Am I paying too much for therapy?
July 19, 2011 6:33 AM   Subscribe

I found a CBT doctor here in NYC, Dr. Fader, and he charges $300 per session with no sliding scale. My insurance, United Healthcare, covers 70% after I hit my $500 deductible. So after hitting that I would be paying $90 out of pocket. Is this a typical amount to pay w/insurance? I'm asking because I can always look around, but this doctor is supposed to be very good and if it's a typical price I might as well stay with him. Thoughts?
posted by blunt_eastwood to Health & Fitness (20 answers total) 2 users marked this as a favorite
 
$90 a session is pretty good, but what you have to add to that is the rarity of a good therapist who takes insurance.
posted by griphus at 6:36 AM on July 19, 2011 [3 favorites]


United Healthcare will pay 70% of the contracted rate with your therapist. Is $300 his United Healthcare rate, or his list price? If $300 is his list price, odds are very good his contracted rate with UHC is closer to $200 - which means you could be paying even less.
posted by COD at 6:41 AM on July 19, 2011


I don't live in NYC, but to my eye that is quite high if you are looking just for CBT or talk therapyu. You would be paying big bucks presumably for the fact that this person is a doctor - Is this doctor a physician or a psychiatrist?

If you are seeking out treatment for a severe disorder, and you are at your wits end, I would just bite the bullet and pay the fee if you feel confident this will get you the help you need (particularly if the process of trying different therapists and not liking them might be dangerous or destabilizing for you).

However, if you are going through a difficult time, are not on the edge of any sort of break, and are just looking for a good cbt therapist, I would hunt around for a reputable MFT or LCSW before breaking out the big PhD guns.

Networktherapy.com is a great resource if you want to keep looking.
posted by pazazygeek at 6:42 AM on July 19, 2011


That seems like the high end of the scale to me, but totally worthwhile if he's good for you. Why pay less for a therapist who will do less for you?

I pay only slightly less out of pocket for my therapist and she is worth every penny.
posted by rosa at 6:46 AM on July 19, 2011 [1 favorite]


I'm a therapist in Los Angeles (I'd venture that the market is pretty similar). That rate is QUITE high. Some therapists can charge high rates because they're well-known and well-marketed (particularly if he's a "CBT guy" and has done a lot of marketing to that effect, because as you have observed on MeFi, people are very responsive to someone being established as a CBT practitioner, but the truth is that most therapists know how to do CBT and most will do it on a sliding scale), but still aren't the right therapist for everyone. If you want to give him a try and see if it works out for you, definitely go for it. But there may be many viable alternatives that are just as good or better, while being cheaper.
posted by so_gracefully at 6:51 AM on July 19, 2011 [1 favorite]


COD is correct....the out of pocket price that most doctors quote is not the "contracted price" with insurance carriers. If he is in network with UHC, there is a price per session that him and UHC agreed upon so that he could be in network.

Call his office, ask them to verify your benefits and/or ask them what you would be paying with your UHC insurance. If he's not in network with UHC, then your math would be correct.

As far as whether or not it's worth it, remember that you don't have to have a PhD psychologist in order to get therapy, especially CBT. Many therapists who only have a Master's degree can and do specialize in CBT. (If you are specifically looking for an expert or someone who has done substantial, innovative research in CBT, then you may want a PhD). Also, does he have other Master's level therapists in his practice? They might be less expensive, still specialize in CBT, and would still benefit from his expertise in CBT by consulting with him.

I definitely don't want to discourage you from doing what works for you, but in counseling and therapy, "Dr." isn't always what you are looking for. Master's level has the same training in actual therapy...a PhD holder has just gone deeper into the research and psych testing side of things.
posted by MultiFaceted at 6:51 AM on July 19, 2011


Response by poster: To clarify, he doesn't take insurance and is a PHD psychologist.

He came highly recommended from another doctor and I defenitly want to do CBT and have someone who is an expert in it.
posted by blunt_eastwood at 6:55 AM on July 19, 2011


It's pretty high, but if you like him and can afford it, go for it! I have therapy with an MSW and my insurance covers most of it, and I'm very happy with it. But if for some reason he were more expensive, I'd roll with it because I'm happy with him. It's really what's best for you. And in NY we have a lot of price, education, specialty, etc options when it comes to our therapy.
posted by sweetkid at 7:01 AM on July 19, 2011


A few questions that you may/may not have thought of (forgive me if you've already researched this...but it may be helpful to others who read this question):

If he doesn't take insurance, will you be filing the claims with UHC yourself? Will you have to pay the full $300 up front and then get reimbursed from UHC? He would also be considered out of network for UHC...have you met your out of network deductible for UHC and would they still pay at the 70% rate?

