How much does therapy cost without insurance?

If you need help right now

If you or someone you know is thinking about suicide or is in a mental health crisis, call or text 988. That reaches the 988 Suicide and Crisis Lifeline. The Lifeline says the service is free and private, and it is open at all hours. You can also chat with the Lifeline online if that feels easier.

Call 911 or go to the nearest emergency room if someone is in immediate danger. Cost should never be a reason to wait before you call for help.

Therapy prices vary by therapist and place

We do not give a dollar range on this page. We looked for a current national price for a therapy session from a government agency or a research group. We could not find a source we trust, and we do not want to guess. Prices differ by city and by the type of therapist, and they also depend on how long each session lasts. A few other things usually change the price too.

• Psychologists and social workers can set different fees than counselors.
• A first visit often costs more than later visits because it includes a longer talk about your history.
• Video visits and office visits can be priced differently, so it is fine to ask.
• Group therapy, where several people meet with one therapist, is often cheaper per person than one-on-one therapy.
• A clinic that gets public money may charge less than a private office.

Each therapist you contact can tell you the self-pay price, which is the price for people who pay without insurance. Our guide on how to ask for the cash price has a phone script you can adapt.

A sliding scale ties the price to your income

The price you pay on a sliding scale depends on how much money you make. SAMHSA is the federal agency that works on mental health and substance use. It says you can ask a provider if they have a sliding-fee scale or other options for a lower cost. Do this when you call to make an appointment.

Here is what you can say when you call. "I do not have insurance, and I would like to know if you offer a sliding scale and how you decide the fee." You can also ask what proof of income they need, if any. Some therapists only keep a few sliding-scale spots, so ask whether there is a waiting list.

NAMI, the National Alliance on Mental Illness, notes that some therapists take your current finances into account and offer sliding-scale fees. A sliding scale applies to what you pay yourself. It is separate from an insurance copay, which is the flat fee a plan charges at each visit.

Community mental health centers and health centers

Community mental health centers are local clinics that offer counseling and other mental health care. Many are run by counties, states or nonprofits. A federal study of mental health treatment facilities used 2010 data. It found that about 4 in 5 offered a sliding fee scale or free services. The rate was higher, at 88 percent, for outpatient mental health centers.

Community health centers, the federally funded clinics that charge by income, also treat mental health needs. HRSA, the federal health resources agency, says these centers treat medical and dental needs as well as mental health needs. They adjust their fees by income and family size. The community health centers guide explains how to find one.

To find a community mental health center near you, call your county health department or dial 2-1-1, a free helpline for local services. Ask how long the wait is for a first visit.

Training clinics at universities

NAMI says many colleges train their graduate psychology students by offering low-cost therapy to the community. The students work under the supervision of an instructor. Search for a nearby university with a psychology or counseling program, and ask whether it has a clinic that sees the public.

Before you sign up, ask about the fee and the wait for a first visit, and ask how long a student can see you. A training clinic can be a good fit if you want regular sessions at a lower fee.

How to keep the cost down once you start

Money questions are easier to ask at the first visit than after a bill arrives. Therapists are used to these questions, and a good one will answer them plainly.

Start by asking how long each session is and what the fee covers. Some offices charge a fee if you miss or cancel a visit, so find out the rule before you book. Another good question is how often the therapist suggests meeting, and whether you can meet less often if money is tight.

Group sessions usually cost less per person, so it is worth asking if they are an option. Ask if the fee can be lowered later if your income changes, and tell the office if it does.

If you are not sure you qualify for Medicaid, check before you pay out of pocket. Medicaid is the public insurance program run by your state, and it can pay for mental health care. Our guide on the Medicaid gap explains who can and cannot get it.

Medicine costs extra on top of therapy. If a doctor prescribes one, our guide on prescriptions without insurance shows how to compare pharmacy prices.

Other places to look

SAMHSA runs a free helpline at 1-800-662-4357 that gives referrals in English and Spanish. The line is private and open at all hours. SAMHSA also runs a treatment finder on the internet that lists state-licensed programs near you.

A primary care doctor can talk with you about how you feel and help you find the right kind of care. To start the conversation, search for a cash-pay doctor near you. The sliding scale clinics guide explains how those fees are set.

This page gives general information and is not medical advice. Call the billing office and ask for a payment plan if a bill from a past visit is hurting your budget.