Hi, I'm Sheila Trabelsi - a licensed counselor and the proud owner of Path to Growth Therapy located in Loveland, CO.
Meet Sheila
When seeking therapy, one of the most important decisions you’ll make is how to pay for your sessions. While insurance is often the first option people consider, private pay (paying out of pocket) offers several unique benefits that might make it the better choice for your mental health journey. Understanding the differences between insurance-based therapy and private pay therapy can help you make an informed decision that aligns with your goals, privacy concerns, and long-term well-being.
In this guide, we’ll explore why some therapists choose not to accept insurance, the key benefits of private pay for clients, how out-of-network reimbursement works, and financial options that can make therapy more accessible.
Many highly qualified therapists opt for a private pay model to offer clients the highest quality of care without the constraints imposed by insurance companies. Here’s why:
Insurance companies require therapists to assign a DSM-5 mental health diagnosis for reimbursement. However, not all therapy clients seek treatment for a clinical disorder. Many individuals pursue therapy for personal growth, stress management, life transitions, or relationship counseling, which may not meet insurance criteria. For example, couples therapy and career coaching are often not covered by insurance (due to lack of diagnosis), despite their immense benefits.
When you use insurance for therapy, your mental health diagnosis becomes part of your permanent medical record. This information could potentially impact future employment opportunities, security clearances, or life insurance rates. Private pay therapy ensures that your records remain confidential between you and your therapist, offering you full control over your personal information.
Certain diagnoses, such as Adjustment Disorder (F43.2), are only valid for six months according to insurance regulations. This creates challenges for individuals who require long-term care but don’t meet the criteria for chronic mental health conditions. With private pay therapy, treatment duration is based on client needs rather than arbitrary timelines set by insurance providers.
Insurance companies often dictate:
Private pay therapy eliminates these restrictions, allowing therapists to design personalized treatment plans that best support client goals without interference.
Although private pay therapy is an investment, it comes with a range of advantages that can significantly improve the quality and effectiveness of your mental health care.
Private pay allows you to receive truly individualized therapy without the limitations of insurance. This means that you and your therapist can focus on what matters most to you, whether that’s overcoming anxiety, improving emotional intelligence, processing trauma, or enhancing personal growth. Therapists are also able to integrate multiple therapeutic approaches without being constrained by insurance guidelines.
If you don’t meet the criteria for a mental health disorder but still want support, private pay allows you to seek therapy without needing a formal diagnosis. This is especially beneficial for high-functioning professionals, entrepreneurs, couples, and individuals working on self-improvement.
Since no information is submitted to an insurance company, private pay therapy ensures that your records remain confidential. This is particularly crucial for executives, healthcare professionals, first responders, or individuals in high-profile careers who value discretion.
Insurance-based therapy often limits the number of covered sessions per year. This can lead to rushed treatment or premature termination. With private pay, therapy is tailored to your pace and progress, ensuring lasting change and deeper healing.
Many highly sought-after therapists operate on a private pay basis due to the extensive training and expertise they offer. This gives you access to top-tier professionals without being limited to providers in an insurance network.
Even if your therapist doesn’t accept insurance, you may still be able to reduce your out-of-pocket costs using out-of-network benefits.
A superbill is a detailed invoice that includes session details and diagnosis codes. Many PPO insurance plans offer partial reimbursement for out-of-network therapy. Many therapists also offer collaboration with companies like Mentaya where you can check your coverage and easily submit for reimbursements of services, rather than hassling with the insurance companies themselves. Check your policy to see if your plan provides coverage for mental health services outside its network.
Contact your insurance provider to ask:
Many therapists are experienced in helping clients navigate the superbill submission process. At Path to Growth Therapy, we provide superbills upon request and partner with Mentaya for easy reimbursement submission and guide clients in understanding how to maximize their insurance benefits.
Therapy is an investment, but it should also be accessible. At Path to Growth Therapy, we offer various payment solutions to help clients prioritize their mental health:
Some clients opt for structured payment plans that allow them to spread the cost of therapy over several months if they are purchasing larger packages like Therapy Intensives or Extended Couples Therapy packages.
Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) can often be used to cover therapy costs, providing a tax-advantaged way to pay for services.
Some financing companies, such as CareCredit or Affirm, offer payment options for mental health services, making therapy more budget-friendly.
When opting for private pay therapy, you will sign an acknowledgment or opt-out form stating that you have chosen to pay out-of-pocket for services rather than using insurance. If you decide to submit a superbill for reimbursement, the process will be between you and your insurance provider. At Path to Growth Therapy, we ensure transparency by clearly outlining payment policies, providing documentation, and helping clients navigate their payment options.
Choosing private pay therapy is an investment in your well-being, personal growth, and future success. With the flexibility to receive customized care, increased privacy, and access to expert therapists, private pay can be one of the best decisions you make for your mental health.
If you’re ready to explore how therapy can support your journey toward greater emotional resilience, improved relationships, and personal fulfillment, we invite you to schedule a consultation at Path to Growth Therapy today.
Your mental health is worth prioritizing, and we’re here to help you every step of the way.