What Is Out-of-Network Therapy?

Out-of-network (OON) therapy means your therapist is not contracted with your insurance company. As an OON provider, I am paid directly by clients. However, many PPO insurance plans offer reimbursement for therapy—even if your therapist is out-of-network.

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Here’s how it typically works:

• You pay your session fee directly to me.

• I provide a superbill (a detailed receipt with all the necessary codes).

• You submit the superbill to your insurance company.

• If your plan includes OON benefits, you receive partial reimbursement after your deductible is met.

 

Example: If the session fee is $250, and your insurance allows $180 and reimburses 60%, you may get back $108—making your out-of-pocket cost $142.

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Self-Pay vs. Out-of-Network: What’s the Difference?
Both models involve paying your therapist directly, but with one key difference:

• Self-Pay Therapy means you’re choosing not to submit anything to insurance. Your care remains entirely private, and you cover the full fee out of pocket.

• Out-of-Network Therapy allows you to seek reimbursement through your PPO insurance by submitting a superbill. You still pay upfront, but may get a portion of the cost back depending on your plan.

 

Why Clients in Colorado and Hawaii Choose Self-Pay or Out-of-Network Therapy

1. More Privacy—With One Important Caveat
When you pay privately, your mental health records are not automatically shared with insurance companies, and you aren’t required to receive a formal diagnosis. This allows for more discretion, especially when exploring sensitive or complex issues.

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However, it's important to know that no medical record is entirely private—in rare cases, therapy notes can be subpoenaed by the courts. That said, paying out-of-pocket offers significantly more control over your information than submitting claims to insurers.

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2. Greater Choice and Clinical Fit
Whether you’re navigating chronic illness, relationship patterns, life transitions, or parenting challenges, finding a therapist who truly understands is essential. Choosing an out-of-network provider removes the limitations of an insurance panel and lets you prioritize connection, clinical expertise, and aligned values.

 

3. Deeper, Tailored Work
Insurance often restricts how often and how long you can be seen. Some plans only approve 6–12 sessions per year. When we work outside that system, we’re free to tailor session length, frequency, and focus to your needs—not your insurer’s policies.

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4. Continuity Without Disruption
Out-of-network therapy offers the consistency many clients need for sustainable progress. There are no reauthorizations, random audits, or session caps that might interrupt your care just as you're starting to gain traction.

 

5. Shorter Wait Times and Better Availability
In-network therapists often carry larger caseloads, leading to long waitlists. As an out-of-network clinician, I intentionally maintain a smaller caseload so I can stay fully engaged, responsive, and prepared for every client session.

 

My Session Fees and Scholarship Options
I believe therapy should be high-quality, meaningful, and accessible. While I do not contract with insurance panels, I’m committed to making my work available to individuals, couples, and families at a range of financial levels.

 

Standard Rates

• 75-minute Couples Therapy Session: $250

• 50-minute Individual Therapy Session: $200

 

Needs-Based Scholarship Rates (Sliding Scale)
Available for clients who meet income eligibility or are navigating significant financial hardship. For Native Hawaiians and long-time local residents in Hawaiʻi, pay-what-you-can models or further discounts may be available. Click here to learn more about how I work to make quality mental health care more accessible.

 

Example Scholarship Tiers:

• Household income under $60,000/year → Individual: $75 | Couples: $115

• Household income under $50,000/year → Lower rates may be considered on a case-by-case basis

You’ll find more details here or by reaching out to inquire about availability and options.

 

Questions to Ask Your Insurance Provider
If you’re planning to submit for reimbursement, call your insurance and ask:

“Do I have out-of-network benefits for outpatient mental health services with a licensed psychologist?”

Key questions:

• What’s my out-of-network deductible and how much has been met?

• What percentage of the session is reimbursed?

• Are CPT codes 90834 (45 minutes) and 90837 (60 minutes) covered?

• Is there a session limit per year?

• Do I need a referral or prior authorization?

• What’s the process for submitting a superbill?

 

Why I’ve Chosen Not to Be In-Network
I made the choice to remain out-of-network because I want to give my clients more than a quick diagnosis and a rushed session.

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Working within insurance often means:

• High caseloads and long waitlists

• Reduced time for preparation, training, and reflection

• More time documenting than actually supporting clients

• Insurance “clawbacks,” claim denials, or restrictions on the type of care I can provide

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Instead, I’ve built my practice to prioritize depth, presence, and true partnership—allowing me to provide thoughtful care rooted in connection, not paperwork.

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Is Out-of-Network Therapy Right for You?
If you’re looking for therapy that goes beyond surface-level tools—therapy that centers around who you are, what matters most to you, and what’s actually happening in your life—working out-of-network may be the best path.

 

Clients often report that the quality of the work, the pace, and the clarity they gain is well worth the investment.

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If you’d like to explore working together, or have questions about how this process works, I invite you to reach out or schedule a complimentary consultation.