If you want the expert and you can afford the $90 for each session, I say go for it. If you find that after a few sessions things aren't working out, you can always stop going or ask for a referral. If it does become too expensive for you, talk with him about that. He might be able to refer you to a colleague that he knows also as an expert in CBT who might be under your insurance.
posted by MultiFaceted at 7:01 AM on July 19, 2011 [1 favorite]


$300 per session in NYC is not high.
posted by dfriedman at 7:43 AM on July 19, 2011 [2 favorites]


I haven't had UHC in a couple of years, but I think the issue is that he doesn't take insurance himself, or that he's out of network. If he were in network, you would have to pay a small copay ($15-$30?) each time rather than 30%. I'd suggest calling UHC and figuring out what the cost would be if he were in network. Then you can decide whether it's worth finding someone else who is. NYC is huge, I'm sure there must be someone equally good who's in network. I think UHC has a website that lets you search for therapists.

As a point of reference, in Northern VA, I pay 15$ a session with Blue Cross/Blue Shield. The amount the insurance pays my therapist is significantly less than $300 and I'm pretty sure it's significantly less than $200. (I know because I have to pay that amount if I cancel within 24 hours, but it's been a year or two since that happened.)
posted by callmejay at 8:10 AM on July 19, 2011


Response by poster: I can find an in-network doctor and pay a $30 co-pay, but I want someone who is skilled in CBT and it seems that most of them do not take insurance.

If anyone knows any recommended CBT doctors who take insurance in NYC please let me know.

All the ones that were referred to me don't.

[QUOTE]If he doesn't take insurance, will you be filing the claims with UHC yourself? Will you have to pay the full $300 up front and then get reimbursed from UHC? He would also be considered out of network for UHC...have you met your out of network deductible for UHC and would they still pay at the 70% rate?[/QUOTE]

I pay the $300 up front and file the claims myself. I haven't met my deductible.

How do I quote responses?
posted by blunt_eastwood at 8:21 AM on July 19, 2011


You should also check that they'll pay 70 percent of the entire three hundred. Some insurance companies consider not the doctors bill but what is "reasonable" for the type of doctor and the region. So you may submit for 300 and they think that 250 is fair and will pay you 70 percent of that.

I don't think 300 is crazy high but it may be on the high end for a PHD and its probably something you have to consider along with how much you like him/whether you feel he is helpful.
posted by SpaceWarp13 at 9:08 AM on July 19, 2011


Response by poster: Thanks for the answers.

I'm having my first consultation with the doctor today so I haven't paid or agreed to anything yet.

I will try to determine if I like him afterwards and then decide.
posted by blunt_eastwood at 9:18 AM on July 19, 2011


How do I quote responses?

We usually just put them in italics, and sometimes link to the comment (click on the comment time and that will give you the url)
posted by sweetkid at 9:31 AM on July 19, 2011




I don't think that's an outrageous price. I see a LCSW in manhattan who specializes in CBT and ADHD. I pay $165 per session, my health insurance reimburses me 70% after I reach my $750 deductible. I've been happy with her, it's definitely an option if you are concerned about cost.
posted by inertia at 11:58 AM on July 19, 2011


What cities are you folks who are saying there are good therapists under insurance? I've know people who worked in health insurance companies say things pretty directly to the contrary.

A therapist who is in high demand doesn't need to jump through insurance company hoops to book a schedule. Mental health through insurance in cities where therapists are in high demand is like getting a Groupon on mental health -- maybe they're good, but they're desperate to fill their roster.

Therapists who just care about serving more folks instead offer a direct sliding scale.

This may not be true for all locations, but I'd imagine there's a high demand on good therapists in NYC.

It seems high to me, but not so high that it's sickeningly unreasonable. So if you connect with him, it wouldn't be foolish to pay it. But good luck with the UHC stuff.
posted by Gucky at 3:10 PM on July 19, 2011


I have a phenomenal therapist in NYC who takes insurance. I fear that people don' t approach therapy because they're worried about the costs, so I hope people do as much research as they're able to find people who are a fit for them and will work with them on payment, or take insurance.


A therapist who is in high demand doesn't need to jump through insurance company hoops to book a schedule. Mental health through insurance in cities where therapists are in high demand is like getting a Groupon on mental health -- maybe they're good, but they're desperate to fill their roster.


I disagree with this.
posted by sweetkid at 3:25 PM on July 19, 2011


Response by poster: Well I just had my second session and so far I think I'm pretty satisfied with the doctor. I should have clarified before that I hadn't actually started seeing him yet when I posted this. My title was a bit misleading and I apologize for that.

We talked about the fees and he offered to lower his fee to $250 for me. So after I hit my $500 deductible, which I already did after these first two sessions, UHC covers 70% which means I am paying $75 out of pocket after all the reimbursments.

Once I hit 2,500 out of pocket though the expenses are covered 100%. Of course I did the math and that would only happen after about 33 vists which would take about 8 months, and since there less than that before 2012 it won't be happening unfortunately :-(.

Hopefully things work out well with this doctor. Thanks for the responses, I'm going to mark this resolved now.

If anyone wants to know who I'm seeing send me a message.
posted by blunt_eastwood at 6:45 AM on July 30, 2011


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