Therapy Cost Statistics (2026)

Therapy costs an average of $143.26 a session for people paying cash, according to a 2024 study in Health Affairs Scholar of the listed rates of 175,083 private practice psychotherapists on Psychology Today, current to the end of 2023.

That is a mean for a typical session; the study does not report a median or separate rates by session length. Therapists who accept insurance listed a lower average cash rate, $141.06, than those who do not, $155.90.

At $143.26, a weekly session for a year comes to about $7,450, and twice a month to about $3,725, by our arithmetic.

Psychologists and other PhD-level providers charge more. Their mean cash rate was $167.69 among those who accept insurance and $195.91 among those who do not.

Master's-level providers, such as licensed counselors, marriage and family therapists and clinical social workers, made up 76.5% of the providers in the study and psychologists 15.6%, so the overall average mostly reflects master's-level rates.

Average session fees run from $122 in Missouri to $227 in North Dakota, according to SimplePractice, a practice-management software company, using 104.7 million session fees recorded by nearly 204,000 therapists in 2023 and 2024. Its figures mix self-pay and insurance-paid fees, so they are industry data and not a cash price.

After North Dakota the highest averages were Alaska at $212, South Dakota at $192 and Washington, D.C. at $189. After Missouri the lowest were Louisiana and South Carolina at $123.

The cash-pay study found the biggest gaps between cash and Medicaid rates in Pennsylvania ($146.88 against $39.00), California ($172.71 against $67.16) and New York ($176.61 against $76.45). Nebraska was the only state where Medicaid paid more than the average cash rate (Zhu et al.).

Medicare's 2026 national rate for a 60-minute psychotherapy session (CPT 90837) in an office is about $167.00, up from $154.29 in 2025. A 45-minute session (90834) is about $113.90 and a 30-minute session about $85.84.

These are our calculations: total relative value units from the CMS fee schedule files multiplied by the 2026 conversion factor of $33.40 (CMS), which is how CMS sets national amounts. Actual payments are adjusted up or down for local costs.

Since January 1, 2024, marriage and family therapists and mental health counselors can bill Medicare on their own. They, like clinical social workers, are paid 75% of the amount for a clinical psychologist (CMS).

After the Part B deductible, "you pay 20% of the Medicare-approved amount" for outpatient mental health visits (Medicare.gov). The deductible is $283 in 2026, up from $257, and the standard premium is $202.90 a month (CMS).

On the national 2026 rate, 20% of a 60-minute session is about $33.40 and of a 45-minute session about $22.78, by our arithmetic. Sessions in a hospital outpatient department can carry an extra hospital charge.

A yearly depression screening costs nothing if the provider accepts assignment, and Medicare now covers mental health care by telehealth permanently.

State Medicaid programs pay an average of $82.77 for a 45-minute psychotherapy session, against the $143.26 average cash rate (Zhu et al.).

Medicaid covers about 15 million nonelderly adults with a mental illness, 29% of the total (KFF). In 2023, 59% of adult Medicaid enrollees with a mental illness received treatment, against 55% of privately insured adults and 37% of the uninsured.

Medicaid spends about $14,000 a year per enrollee with a mental health diagnosis, against about $7,000 for those without, and about $21,000 for enrollees with a serious mental illness.

About one-third of private practice psychotherapists do not accept insurance; 64.9% do (Zhu et al.). Acceptance was 90.5% in North Dakota, against 55.4% in California and 41.0% in Washington, D.C.

Among psychologists, 34% were not in-network with any insurance panel in 2024 (APA). Nearly half of those (48%) had taken insurance at some point, and only 18% of psychologists had never done so.

More psychologists take Medicare than Medicaid. In 2024, 36% of psychologists took traditional Medicare and 26% Medicare Advantage, against 18% for managed Medicaid and 16% for traditional Medicaid. In 2025, 62% said they accept some form of insurance, a differently worded question.

Of psychologists who left or never joined insurance networks, 82% cited insufficient reimbursement in 2024. Administrative burden was cited by 62%, payment reliability by 52% and coverage denials by 37%.

The GAO heard the same from 19 of 29 stakeholder groups it contacted in 2022: low reimbursement makes in-network providers hard to find, and some providers can earn more outside networks.

In commercial PPO claims for 2017, primary care was reimbursed 23.8% more than behavioral care, measured against Medicare-allowed amounts (Milliman, an actuarial firm, industry data).

In 2017, 17.2% of behavioral health office visits were to an out-of-network provider, against 3.2% for primary care and 4.3% for medical and surgical specialists (Milliman).

That made a behavioral visit 5.4 times more likely to be out of network than a primary care visit, up from 5.0 times in 2013. For children the ratio was 10.1 times.

These figures are from 2017. The federal parity report to Congress gives enforcement counts, not an out-of-network rate. Out of network, a patient typically pays the therapist's fee and claims back whatever share the plan allows.

