How Much Does Therapy Cost in the USA in 2026?

What a therapy session costs in the US depends on who you see and how you pay. One Nashville group practice charges $175 to $250 for a 50-minute session with a licensed therapist, $125 to $175 with an associate therapist and $25 to $125 with an intern¹. Medicare's 2026 non-facility payment rate for psychotherapy code 90837 is $167.00². That code covers a 60-minute session with the patient³.

The practice's figures are examples, not a set rate. Therapists set their own fees.

If those figures are out of reach, the section on lower-cost routes below is the more useful part of this page. It covers reduced-fee places, university training clinics, community health centers, Medicaid and tax-free accounts.

Licenses and titles

Job titles and specialties for mental health professionals can vary by state⁴. Psychologists hold a PhD or PsyD, and licensure boards in each state license them⁴. For master's-level counselors and therapists, licensure varies by specialty and state; examples include licensed professional counselor (LPC) and licensed marriage and family therapist (LMFT)⁴. Clinical social workers hold a master's degree in social work, with licenses such as licensed clinical social worker (LCSW)⁴. Psychiatrists are licensed medical doctors who can diagnose mental health conditions, prescribe and monitor medication, and provide therapy⁴.

Some practices also offer sessions with clinicians who are not yet fully licensed. At the Nashville practice above, associate therapists have completed graduate school¹. Its interns are graduate students in the final phase of their clinical training¹. Our guide to mental health licensing in the USA explains who licenses each profession and how to verify a license.

What Medicare pays

Medicare's 2026 rates give a benchmark to hold a quote against. At the same non-facility rate, it pays $109.55 for code 90847 and $173.35 for code 90791². Code 90847 is a 50-minute family psychotherapy session with the patient present, and 90791 is a diagnostic evaluation³. Codes 90832, 90834 and 90837 cover 30, 45 and 60 minutes with the patient, and the coding manual allows some flexibility³. Ask how long a session lasts before you compare fees.

If you have Medicare, Part B covers outpatient mental health care from psychiatrists, clinical psychologists, clinical social workers, nurse practitioners, marriage and family therapists and mental health counselors, among others⁵. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount⁵.

Since January 1, 2024, marriage and family therapists and mental health counselors can bill Medicare independently⁶. Medicare Part B pays them 75% of what it pays a clinical psychologist⁶.

In network or out of network

Your plan's network decides much of what you pay. Out-of-network coinsurance is the share of the allowed amount you pay to providers who don't contract with your plan, and it usually costs you more than in-network coinsurance⁷.

Some practices take no insurance at all. The Nashville practice above works as an out-of-network provider: you pay at each session, and it can give you a superbill, a detailed receipt you can submit to your insurer for possible reimbursement¹. It suggests asking your insurer about out-of-network mental health benefits, reimbursement rates and deductibles¹.

All Marketplace plans must cover behavioral health treatment, such as psychotherapy and counseling⁸. Their limits on mental health care, such as copayments or limits on visits, generally can't be more restrictive than their limits on medical and surgical care⁸.

Before you book, ask the therapist whether they are in network with your specific plan, not only whether they take insurance. Then ask your insurer what it pays for outpatient mental health care out of network, and what your deductible is.

If you cannot afford private fees

Several routes cost less than a private fee, and some cost very little.

Reduced-fee places

Ask a practice whether it keeps reduced-fee places. At the Nashville practice above, every therapist makes room for clients who need a reduced rate¹.

University training clinics

The University of Utah's Utah Community Mental Health Clinic is a training clinic that charges $20 an hour for intakes and individual therapy⁹. It sets reduced fees by income and financial need, from $1 to $15 a session⁹. Its fees support graduate student training and supervision⁹. A university near you may run a similar clinic: ask its psychology or counseling department.

Community health centers

If you can't afford a health plan and don't qualify for Medicaid or the Children's Health Insurance Program (CHIP), you can get low-cost care at a community health center¹⁰. What you pay there depends on your income¹⁰. Health centers provide general primary care and referrals to specialized care, including mental health¹⁰.

Medicaid

Medicaid provides free or low-cost health coverage to some people with low incomes, families and children, pregnant women, older people and people with disabilities¹¹. Whether you qualify depends partly on whether your state has expanded its program¹¹. Medicaid is the single largest payer for mental health services in the United States¹².

Tax-free money

The IRS counts amounts you pay a psychologist for medical care, and payments for psychiatric care, as medical expenses¹³. Money from a health savings account (HSA) or a health flexible spending account (FSA) that pays for qualified medical expenses isn't taxed¹⁴.

Ask for a good faith estimate

If you aren't using health insurance, a provider usually must give you a good faith estimate of expected charges if you ask for one or schedule at least 3 business days ahead¹⁵.

If you need someone now

Call, text or chat with the 988 Suicide & Crisis Lifeline¹⁶. It is available 24/7/365, and conversations are free and confidential¹⁶. 911 is the primary contact for medical emergencies and other situations that need immediate physical intervention¹⁷.

Sources

1. [1] A Nashville group practice, The cost of therapy: published fees per 50-minute session by clinician level, out-of-network billing and reduced rates (read November 2026).
2. [2] American Psychological Association Services, Medicare changes coming in 2026 (November 21, 2025): 2026 Medicare payment rates by code.
3. [3] American Psychological Association Services, Psychotherapy codes for psychologists (last updated August 2023): what each code covers and its session length.
4. [4] National Alliance on Mental Illness (NAMI), Types of mental health professionals (updated April 2020): degrees and licenses.
5. [5] Medicare.gov, Mental health care (outpatient): who Part B covers and what you pay (read November 2026).
6. [6] Centers for Medicare & Medicaid Services (CMS), Marriage and family therapists and mental health counselors: the January 2024 change and the 75% payment rate (read November 2026).
7. [7] HealthCare.gov, Out-of-network coinsurance (glossary, read November 2026).
8. [8] HealthCare.gov, Mental health and substance abuse coverage: Marketplace plan coverage and parity (read November 2026).
9. [9] University of Utah, Utah Community Mental Health Clinic, Cost and fees (last updated May 2025).
10. [10] HealthCare.gov, How to find low-cost health care in your community (read November 2026).
11. [11] HealthCare.gov, Medicaid (glossary, read November 2026).
12. [12] Medicaid.gov, Behavioral health services (read November 2026).
13. [13] Internal Revenue Service, Publication 502, Medical and dental expenses (read November 2026).
14. [14] Internal Revenue Service, Publication 969, Health savings accounts and other tax-favored health plans (read November 2026).
15. [15] CMS, What is a good faith estimate? (read November 2026).
16. [16] 988 Suicide & Crisis Lifeline, home page (read November 2026).
17. [17] Substance Abuse and Mental Health Services Administration (SAMHSA), 988 frequently asked questions: how 988 differs from 911 (read November 2026).

Fees reviewed in November 2026 against a practice that publishes its own fees, Medicare's published 2026 rates and therapist directory listings.