If you’ve started looking for a therapist, you’ve probably run into the phrase “out-of-network” and felt your stomach drop a little. It sounds like a polite way of saying expensive, or not for you. I want to walk through what it actually means, because the reality is more workable than most people assume, and often less costly than it first appears.
Being out-of-network simply means I don’t have a contract with insurance companies. I’m not on their panels, so I don’t bill them directly. You pay me for our work together, and depending on your plan, your insurance may reimburse you for a meaningful portion of what you paid.
That last part is the piece most people don’t know they have.
This isn’t about making therapy harder to access. It’s a deliberate choice about the quality of the work.
When a therapist is in-network, the insurance company sits quietly in the room. It decides how many sessions you’re allowed, requires a mental-health diagnosis to justify payment, and can request your treatment records to determine whether your care “qualifies.” Those constraints shape the therapy whether you want them to or not.
Working outside of insurance means our work is directed by you and me, by what you actually need, for as long as you actually need it, rather than by what a plan will authorize. Your history stays between us. There’s no diagnosis required on file with an insurer, and no session limit handed down by someone who has never met you.
For the kind of deep, attachment-focused, trauma-informed work I do, that freedom matters. It’s why many therapists who specialize choose to practice this way.
Here’s the part worth understanding, because it can change the math entirely.
Many insurance plans, especially PPO plans, include out-of-network benefits. This means that even though I’m not in your network, your plan will still reimburse you for a percentage of what you pay me, once you’ve met your out-of-network deductible.
The way it works is straightforward. You pay my fee at the time of our session. Your claim gets submitted to your insurance company. Once you’ve met your out-of-network deductible, they reimburse you directly for their share.
Depending on your plan, that reimbursement can cover a real portion of each session. Some people are surprised to learn their plan pays back the majority of the cost.
The part that usually scares people off out-of-network care isn’t the cost. It’s the hassle: paying full price, filing claims yourself, and waiting on hold with your insurance company.
I’ve tried to remove that friction. I use a tool called Thrizer that handles the insurance side for you. Before we ever talk, you can use it to check your out-of-network benefits in about a minute, so you know exactly what your plan would reimburse instead of guessing. And if we work together, Thrizer submits your claims for you, so you’re not chasing your insurance company or filing paperwork yourself.
You can check your own benefits right now on my Fees & Insurance page. It’s free, it takes about a minute, and there’s no obligation.
Say your plan has an out-of-network “allowed amount” of $200 per session and reimburses 70% of that after your deductible. That’s $140 back per session, meaning your true out-of-pocket cost is far lower than the sticker price once your deductible is met.
Every plan is different, so this is only an illustration, not a promise. But it shows why “out-of-network” and “unaffordable” are not the same thing.
You don’t have to call your insurance company and decode a maze of jargon to figure this out. The fastest way is the benefits checker on my Fees & Insurance page. You enter your plan details and get an instant estimate of what your out-of-network reimbursement looks like, before we ever talk.
If you’d rather ask your insurer directly, these are the questions to ask: Do I have out-of-network outpatient mental health benefits? What is my out-of-network deductible, and how much of it have I met this year? What percentage do you reimburse for out-of-network outpatient psychotherapy (CPT code 90837)? Is there a limit on the number of sessions?
A superbill is just a detailed receipt. It lists the dates we met, the service codes, a diagnosis code, my license and practice information, and what you paid. It’s the document your insurance needs to process your reimbursement. It isn’t something to feel intimidated by. I provide it, and Thrizer makes submitting it nearly automatic.
I want to be honest here, because the goal is for you to get good care, with me or with someone else.
If your plan has no out-of-network benefits (some HMO and EPO plans don’t), a claim won’t get you reimbursed, and you’d be paying the full fee yourself. If cost is the deciding factor and in-network care is what makes therapy possible for you right now, that is completely valid, and I’m always glad to help point you toward good in-network options.
There’s no wrong choice here. The right therapy is the therapy you can actually access and stay in.
“Out-of-network” isn’t a closed door. For many people it means paying upfront and getting a portion back, in exchange for care that stays fully between the two of us and isn’t rationed by a company that’s never met you. And with Thrizer handling the benefits check and the paperwork, the insurance side is far less of a headache than it used to be.
If you’re curious what it would look like for you, the quickest next step is to check your out-of-network benefits. It takes about a minute. Or you can reach out and we can talk it through together.
This post is for general educational purposes and isn’t insurance or financial advice. Coverage and reimbursement vary by plan; your insurer determines your actual benefits.
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