Hey, it's Candice here.
Money is one of the most common reasons people put off therapy, and one of the least talked about. People will tell me about panic attacks, grief, and trouble in their marriage on a first call, then go quiet and say, "Okay, but… what does this actually cost?"
That's a completely reasonable question. Here's a straight answer, including how to find out whether your insurance will pay some of it back.
What therapy typically costs in California
Rates vary a lot depending on where the therapist is, their license, how much experience they have, and what they specialize in. In major California metro areas like Los Angeles and the Bay Area, private-pay sessions with an experienced licensed therapist are often in the range of a couple hundred dollars or more per session.
My current rates:
- Initial session: $300
- Ongoing sessions (50–55 min): $275
- Therapy intensives: $1,400 – $1,950 (see below)
All sessions are online, for clients anywhere in California. You can see the full details on my Rates & Insurance page.
Under the No Surprises Act, you also have the right to a Good Faith Estimate of what your care is expected to cost.
Why some therapists are private pay
I'm a private-pay practice, which means I don't bill insurance directly. I want to be transparent about why, because it isn't about being exclusive.
A big reason is time. Billing insurance takes a lot of it: claims, authorizations, paperwork, follow-up calls. Private pay means more of my time and attention goes to you and our sessions, not to billing.
It also keeps our work centered on you. When a therapist is in-network, insurance generally requires a diagnosis to justify the sessions, and it can have a say in how many sessions you get and what the work focuses on. With private pay, your goals, your pace and your priorities set the direction.
One thing private pay doesn't change: therapy records are confidential, but there are legal limits to that confidentiality whether or not insurance is involved. Records can still be subpoenaed, for example.
That said, private pay doesn't have to mean "insurance pays nothing." That's where superbills come in.
What's a superbill?
A superbill is an itemized receipt for our sessions that you can send to your insurance company to ask for out-of-network reimbursement. It includes the details insurers usually ask for, like dates of service, session codes, my license and NPI information, and a diagnosis code.
You pay me at the time of the session. Then you submit the superbill to your insurance, and if your plan has out-of-network benefits, they pay you back a portion.
How to check your out-of-network benefits (5-minute call script)
Call the member services number on the back of your insurance card and ask:
- "Do I have out-of-network benefits for outpatient mental health?"
- "What's my out-of-network deductible, and how much of it have I met this year?"
- "Once I meet the deductible, what percentage do you reimburse for CPT codes 90834 and 90837?" (90834 is the code for a 38–52 minute session and 90837 is for 53 minutes or longer. Your superbill will show whichever matches your session. For a first session, also ask about 90791.)
- "Is telehealth covered at the same rate?"
- "How do I submit a superbill, and how long does reimbursement usually take?"
Write the answers down. Whether you get reimbursed, and how much, depends entirely on your plan. Some people get a meaningful share back, and others have high deductibles that need to be met first. Knowing your numbers before you start takes a lot of the stress out of it.
A few other ways people pay for therapy:
- HSA / FSA: therapy is often an eligible expense. Check with your plan administrator.
- Employer benefits: some employers offer mental health stipends or reimbursement beyond an EAP.
Is therapy worth the cost?
I'll answer this one honestly, including the part that doesn't point toward me.
Not everyone needs ongoing weekly therapy. Sometimes what you need is a few practical tools, and a workshop or some focused reading will get you there. (I wrote about this on Substack: Do I need therapy, or do I just need some tools?)
But here's what I'd ask you to weigh: what is the current situation costing you? Lost sleep. Short temper with people you love. Work that takes twice as long because your mind keeps looping. The weekend you spent recovering instead of living. Those costs are real too. They just don't come with a receipt.
Ways to get more value from therapy
- Come with something to work on. Even "I want to stop lying awake replaying conversations" is a great starting point.
- Practice between sessions. You'll leave with tools to try. The work between sessions is where a lot of the change happens.
- Consider an intensive. If you have one specific goal, a therapy intensive packs focused work into a short window. Hour for hour, it costs less than standard weekly sessions.
Ready to take the next step?
- Questions about cost or fit? Book a free 10-minute call. Money questions are welcome. Nothing is awkward here.
- Ready to begin? Book your Initial Session.
Frequently asked questions
How much does a therapy session cost in California?
It varies by location, license and experience. In major California cities, private-pay sessions with an experienced licensed therapist commonly cost a couple hundred dollars or more. Candice Beaton, LCSW, charges $300 for an initial session and $275 for ongoing 50–55 minute sessions.
Does insurance cover therapy with a private-pay therapist?
Often it covers some of it, if your plan has out-of-network benefits. You pay the therapist, submit a superbill, and your insurer reimburses a portion based on your plan.
What is a superbill for therapy?
An itemized receipt with dates of service, CPT codes, diagnosis code, and provider details that you submit to insurance to request out-of-network reimbursement.
Can I use my HSA or FSA for therapy?
In many cases, yes. Therapy is commonly an eligible medical expense. Check with your plan administrator.
What CPT code should I ask my insurance about?
90834 for a 38–52 minute session, 90837 for 53 minutes or longer, and 90791 for an initial evaluation.
About the author
Candice Beaton, LCSW (California license #86047) is a Los Angeles–based psychotherapist who has been in clinical practice for ten years and specializes in anxiety, burnout and high-functioning stress. She works with adults online across California using CBT, DBT, ACT and mindfulness-based approaches, offers therapy intensives and the Under Pressure workplace program, and writes The Steady Mind on Substack. Read more about Candice.
Disclaimer: This article is for education and isn't a substitute for individual care. If you're in crisis, call or text 988.
Candice Beaton, LCSW
Licensed psychotherapist · Modern Therapy CB
