial call with a prospective client, you can anticipate they will ask, “How much does therapy cost?”
Therapists in private practice who set their own rates may find that it feels challenging and uncomfortable to determine and adjust, when needed, the price of therapy in their practice.
Several factors are at play for therapists setting therapy rates—geographic area, therapeutic specialty, years of experience, and whether or not the therapist accepts insurance.
In this white paper, we examine the average costs of therapy from 2019 to 2024, using SimplePractice data* on CPT codes for psychotherapy and original research. Additionally, we provide tips and resources to better enable clinicians to set fair therapy rates that support and sustain a healthy therapy business.
According to SimplePractice internal data, the cost of therapy has risen over 12% in the past five years.
Download the free 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.
Rising costs of therapy
So, how much does therapy cost in America today?
While it's helpful to know what therapists in your state or area are charging for therapy, this can be an uncomfortable topic to bring up with fellow therapists who may be your friends and colleagues.
In this report, we’ve broken down the average costs of therapy by year—from 2019 to 2024—and by U.S. state.
The demand for behavioral health services has recently reached all-time highs.
According to the American Psychological Association (APA), mental health diagnoses among adults ages 35 to 44 have increased from 31% in 2019 to 45% in 2023. In addition, 50% of adults ages 18 to 34 reported a mental health diagnosis in 2023—the highest rate among all age groups.
The COVID-19 pandemic has caused significant lasting effects, with nearly 80% of psychologists reporting an increase in patients with anxiety disorders since the start of the pandemic and 66% of psychologists seeing a rise in demand for depression treatment.
With the high demand for mental health care—plus recent inflation in the United States—it’s no surprise that the price of psychotherapy has increased over the past five years.
“Inflation has forced me to raise my rates higher than I normally would,” says Kari Silverberg, LMFT, a therapist in Minnesota. “Fees for everything I use to run my practice, like Quickbooks, email encryption, and insurance have all increased. Not to mention needing more take home pay to meet the rising costs of food, housing, and other personal expenses.”
How much does therapy cost across the U.S.?
In 2023-2024, the average fee per session varied by state and region—from as low as $122, to as high as $227, according to SimplePractice data.
States with highest costs of therapy
Two states surpassed the $200 per therapy session mark:
1. North Dakota, with an average cost of $227 per session.
2. Alaska, with an average cost of $212 per session.
Following North Dakota and Alaska, the 10 states/territories with the highest costs of therapy include:
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
11. Wyoming: $172
12. Hawaii: $167
States with lowest costs of therapy
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.
Indiana, Florida, and Texas also make the list of the states with lowest costs.
The 10 states with the lowest costs of therapy 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
Additional factors impacting the cost of therapy
In addition to location, when setting rates for their services, therapists may factor in:
Years of experience
A therapist may start out with lower rates when they’re new to the profession and increase them as they build more experience. So, in addition to location, experience should be factored into calculating the right rate.
“I check local therapy websites for common rates, and consider fees and their years of experience and training to compare it to my own,” says Silverberg.
Type of therapy or techniques offered
Many therapists offer cognitive behavioral therapy (CBT), however a particular clinician may also be trained in eye movement desensitization and reprocessing (EMDR) as well, which may be more rare and/or in-demand in a particular geographic area.
Therefore, the therapist trained in additional modalities may be able to charge more for their services than other therapists in their area.
Specializations
Does the therapist specialize in treating clients with substance use disorders?
Or do they have expertise with a certain subset of the population—like kids or couples?
Offering specialized services or expertise distinguishes therapists and makes them more appealing to certain client populations—especially if they’re underserved or in high demand.
Degree or license type
Clinical psychologists who must have PhDs and PsyDs, for example, may set higher rates than therapists or counselors with master’s degrees.
Rates will also vary between psychiatrists, psychologists, licensed professional counselors (LPCs), licensed clinical social workers (LCSWs), and marriage and family therapists (MFTs).
