Looking for a Therapist? Understanding Out-of-Network Therapy and How to Pay for It

Looking for a therapist? Here’s how to understand therapy costs, insurance, and what it means to see an out-of-network provider.

Choosing a therapist is a personal and sometimes vulnerable decision. We understand that cost and insurance coverage are often part of the equation — and that when you hear we’re an out-of-network (OON) practice, it might give you pause.

That hesitation absolutely makes sense. At Coastal Collaborative Care, we recognize that insurance companies play an important role in helping many people access care. We appreciate the benefits they provide and understand their value in the healthcare system. Our decision to be an out-of-network practice is not a rejection of insurance, but a commitment to offering the most personalized and flexible care possible.

Why Many Therapists Don’t Take Insurance

Insurance providers often impose restrictions that can interfere with the therapeutic process — limiting the number of sessions, requiring a diagnosis to justify care, or forcing therapists to follow rigid treatment plans that may not reflect your actual needs.

At Coastal Collaborative Care, being out-of-network means we can:

• Offer flexible, individualized care without outside interference
• Focus on your goals and values, not insurance requirements
• Avoid unnecessary diagnoses when not clinically warranted
• Support a relationship rooted in trust, collaboration, and autonomy

Therapy should be about you — your story, your healing, your timeline — not be dictated by forms, codes, or treatment plans created for insurance approval.

The Value of Private Pay Therapy

We know paying privately for therapy is a financial decision — and it can feel like a big one. You might be asking: Is this really worth it? Our answer is a wholehearted yes.

We believe the emotional work you do in therapy — becoming more self-aware, more connected, more able to respond rather than react — is one of the most valuable investments you can make. Your well-being, your child’s resilience, your ability to navigate life with greater stability and confidence — all of that deserves to be prioritized. You’re not just investing in therapy; you’re investing in a stronger foundation for your future.

When you invest in therapy at Coastal Collaborative Care, you’re not just paying for time — you’re investing in depth, presence, and continuity of care that extends beyond the therapy hour.

Because we’re not restricted by insurance networks, we have the freedom to:

• Work at a pace that’s right for you or your child
• Avoid labeling or over-pathologizing just to meet billing requirements
• Stay focused on your long-term growth, not short-term symptom tracking
• Offer support between sessions when appropriate — such as check-ins, collaboration with other providers, or email communication
• Coordinate care with schools, pediatricians, dietitians, psychiatrists, or other specialists when needed

This kind of flexibility and responsiveness is often limited or unavailable in traditional insurance-based settings. But here, it’s part of how we practice — because real life doesn’t pause between appointments.

Private pay therapy isn’t about exclusivity. It’s about creating space for deep, personalized work that honors your story, your needs, and your timing. You’re not entering a system — you’re entering a relationship rooted in respect and care.

Can I Get Reimbursed for Out-of-Network Therapy?

Yes, and maybe — many clients receive partial reimbursement from their insurance plan.

If you have out-of-network mental health benefits, you may be eligible for reimbursement for a portion of your session fees. At Coastal Collaborative Care, we provide monthly superbills (specialized receipts) that you can submit to your insurance provider to request reimbursement.

Our Partnership With Mentaya: Helping You Get Reimbursed

Because we know the reimbursement process can be confusing and time-consuming, we’ve partnered with Mentaya, a platform that simplifies the entire process. We can help you check whether your plan includes out-of-network benefits and give you a clearer understanding of your coverage. We provide superbills for all clients, and if you have out-of-network benefits, you can use Mentaya by having us submit your superbill to Mentaya for processing, or you can work with Mentaya yourself — whichever feels easier. Mentaya can check benefits, submit claims, track reimbursements, and help maximize the coverage your plan provides. Using this service with us is always completely optional.

Instead of managing paperwork, portals, and insurance follow-up on your own, we partnered with Mentaya in hopes it helps streamline the process so you can stay focused on your healing, not administrative tasks.

Learn more at: https://www.mentaya.com/

How to Check Your Out-of-Network Mental Health Benefits

If you prefer to verify benefits yourself, we’re here to help you navigate this. The first step is calling the number on the back of your insurance card to ask about your out-of-network mental health benefits. Tip: Have your insurance card ready before you call, and something to take notes with.

We have provided a sample script to make it easier: 

Hello, my name is [Your Name], and I’m calling to ask about my out-of-network mental health benefits. I’m planning to see a licensed therapist who is out-of-network, and I’d like to understand what kind of coverage or reimbursement I might be eligible for.

