Reduced session fees for “out of pocket” clients?

Can anyone tell me why mental health professionals claim they would much rather have fee based practices, yet they generally expect to receive their “full fee” from out-of pocket clients rather than the amount they receive for clients using insurance?

In other words my therapist gets $65 from the insurance company and a $15 co pay from me, so that $80 for the session. The therapist’s (an LCSW) regular rate is $150 per 50 minute session, (this is the goiing rate in Ct.)

If a therapist is accepting a “reduced fee” per session from the insurance company ,why not accept the same fee from “out-of pocket” clients?

6 Responses

  1. I know this seems confusing and at face it is. Therapists often have quite mixed feelings about contracting with insurance companies. They don’t offer the level of privacy that they purport to offer and they make the therapist do a lot of extra work that is said to be “good practice” but in actuality does little to help the client. They know that many clients can not afford therapy without using their insurance but they often can not maintain their practice with JUST working with insurance.

  2. Hi Vicky
    So why not accept the contracted dollar amount the insurance company pays out, plus the amount of the co-pay, from “out-of pocket” clients? ( ie. if the insurance company is giving you $65 a session plus the client has a $15 copay , that equals $80 )
    This eliminates the privacy issue and the only “extra” work is billing and providing receipts to the client.

    Massage Therapists generally do not accept insurance and are billing out at an average of $80/hr in my area of the country and maintaining their practices, why not Mental Health Professionals?

    IMO…Mental Health Services billed out at $150/hr are ridiculously unaffordable.

  3. For many therapists, $80 does not represent an amount that they can sustain their practices on. Many therapists will work with clients on a lower fee than their regular fee, some do pro-bono work. Mental health professionals have much more schooling and many more costs to maintaining their practice than massage therapists. I’m just reporting some of the issues I am not necessarily supporting them.

  4. It’s a tough economy for everyone!
    I will argue the point you have saying
    “Mental health professionals have much more schooling and many more costs to maintaining their practice than massage therapists”
    Some MHP’s have more “original” schooling, some of us LMT’s have college degrees plus 2 years massage education.. In Connecticut Massage therapists also are required by law to take CEU’s The overhead costs I would say are also higher. Licensing fees to the State are $250 every two years. Liability insurance, equivalent to that of MHP’s is necessary and. overhead is also “higher” with office supplies and laundry.

    Beyond that…what additional expenses does the MHP have? ( other than a billing service, if used)

    Personally, I work a “day job” for the paycheck and benefits, and Massage is the “fun stuff”.

  5. Look, apparently you need to be “right” here so OK, you win. You are right. One thing I have learned over my life is I can either be “right” or happy, not both. The fact of the matter is that there are 2 things at work here. In Conn, the market probably will allow an LCSW to charge $150 because they can get that. If I were on the east coast, the market would support that for me as well. I also work an agency job and have a private practice like you. The second thing is that any therapist, mental health or massage, can charge in individual client whatever they want so if you want therapy you should contact a few and see who will be willing to slide their scale for you. I bet someone would.

  6. In presenting this option, my goal is to find out “why?” there is not such an option available, and what therapists would find acceptable.The session price is either “too” high, or covered by insurance. There are a few MHP’s who do sliding scale fees, but a client has to meet certain financially based requirements. Just because someone can get their bills paid doesn’t mean there is “enough” extra cash in the money jar for Mental Health Services, but perhaps there could be if the session fees weren’t so high. I’m seeking ( as I’m sure are many others) workable solutions that would make MH care more available. It has to start somewhere!

    btw…thanks for the sliding scale info, but personally I do not need a sliding scale fee, and I am grateful for my “day job” for a paycheck and benefits.

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