In 2024, 6.1 million adults with a mental illness felt they needed treatment and did not get it. Of those, 65.2% said treatment would cost too much, second only to thinking they should handle it on their own (71.0%) (SAMHSA).

Among insured adults who did not get mental health care they thought they needed, 44% said they could not afford it and 37% that insurance would not cover it (KFF, 2023). One in six insured adults (17%) went without, including 27% of Medicaid enrollees and 7% of Medicare enrollees.

In a 2022 KFF/CNN survey, eight in ten adults called the cost of mental health care a "big problem," and 63% said the same about the lack of providers who take insurance (KFF).

In 2024, 61.5 million adults (23.4%) had a mental illness. Of those, 52.1% received some mental health treatment and 29.5 million received none. Among adults with a serious mental illness, 70.8% were treated (SAMHSA).

Across all adults, 22.9% received some mental health treatment in the year: 16.7% took prescription medication, 13.3% had outpatient treatment and 12.8% were treated by telehealth.

In the last Census Household Pulse wave to ask, in spring 2022, 11.3% of adults had received counseling or therapy in the past four weeks and 11.5% needed it but did not get it (CDC/NCHS).

In 2024, 53% of psychologists had no openings for new patients and 39% kept a waitlist (APA). In 2025, 46% had no openings.

Among those reporting a typical wait, 56% could see a new patient within a month, 27% in one to three months, and 17% in four months or more. A third of those with waitlists said they had grown longer.

Psychologists received a mean of 8.76 new patient inquiries a month, and 32% agreed they had not been able to meet demand.

As of September 30, 2026, 154,557,656 people lived in one of 7,127 federally designated mental health professional shortage areas, where 26.24% of the need for providers is met (HRSA). Removing every designation would take 7,796 more practitioners.

Most of these designations are based on the ratio of people to psychiatrists alone, so they do not count psychologists, social workers or counselors working in the area.

Florida had 241 designations covering 12.3 million people, Illinois 245 covering 8.6 million and New York 213 covering 4.0 million.

In 2024, 12.8% of adults (33.4 million) received mental health treatment by telehealth, including 32.6% of adults with a mental illness (SAMHSA).

Most psychologists now work in a hybrid way. In 2024, 69% saw some patients in person and some remotely, 19% saw everyone remotely and 12% saw everyone in person. Of those treating remotely, 94% used video and 36% audio-only calls (APA).

Medicare now covers telehealth for behavioral and mental health on a permanent basis (CMS).

Clinical and counseling psychologists earned a median of $100,580 in May 2025 (BLS). Marriage and family therapists earned $66,940 (BLS), mental health and substance abuse social workers $60,280 (BLS), and mental health counselors $59,350.

Employment of substance abuse, behavioral disorder and mental health counselors, the fastest-growing of these jobs, is projected to grow 18% from 2025 to 2035, adding 98,000 jobs, and marriage and family therapists 14%.

In 2024, 70% of psychologists worked mainly in private practice, and 79% of those practised alone (APA).

Federal parity law requires most health plans to cover mental health care on terms no more restrictive than medical care. In 2024 the Labor, HHS and Treasury departments tightened the rule, and in May 2025 said they would not enforce the new parts while litigation continues (DOL report to Congress).

Enforcement under the existing rule led to corrections affecting more than 18 million plan participants between August 2023 and July 2025. One 2024 determination cited a plan's out-of-network reimbursement rates.

Employers rate their behavioral networks narrower than their medical ones. In 2026, 22% of firms called their mental health network "very broad," and among small firms 21% did so against 50% for medical care (KFF).

The Consumer Price Index has no item for therapy. Professional services, which also covers physicians and dentists, rose 3.4% in the 12 months to September 2026, against 3.7% for all items and 2.5% for medical care services (BLS).

The narrower item for services by other medical professionals, which includes therapists, was not published for that month.

IRS Publication 502 counts "amounts you pay for therapy received as medical treatment" as a medical expense, along with psychiatric care and payments to a psychologist for medical care. That is the definition health savings accounts and health FSAs use.

Itemizers can deduct medical expenses above 7.5% of adjusted gross income. A year of weekly sessions at the average cash rate, about $7,450, would exceed one person's 2026 health FSA limit of $3,400 (IRS Rev. Proc. 2025-32).

In a high-deductible health plan, the patient generally pays the negotiated rate for therapy until the deductible is met. The 2026 minimum deductible for an HSA-eligible plan is $1,700 for self-only coverage and $3,400 for family coverage (IRS Rev. Proc. 2025-19).

The $143.26 cash rate is what therapists list in a directory, not what each patient pays after any sliding scale. SimplePractice's state fees mix cash and insurance payments. Medicare amounts are national rates before local adjustment.

Survey figures from SAMHSA, KFF and the APA use different populations and years, so compare them with care. APA's 2024 and 2025 insurance questions were worded differently.

This page describes costs. It is not medical advice. Anyone in crisis can call or text 988, the Suicide and Crisis Lifeline.