Here are the specific questions I need help with:

1. Do I have out-of-network benefits for outpatient mental health services?
   (If yes, continue with the following.)
2. What is my out-of-network deductible, and how much of it has already been met this year?
3. After I meet my deductible, what percentage of each therapy session is reimbursed?
4. Is there a maximum number of therapy sessions allowed per year?
5. Do I need any pre-authorization or referral from an in-network provider for out-of-network therapy?
6. Are the following CPT codes covered under my plan, and if so, at what rate?
   • 90791 – Initial intake/diagnostic evaluation
   • 90837 – Individual therapy, 60 minutes
   • 90834 – Individual therapy, 45 minutes
   • 90832 – Individual therapy, 30 minutes
   • 90846 – Family therapy (without the client)
   • 90847 – Family therapy (with the client)
7. What documentation do I need to submit for reimbursement?
   (Let them know you will receive a monthly superbill from your therapist.)
8. Where and how should I submit the superbill — online portal, mail, or fax?
9. How long does it usually take to process out-of-network claims?

Thank you so much for your help. That gives me a clearer understanding of how to move forward.

How to Request an Out-of-Network Exception

If your insurance plan does not include out-of-network benefits, you may still have options. An out-of-network exception can be requested by clients who do not have out-of-network mental health benefits. This is a special approval that allows insurance coverage for treatment with an out-of-network provider when no in-network provider can meet your needs.

This can be requested when a client cannot access appropriate care within their network—such as when in-network providers do not specialize in the care they need, or if an in-network provider does not have any availability. 

This is especially relevant for eating disorder treatment, which is a highly specialized area of care. Many in-network providers may not have the training or experience necessary to effectively treat eating disorders, or any in-network providers don’t have availability for new clients. Because eating disorders require a multidisciplinary and expert approach, insurance companies may grant an exception to ensure the client receives appropriate care. 

To request an out-of-network exception, the client should call the member services number on the back of their insurance card and ask to file an “out-of-network exception.” They should explain that they have been unable to find in-network providers with eating disorder expertise or an in-network provider accepting new clients, and request the out-of-network exception form to see a specialized out-of-network provider for covered care.

A therapist at Coastal Collaborative Care would be happy to help you through this process by completing the necessary form for you to submit to your insurance company. Please note that you will need to pay your therapist out-of-pocket at the time of service. However, you can then submit the superbill to your insurance company for potential reimbursement if the out-of-network exception is approved. This process helps ensure you can access the specialized care you need, even when in-network options are not available.

Using HSA, FSA, or HRA Funds to Pay for Therapy

Another option many clients use is applying HSA (Health Savings Account), FSA (Flexible Spending Account), or HRA (Health Reimbursement Arrangement) funds to cover therapy, depending on their plan. These accounts are designed to help you pay for eligible healthcare expenses using pre-tax dollars, which can significantly reduce the cost of care.

For a clear explanation of how these accounts work, what’s covered, and who qualifies, the IRS provides a helpful guide in Publication 969, available here:
https://www.irs.gov/publications/p969

Using these accounts can be a meaningful way to make therapy more affordable while still allowing you to choose the provider who best fits your needs.

Why Coastal Collaborative Care Chooses to Stay Out-of-Network

At Coastal Collaborative Care, we’ve chosen to remain out-of-network because we believe therapy should be shaped by the needs of real people — not insurance policies.

Our approach is grounded in the kind of care we would want for ourselves or our loved ones: thoughtful, flexible, accessible, and deeply human. By working outside the constraints of insurance networks, we can offer therapy that is truly personalized, collaborative, and paced around your life, not a system’s checklist.

Whether you’re coming to therapy for yourself or your child, we’re here to build something meaningful with you — a relationship rooted in trust and genuine care. Healing happens best when you feel safe, seen, and supported. That’s the kind of space we’re dedicated to creating.

Ready for Therapy That’s Built Around You?

At Coastal Collaborative Care, we believe therapy should be as unique as you are—unrushed, collaborative, and free from one-size-fits-all treatment plans. Choosing an out-of-network therapist means you get care that’s shaped by your needs, not insurance requirements.

If you’re curious about whether working with an out-of-network therapist is the right fit for you or your child, we’re here to help you explore your options and answer your questions.

• Learn more about our therapy services
• Meet our compassionate, inclusive team
• Get in touch to schedule a free consultation