For the more than 30 million US adults who do not receive the mental health services they need, 45% cite cost as a barrier to care. Our data show that the idea that psychotherapy is expensive is a myth. We analyzed some of our 2014 data and here’s what we found:
–For those with insurance who had more than one session, the total average out of pocket cost to a patient for a course of treatment was just $74! The average number of sessions was 6.8, the total insurance reimbursement was $354 and total charges before write off’s was $930.
–Average out of pocket costs of $74 suggests that therapists are under-collecting copays.
However, psychotherapy is expensive if the patient does not have insurance. We found:
–The total cost of and episode of care to a patient without insurance was $306. The average number of sessions was 8.4.
A major difference between insured and uninsured patients was drop out rate. 38% of patients with no insurance dropped out after 1 session, whereas only 14% of insurance patients dropped out. Not having insurance translates into a 270% increase in the likelihood of dropping out of treatment.
What is the import of these data? The word needs to get out that psychotherapy is not, as most people think, expensive. In the last quarter century a number of changes have made psychotherapy affordable, including parity (which reduced copayments), the Affordable Care Act (which extended coverage), and the embrace by the field of the short term treatment model (which reduced the length of an episode of care). These changes have resulted in psychotherapy being highly affordable. **The fact is that today psychotherapy for most common psychiatric conditions is the least costly first line treatment option. **
That said, cost is a factor for the uninsured and those with high deductible plans. Therapists need to be sensitive to cost and should provide affordable options to the under- or uninsured.
