How Sliding Scale Therapy Works

Understanding How Sliding Scale Therapy Works

Natalie Buchwald, LMHCTherapy

By Natalie Buchwald, LMHC | Last Updated: June 15th, 2023
Reviewed by Steven Buchwald

Psychotherapy is a useful tool for people in many difficult circumstances. Deciding to see a psychotherapist is the first step to getting relief. It can present light at the end of the tunnel for those who have been battling anxiety or depression. 

The only downside is that psychotherapy can be expensive. This is especially problematic for people who are already not in a positive mental state and who may struggle to find a way to overcome the obstacles they face. 

Not affording treatment should not be a barrier to actually receiving treatment. Yet for many, it is. Those without comprehensive health insurance may find themselves in a situation where they have to decide between household bills and therapy. Even those who do have health insurance may find it difficult to pay for mental health services. That’s because many health insurance plans do not provide full coverage for psychotherapy. 

What is Sliding Scale Therapy?

One solution to the cost problem is sliding scale therapy pricing. Some therapists offer sliding scale fee therapy to patients who are not covered by insurance or whose insurance is not accepted by the therapist of interest.  

A sliding scale fee structure can help people get treatment without breaking the bank. With sliding scale, a therapist will offer different pricing based on a person’s income level. People who bring in less income will pay less for a therapy session. Those who fall at the higher end of the income spectrum will pay a greater amount. 

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How Does Sliding Scale Therapy Work?

Sliding scale therapy pricing is a type of fee structure where people with fewer resources are responsible for paying a lower fee. The amount that a client is responsible for paying is determined based on income. The lower a person’s income, the less they have to pay to see a therapist.

Therapy is not the only profession to rely on this type of sliding scale structure; other medical providers, dentists, and even lawyers use a sliding scale to provide a more affordable way to pay. 

The amount a client is responsible to pay may be directly related to an income number or it may be relative to a person’s income as it compares to the Federal Poverty Level (FPL). For example, if a therapist typically charges $200 per hour, those who have an income at or below 100 percent of the FPL may pay a minimum fee that the therapist has determined. Those who have an income above the FPL may pay incrementally more based on what percentage rate their income falls. 

Is “Out of Pocket Therapy” a Thing?

Some people without health insurance may look for out of pocket options, where they pay for the entire cost of their therapy sessions 

Out-of-pocket therapy is very cost-prohibitive as many therapists charge upward of 300$ per session. This can add up quickly for someone who is not covered by health insurance. Seeing a therapist over the long term, which is typically advised, can lead to a heavy financial burden for someone who doesn’t have health insurance coverage. Accruing debt may not be beneficial for a person’s mental or financial health.

While out-of-pocket therapy is available, people are likely to get better rates by seeking out a provider that offers sliding scale therapy pricing. The best bet is obviously to find an affordable health insurance plan with generous mental health coverage. However, this may not be a viable option for everyone. If you can’t afford a health insurance plan or if your current plan does not cover mental health services, you may want to seek out other affordable therapy options. 

With Out of Network Benefits, get Reimbursed for Therapy

Another beneficial option is to pay out of pocket and be reimbursed — at least in part — by your insurance company. While many insurance companies provide a list of in-network therapists, you may find that your preferred therapist is not on that list.

This doesn’t mean that you must forego seeing your favorite therapist. Instead, call your insurance company to find out if they offer some reimbursement for seeing an out-of-network provider for code 90837 or code 90834 (both codes for psychotherapy).

This would allow you to continue seeing your favorite therapist without having to pay 100% of the costs out of pocket. We encourage you to check with your insurance to see if they may offer out of network benefits for psychotherapy.

Affordable Therapy in Manhattan

Manhattan Mental Health Counseling offers a great alternative to sliding scale therapy by offering clients some of the most affordable rates in Manhattan. At $175 per session after the first intake session, our rates are very affordable and enable clients to get the mental health treatment and therapy they need. 

Mental health issues take some time to treat. Our pricing plans make taking the time to work on yourself a possibility.

Finding affordable therapy in New York City can be a daunting task. Big cities tend to be more expensive than rural areas. They draw top talent that often charges top rates for their services. 

Fortunately, Manhattan Mental Health Counseling combines the best of both worlds by offering top tier therapists at affordable rates. We offer individual psychotherapy sessions as well as couples sessions. Sessions times vary based on needs and medical necessity from 45 to 60 minutes. Our counselors are licensed and have years of experience supporting clients on their journey to make healthy life choices and changes. 

Those in New York state seeking a trusted provider that offers mental health services and therapy should contact us to learn about our rates and services.