Therapy without an insurance
company in the room.
Matthew Simpson, LMHC · $125/session · Sliding scale available · Telehealth only
What paying out of pocket actually gets you
This isn't a lecture on why insurance is bad. Insurance covers therapy for a lot of people and that's worth something. But there are real reasons some clients prefer not to use it — and it's worth being direct about what those are.
When you use insurance, a diagnosis code goes on your record. Your insurer can access your treatment history. Your coverage limits are your insurer's limits — not a clinical judgment about what you actually need. And your therapist has to justify the work using criteria designed around cost management, not your situation.
Cash pay removes that layer. The clinical relationship is between you and the therapist. What we address is what you actually need. No required diagnosis to start, no session caps, no prior authorization, no third-party review of your records.
For many people — especially those who are high-functioning enough that the system might not flag them as severe, or who work in fields where a mental health record carries professional risk — that matters.
No diagnosis required to start
Insurance billing requires a diagnosis code on file from session one. Many people — particularly those who are late-identified or self-identified as neurodivergent — don't have a formal diagnosis and aren't looking to get one. Cash pay skips that requirement entirely.
Full confidentiality
Insurers have access to claims data including diagnosis and treatment history. For clients in certain industries or with certain concerns about their records, that's not a neutral fact. Cash pay keeps the clinical relationship private.
Clinical decisions stay clinical
No prior authorization. No session limits. No coverage review. The work continues as long as it's useful, and adjusts based on what's actually happening — not what an insurance protocol allows.
What therapy costs here
Straightforward pricing. No hidden fees, no intake charge, no cancellation traps.
$125 / session
60 minutes, weekly. That's the standard rate. No initial assessment fee, no separate intake charge. The first paid session is a regular therapy session.
Sliding scale available
A limited number of reduced-fee slots are available for clients who need them. Reach out directly to discuss what you're working with and whether a sliding scale slot is currently open.
HSA & FSA accepted
Therapy with a licensed mental health clinician qualifies as a medical expense under IRS guidelines. HSA and FSA cards are accepted directly — no reimbursement process required.
Before committing to anything
The 20-minute pre-consultation is free and has no commitment attached to it. It's a conversation about what's happening, what you're looking for, and whether this approach is the right fit — before either of us decides to proceed.
Book the Free ConsultationHow to get money back from your insurance plan
If your plan includes out-of-network mental health benefits — common with PPO plans — you can typically recover a significant portion of the session cost. The process is more straightforward than it sounds.
You pay the session fee directly. Alma (the scheduling and billing platform this practice uses) automatically generates a superbill — a detailed receipt with the diagnosis code, procedure code, and all the information your insurer needs to process a claim. You submit that to your insurer. They reimburse you directly, typically within a few weeks.
The reimbursement rate depends on your specific plan, your deductible status, and your out-of-network coverage level. Before starting, it's worth calling the member services number on the back of your insurance card and asking: "What are my out-of-network mental health benefits, and what is my OON deductible?" That one call will tell you what to expect.
How superbill reimbursement works
- Pay $125 at the time of session
- Receive a superbill automatically via Alma
- Submit superbill to your insurer (online portal or mail)
- Receive reimbursement directly from insurer
- Typical reimbursement: 40–80% of session cost, after deductible
Example: $125 session × 60% OON reimbursement = $75 covered by insurer. Your effective cost: $50/session.
Questions to ask your insurer
- Do I have out-of-network mental health benefits?
- What is my OON deductible, and how much of it have I met?
- What percentage of the allowed amount does the plan reimburse after deductible?
- How do I submit an out-of-network claim?
Currently in-network with Aetna & Cigna
If you have Aetna or Cigna coverage and want to use it, that option is currently available. In-network means you pay only your copay or cost-share amount, and the practice handles billing directly with the insurer.
The pre-consultation is a good time to talk through your specific situation — insurance vs. cash pay, sliding scale eligibility, and what makes sense given your coverage.
View Full Fees & Insurance InfoWhat people ask about fees and payment
No. Many clients are self-identified or late-identified as neurodivergent. Cash-pay therapy doesn't require a formal diagnosis — we work from what you're actually experiencing. If insurance billing is involved, a diagnosis code is required on file from session one. Cash pay removes that requirement entirely.
Yes. A limited number of sliding scale slots are available for clients who need reduced fees. Availability varies — reach out directly to discuss whether a slot is currently open and what the reduced rate would look like for your situation.
Yes. Therapy with a licensed mental health clinician is a qualified medical expense under IRS guidelines. HSA and FSA cards are accepted directly. You don't need to pay out of pocket and submit for reimbursement separately — you can pay with the card at the time of session.
Cancellations require 24 hours' notice to avoid a late cancellation fee. The full session rate applies to late cancellations and no-shows. This is standard practice and covered in the intake documentation. If something comes up, reach out as early as possible.
In-network means the therapist has contracted with the insurer at a negotiated rate. You pay your copay or coinsurance amount; the insurer pays the rest directly to the provider. Out-of-network means no contract — you pay the full session fee and submit for reimbursement yourself, at a rate your plan determines. In-network is simpler and typically lower upfront cost. Out-of-network gives you access to providers outside the network, with reimbursement (often 40–80%) coming back to you directly.
A superbill is a detailed receipt that includes everything your insurer needs to process an out-of-network claim: the provider's name, license number, NPI, your diagnosis code, the procedure code for the session, the date, and the amount paid. Alma (the platform this practice uses for scheduling and billing) generates superbills automatically after each session. You use the superbill to submit your reimbursement claim directly to your insurer.
Your right to a Good Faith Estimate
Under the No Surprises Act, you have the right to receive a Good Faith Estimate of expected costs before beginning services. For therapy at $125/session, the annual cost at weekly frequency is approximately $6,500. This estimate reflects the session rate and does not guarantee coverage or reimbursement.
If you receive a bill that is $400 or more above your Good Faith Estimate, you have the right to dispute it. For questions, contact cms.gov/nosurprises.
Start with a free 20-minute conversation.
No intake forms, no commitment. A real conversation about what's happening, what you're looking for, and whether this is the right fit — before you spend a dollar.