Business expenses
Therapists in cities or neighborhoods with a high cost of rent for office space may set higher rates to offset business costs, compared to clinicians in less expensive neighborhoods or those who only see clients virtually via telehealth.
How much is therapy with insurance?
Prospective clients with health insurance will often ask, “How much is a therapy session with insurance?” or “How much does therapy cost without insurance?” Therefore, it's essential therapists are prepared to answer these questions.
Whether or not to accept insurance can be a tricky decision for clinicians to make.
The insurance credentialing process can be lengthy and arduous.
That said, choosing to accept insurance for therapy can make a significant difference in increasing access to care, positively impacting the number and diversity of clients who are able to afford therapy.
With the mental health parity law, mental health services coverage is required to be comparable to physical health coverage.
For example, if a client’s health insurance charges them a $20 co-pay for medical provider visits, mental health visits must abide by the same prices.
In general, co-pays tend to cost about $20 for in-network providers and $60 for out-of-network therapists.
Here are some considerations for therapists when determining whether or not to accept insurance:
- What’s the socioeconomic status of clients in your city, state, or area? Would most people be able to afford to pay for therapy out-of-pocket if they aren’t able to use insurance?
- Is the therapist willing to market their services to gain clients—or, would it be easier to be listed in insurance directories where clients can search and find a therapist?
- What insurance companies are most common in the area? Are most people on Medicare or Medicaid, or do they have insurance coverage through their employers?
“The balance for each [clinician] is different,” says clinical psychologist Lindsay Oberleitner, PhD, director of clinical strategy at SimplePractice.
“For some of us, it means taking insurance as well as private pay, or it might involve helping clients figure out how to submit out-of-network claims,” Oberleitner says. “For others, it might involve finding ways to reduce the costs of running our businesses where possible before we increase fees. For others, it might be building a network of referrals for lower cost or in-network services to send prospective clients to.”
How to determine therapy rates
For new therapists setting their rates for the first time or therapists in private practice determining whether they should increase rates, there are numerous questions to consider.
“It is many times clear to us that we need to increase our rates for our own financial security and increased costs, but many of the fears we are carrying are the immediate ‘what ifs,’” says Oberletitner. “‘What if my clients cannot afford my rate?’” ‘What if I cannot maintain my caseload?’”
According to Oberleitner, a few tips that can help when setting or raising rates are:
- Easing existing clients into the increase, allowing time to plan and adjust, or giving them advance notice about when your rates will increase annually so they can anticipate and expect it (e.g., Jan 1).
- Consider including alternative fee structures such as low cost slots, reduced fees, income tiers, or a sliding scale.
- Being clear on your fees on your website and any early communications so that potential clients can self-select that your fees work for them. For example, include a FAQ section on your website addressing questions such as “How much does therapy cost per hour?”
What’s included in the "How much does therapy cost?" white paper?
Download the free “How much does therapy cost?” white paper, available at the top of this article, to see the complete state-by-state data, including the following information:
- Details on the rise in the cost of therapy over the past five years
- Average costs from 2019 to 2024
- Average costs across the U.S.
- Factors affecting the price of therapy
- Geographic location
- Clinician specialty, credentials, and experience
- How much is therapy with insurance?
- Deciding whether or not to accept insurance
- Negotiating reimbursement rates
- Increasing access to care
- Can telehealth help expand access to therapy?
- What do these rates mean for mental health clinicians?
- How to set and raise therapy rates
- Calculating therapy rates
- Increasing session rates
- Alternative fee offerings
Sources
- Benson, N. M., & Song, Z. (2020). Prices And Cost Sharing For Psychotherapy In Network Versus Out Of Network In The United States. https://doi.org/10.1377/hlthaff.2019.01468
- Does your insurance cover mental health services? (2014). https://www.apa.org/topics/managed-care-insurance/parity-guide
- Increased need for mental health care strains capacity. (2022). https://www.apa.org/news/press/releases/2022/11/mental-health-care-strains
- Stress in America 2023: A nation recovering from collective trauma. (2023). https://www.apa.org/news/press/releases/stress/2023/collective-trauma-recovery
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