When people consider starting therapy, one of the first questions they ask is: “Do you take my insurance?” While this is a reasonable question, it may not always lead to the best care or experience. At Indy Mental Health and Wellness, I want to shed light on private pay therapy—what it is, how it compares to using insurance, and why it can be a more empowering and flexible choice for your mental health journey.

What Is Private Pay Therapy?

Private pay therapy simply means you pay your therapist directly for services, rather than going through your health insurance provider. You are responsible for the cost of your sessions, typically on a per-visit basis, and can choose whether or not to seek reimbursement from your insurance if you have out-of-network benefits.

This may sound daunting at first, but private pay therapy has many advantages—and for many people, it’s actually a better fit, both financially and clinically.

Insurance vs. Private Pay: Key Differences

Diagnosis:

Insurance – Yes. A mental health diagnosis is required to justify treatment.

Private Pay – No. A diagnosis is not needed to begin or continue therapy.

Privacy:

Insurance – Your records and treatment plans may be accessed by your insurance company.

Private Pay – Sessions are fully confidential between you and your therapist.

Couples:

Insurance – Rarely covered; not considered “medically necessary.”

Private Pay – Always available; no restrictions.

Session Limits:

Insurance – Often limited to a number of sessions or subject to approval.

Private Pay – You and your therapist decide the length and frequency of treatment.

Deductibles:

Insurance – Must meet a high deductible before benefits apply.

Private Pay – No deductible required – you pay per session.

Provider Choice:

Insurance – Must choose from a limited in-network list.

Private Pay – You choose your ideal therapist, regardless of network.

Why Private Pay Can Be a Better Option

No Diagnosis Required

When using insurance, your therapist is required to assign you a mental health diagnosis to justify treatment. This diagnosis becomes part of your permanent medical record, which can impact future insurance eligibility, employment applications, or life/disability insurance.

With private pay, no diagnosis is required unless you want one. You can seek support for life transitions, relationship challenges, stress, burnout, or personal growth—without being labeled or pathologized.

Full Privacy and Confidentiality

Insurance companies often require detailed documentation of your symptoms, treatment plans, and progress. This means a third party is involved in your care decisions.

Private pay therapy offers full confidentiality. Your sessions are between you and your therapist—period.

Freedom to Focus on What Matters to You

Many important issues people want to work on—such as improving communication in relationships, processing grief, or navigating career changes—don’t qualify for insurance reimbursement.

This is especially true for couples counseling, which is almost never covered by insurance. With private pay, you can pursue the therapy that fits your needs, not just what’s covered.

No Insurance Hassles or Surprise Bills

Using insurance often comes with frustrations: high deductibles, pre-authorization requirements, denied claims, and unexpected costs. With private pay, you know exactly what you’re paying and can plan accordingly.

What About Out-of-Network Benefits?

Many insurance plans offer out-of-network reimbursement, which means you can still get some financial support even when seeing a therapist who doesn’t take insurance directly.

Here’s how it works:

1. You pay for your session up front.

2. Your therapist provides you with a superbill (an itemized receipt with diagnosis and service codes).

3. You submit this to your insurance company for partial reimbursement.

4. You get a check or direct deposit if your plan offers out-of-network mental health coverage.

Depending on your plan, you might get 50–80% of the session fee reimbursed after your out-of-network deductible is met.

If you’re unsure whether you have these benefits, we recommend calling the number on the back of your insurance card and asking:

· Do I have out-of-network mental health coverage?

· What is my out-of-network deductible?

· How much will I be reimbursed for CPT code 90837 (a common code for 60-minute therapy sessions)?

Therapy is an investment in your long-term well-being, relationships, and quality of life. While using insurance may seem like the most economical route at first glance, private pay therapy offers:

· Greater flexibility

· Deeper privacy

· Personalized treatment

· Access to services like couples therapy

· Freedom from the bureaucracy of insurance systems

At Indy Mental Health and Wellness, I believe you deserve therapy that works for you—not your insurance company. If you’re ready to start your therapy journey or have questions about how private pay works, we’re here to help. Reach out to schedule a free consultation or learn more.

Click HERE to schedule an appointment!