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  • Susan Ellis

The advantages of paying cash for therapy

By Susan Ellis, MS, LPC-IT


When searching for a mental health provider you might see the words “cash-pay” or “self-pay." This means that you will pay for your services out of pocket directly to the therapist at the time of your appointment.

Cash-pay clients can pay for these services by cash, check, credit card, or Health Savings Account.

You may wish to use your insurance benefits to pay for your therapy sessions. However, there are benefits to paying out of pocket for our services.

  1. Protect your privacy-By using your insurance a therapist must provide a diagnosis to the insurance company. This diagnosis becomes part of your permanent medical record. You can opt to pay for services yourself to maintain your privacy since therapists will not have to share a diagnosis or when they see you with anyone. Once this information has been given to the insurance company, the therapist has no further ability to control the dissemination of that information and it becomes part of your permanent record. Unfortunately, this can impact future health, life, and disability benefits and premiums should you be unemployed, self-employed, or need to purchase your own benefits.

  2. Eliminates surprises from billing – By being a cash pay client you’ll know upfront what you’re responsible for, and there are no guessing games regarding coverage, co-pays, deductibles. You’ll know from the beginning what to expect, can budget accordingly, and won’t be shocked with a huge bill at the end of the month.

  3. Pay for your sessions using your HSA benefits. If you have a health savings account, you may choose to pay your therapist using your Health Savings Account. By using your HSA card you are paying for your therapy sessions using pre-taxed income, saving yourself money in the long run.

  4. No limits on the number or lengths of sessions—Some insurance company plans will limit the number of times you can see a therapist per week or will limit the number of sessions you can have per calendar year. Other insurance companies will limit the length of your session, often only approving 45-minute sessions. When you pay your therapist directly you can decide the frequency and duration of your sessions.

  5. Cost savings: Once you tell a therapist’s office you are insured, they are contractually obligated to charge you the rate they agreed to with the insurer. Many plans will not start covering mental health services until you have met a very high deductible. You will have to pay the contracted amount for services out of pocket until your deducible is met. Our office offers a cash payment rate, and some clients qualify for a sliding scale fee based on income.

  6. Chose the way you conduct your visits—During the pandemic, many clients discovered that they enjoyed participating in telehealth sessions with their therapists each week. Insurance companies are eliminating coverage for this convenient service. Cash pay clients have the option of remaining strictly telehealth as they work with their therapist.

Insurance companies act with their bottom line, profitability, and bureaucratic guidelines in mind. Their number one concern is not your best interest or that you receive the best care available, but rather how much profit they can make by saving themselves money. You have the power to bypass this problematic system when you elect to be a cash pay client. Call our office today to schedule an appointment with a therapist who will work with your best interest in mind. It can and will get better.

Susan Ellis is a therapist at Falls Counseling. She specializes in treating clients with complex trauma, mood disorders, anxiety, depression, and grief. Susan is accepting new clients.

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