How to find a therapist you can afford

The short answer

• Start with what you already have. That may be the behavioral health number on your insurance card, your Medi-Cal health plan, your county's mental health access line, a free employee assistance program (EAP) at work, or a campus counseling center.
• No insurance, or a high deductible? Look at community health centers, which set fees by income; university training clinics, where supervised graduate students see clients at low cost; and SAMHSA's FindTreatment.gov, which shows what payment each listed program accepts.
• Ask about money before the first session. Get the fee, the cancellation policy and the therapist's network status in writing. If you pay for yourself, you can ask for a Good Faith Estimate.
• Check the license. In California, the Department of Consumer Affairs License Search shows whether a therapist's license or registration is current and whether there has been discipline.

Step 1: Find your starting point

You can use more than one row at a time. For example, you might use free EAP sessions while you look for an in-network therapist for longer-term care.

If you have insurance through a job or the Marketplace

Call the plan before you search on your own. Online directories can be out of date. Ask member services for in-network therapists who are taking new clients, and ask what you will pay: a flat copay, or coinsurance (a percentage of the cost) after you meet your deductible.

Get network status in writing. Under federal law, job-based and individual plans must answer your question about whether a provider is in network within 1 business day of your call, in writing (on paper or electronically, as you ask). If the plan's directory or its answer said a therapist was in network and that turns out to be wrong, the plan cannot charge you more than its in-network cost-sharing for that covered care. These protections apply to plan years beginning on or after January 1, 2022. Save the plan's answer.

Know the parity rule. A federal law, the Mental Health Parity and Addiction Equity Act, says that when a plan covers mental health care, its copays, visit limits and rules such as prior approval generally cannot be stricter than those for comparable medical and surgical care. All Marketplace plans must cover mental health care, including psychotherapy and counseling, as an essential health benefit.

Where the federal parity rules stand as of October 21, 2026:

• In 2024, federal agencies issued a rule to strengthen parity. After a lawsuit challenged it, the agencies announced on May 15, 2025 that they would not enforce the parts of that rule that were new while they reconsider it. That pause lasts until a final court decision, plus 18 months. In a September 30, 2026 court filing, the agencies said they will propose a revised rule rather than defend the 2024 rule, and that the pause continues.
• The law itself still applies, along with the earlier 2013 rule and a 2021 requirement that plans be able to show how they apply limits such as prior approval.
• On September 8, 2026, the U.S. Department of Labor told its investigators to focus on exclusions that apply only to mental health care, on medical-necessity and prior-approval reviews, and on whether networks let people get covered care in network.

If your plan denies therapy as not medically necessary, ask in writing for the reason and for the criteria the plan used. For job-based plans, you have at least 180 days to file an appeal. The Labor Department's benefits advisors help with job-based plans at 1-866-444-3272. For other private plans, your state's insurance regulator takes complaints.

In California. For commercial plans regulated by the Department of Managed Health Care (DMHC), state law requires coverage of medically necessary mental health and substance use treatment at the same cost as physical health conditions. These plans must also offer:

• a non-urgent appointment with a therapist or other non-physician mental health provider within 10 business days of your request, and
• follow-up appointments within 10 business days of your last one, if you are in ongoing treatment.

A longer wait is allowed if a qualified provider notes that it will not harm your health. If no in-network provider is available, the plan must arrange and cover out-of-network care at no additional cost to you. Start with the plan. If that does not work, contact the DMHC Help Center at 1-888-466-2219 (TDD 1-877-688-9891); urgent problems can go to the DMHC right away. Not every plan is regulated by the DMHC, so ask member services which agency oversees yours.

Seeing a therapist outside your network

Some therapists do not take insurance. You may still get part of the cost back. Before you book, call your plan and ask:

• Do I have out-of-network benefits for outpatient mental health care?
• What is my out-of-network deductible, and how much of it have I met?
• What share do you pay after the deductible?
• What is your allowed amount for a 45-minute (code 90834) or 60-minute (code 90837) psychotherapy session?
• How do I send in a claim, and what is the deadline?

The allowed amount is the most the plan will pay for a covered service. An out-of-network therapist can bill you for the difference between their fee and the allowed amount; this is called balance billing. Federal surprise-billing protections cover emergency care, some care linked to in-network hospitals and surgery centers, and air ambulances. They do not cover a therapist you choose outside your network for regular sessions.

