How do therapy fees work?

Counselors charge a “per session” fee for every clinical hour. Some clients pay this fee directly - this is called private pay. Other clients ask us to charge their insurance company for the fees.

At the Seattle Counseling Center, we have two fees. Licensed Mental Health Counselors (LMHC) charge $165/session and Licensed Mental Health Counselor Associates (LMHCA/P) charge $145/session.

Therapists at the Seattle Counseling Center are in-network with the following insurance companies:

• Premera

• Regence

• First Choice

• Blue Cross/Blue Shield

• Kaiser PPO

For all private pay clients, we provide a monthly superbill.

I don’t understand what all these terms mean. Can you help?

Using insurance for therapy can be confusing. Here are the key terms to help untangle the information:

• In-Network vs. Out-of-Network:

  • In-Network means we have an agreement with your insurance company to accept their negotiated rates. You usually pay only your deductible or co-pay.

  • Out-of-Network means we do not have a direct agreement with your insurance. You pay the session fee upfront, and your insurance may reimburse you partially. We provide superbills to simplify this process.

• Deductible: The amount you pay for healthcare services before your insurance starts covering costs.

• Co-Pay: A fixed amount you pay per session.

• Co-Insurance: A percentage of the session fee you are responsible for after meeting your deductible.

• Contracted Rate: The fee that your therapist has agreed upon with your insurance company. This is often lower than the therapist’s standard session fee, and your insurance plan may cover part of this amount according to your benefits.

• Superbill: A detailed receipt that you submit to your insurance company for reimbursement if you are out-of-network.

How do they work together?

This is where it gets tricky. Every plan has a different deductible, co-pay, co-insurance, contracted rate, and mental health coverage. Some plans have all, some plans only have a few of these pieces.

1. Deductible
Your deductible is the amount you need to pay out of pocket each year before your insurance starts covering services.

• Example: If your deductible is $1,500, you’ll pay the full contracted rate for therapy until you’ve spent $1,500 on covered medical expenses that year.

• After meeting your deductible, your insurance begins to pay for a portion of your therapy sessions.

2. Copay
Some plans require a fixed copay — a set dollar amount (for example, $20 or $40 per session) — each time you attend therapy.

• Copays are due at the time of your session.

• If your plan includes both a deductible and a copay, the copay usually applies after you’ve met your deductible.

3. Coinsurance
Instead of a flat copay, some plans use coinsurance, which means you pay a percentage of the session fee and insurance pays the rest.

• Example: If your plan has 20% coinsurance, you pay 20% of the contracted rate and insurance pays 80%.

4. Contracted Rate (or “Allowed Amount”)
This is the amount your therapist has agreed upon with your insurance company for each session.

• Even if your therapist’s full fee is higher, you’ll only be billed up to the contracted rate when using insurance.

• Your deductible, copay, or coinsurance is calculated based on this contracted rate.

5. Mental Health Coverage Before the Deductible
Some plans cover mental health services before you’ve met your deductible.

• This means you might pay only a copay right away rather than the full contracted rate.

• The only way to know for sure is to check your specific plan — benefits vary widely, even within the same insurance company.

How do I know what my coverage is?

It’s important you understand your coverage before beginning a counseling relationship. Here’s how to determine your coverage for in-network or out-of-network services.

1. Locate your insurance card and find your plan name and member ID.

2. Call your insurance company with the following questions:

   • What is my deductible? How much do I have remaining before I’ve met my deductible?

   • What is my co-pay or co-insurance for therapy?

   • How many sessions are covered per year?

   • Do I need a referral or prior authorization?

   • Is my therapist in network?

   • Do I have coverage for out-of-network providers?

   • Do you cover telehealth sessions?

Seattle Counseling Center can offer a courtesy benefit check; however, clients are ultimately responsible for payment of therapy services, regardless of what their insurance covers. We encourage clients to verify their insurance benefits and understand their coverage before scheduling sessions. Our office is happy to provide superbills and assist with insurance questions, but clients are responsible for knowing the details of their plan.

I want to get started but I’m still confused. Can you help?

Absolutely! Either send us an email at office@seattlecounselingcenter.org or schedule a free, 20 minute consultation and we’ll happily help understand your financial responsibility.