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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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You pay your session fee directly to me, and I provide a superbill — a detailed receipt with all necessary codes. You then submit the superbill to your insurance company, and if your plan includes out-of-network 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

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Clients in Colorado and Hawai'i choose self-pay or out-of-network therapy for several reasons.

 

First, paying privately means your mental health records are not automatically shared with insurance companies and you aren't required to receive a formal diagnosis — though it's worth noting that no medical record is entirely private, and therapy notes can in rare cases be subpoenaed.

 

Second, choosing an out-of-network provider removes the limitations of an insurance panel, letting you prioritize connection, clinical expertise, and aligned values.

 

Third, insurance often restricts how often and how long you can be seen, sometimes approving only six to twelve sessions per year — working outside that system allows us to tailor everything to your needs.

 

Fourth, out-of-network therapy offers the consistency many clients need, with no reauthorizations, audits, or session caps that might interrupt your care just as you're gaining traction.

 

And fifth, because I intentionally maintain a smaller caseload, you benefit from shorter wait times and a therapist who is fully engaged and prepared for every 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: $325

• 50-minute Individual Therapy Session: $225

 

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.

Learn more about accessible care options →

 

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

View full scholarship details → 

 

Questions to Ask Your Insurance Provider

When you call your insurance provider, ask whether you have out-of-network benefits for outpatient mental health services with a licensed psychologist. You'll also want to know your out-of-network deductible and how much has been met, what percentage of the session is reimbursed, whether CPT codes 90834 and 90837 are covered, whether there's a session limit per year, whether you need a referral or prior authorization, and what the process is 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 and reflection, more time documenting than supporting clients, and the risk of 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.