Ask the therapist for a superbill. This is an itemized receipt with the details a plan needs to process a claim, such as dates of service, service codes and diagnosis codes. Send it with your plan's claim form, and keep copies of everything.

If you have Medi-Cal (California)

Medi-Cal covers therapy, but through two systems:

• Your Medi-Cal health plan covers "non-specialty" mental health services. These are for adults 21 and older with mild-to-moderate distress or impairment, for members under 21 whatever their level of distress, and for people of any age with a possible condition that has not been diagnosed yet. They include individual, group and family therapy, psychological testing when needed, and psychiatric consultation.
• Your county mental health plan provides "specialty" mental health services for more serious needs.

You do not have to work out which system fits before you ask for help. Under Medi-Cal's "No Wrong Door" policy, assessment and treatment are covered while that is being decided, even if the assessment later points to the other system. And under a state policy letter dated February 2, 2026, your health plan may not require a referral from your primary care provider, or prior approval, for a first mental health assessment with a licensed mental health provider in its network.

How to start:

• Call the member services number on your health plan card and ask for a mental health assessment, or
• Call your county's access line. The Department of Health Care Services (DHCS) keeps a list of county mental health plan phone numbers. In Fresno County, the 24/7 Access Line is 1-800-654-3937, for information, screening and referrals.

If you get stuck, the Medi-Cal Managed Care and Mental Health Office of the Ombudsman helps with problems involving either system: 1-888-452-8609, Monday to Friday, 8 a.m. to 5 p.m. Behavioral-Health Care Through Medi-Cal explains the two systems in more depth. Not enrolled? You can apply for Medi-Cal any time of year. Some 2026 changes affect adults based on immigration status; Medi-Cal in Plain Language explains them.

If you have Medicare

Medicare Part B covers outpatient mental health care from psychiatrists and other doctors, clinical psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, physician assistants, marriage and family therapists, and mental health counselors. After the Part B deductible, you generally pay 20% of the Medicare-approved amount. A hospital outpatient clinic may add its own charge. Through December 31, 2027, Medicare covers telehealth services, including outpatient psychotherapy, from anywhere in the U.S. If you have a Medicare Advantage plan, check that the therapist is in its network.

If you have no insurance, or your deductible is high

• Community health centers. Federally funded health centers offer mental health and substance use care along with primary care. Fees are adjusted by income and family size, and health centers must serve people even when they cannot pay. Search HRSA's Find a Health Center tool at findahealthcenter.hrsa.gov, and ask what proof of income and household size to bring.
• University training clinics. Many graduate programs in psychology, counseling, and marriage and family therapy run clinics where trainees see clients under the supervision of licensed clinicians. Some serve the public at low cost or on a sliding scale. Search for a nearby college or university with "psychology clinic" or "counseling clinic," and ask whether it sees community members.
• FindTreatment.gov. SAMHSA's confidential locator lists state-licensed mental health and substance use treatment programs, not individual private therapists. Listings show the payment, insurance or funding each program accepts, and some programs offer free or low-cost care, sliding-scale fees or payment assistance. Call to confirm. SAMHSA's National Helpline, 1-800-662-4357, gives free, confidential treatment referrals and information 24/7, in English and Spanish.
• Your county. Your local health department's website is a good place to look for public mental health services. In California, start with the county access lines described above.
• Check whether you now qualify for coverage. Medi-Cal applications are open year round. Open enrollment for 2027 private plans starts November 1, 2026. It ends January 15, 2027 on HealthCare.gov; Covered California's open enrollment runs to January 31, 2027.

Ask for a Good Faith Estimate. If you are uninsured or choose not to use insurance, providers must give you a written estimate of expected charges when you schedule at least 3 business days ahead, or when you ask. For ongoing counseling, one estimate can cover up to 12 months of expected sessions. If the bill is at least $400 more than the estimate, you may be able to dispute it. You must start within 120 calendar days of the date on the bill, and there is a $25 fee. For questions or complaints, call 1-800-985-3059.

If you were hurt by a crime in California, CalVCB can help pay for mental health treatment for victims and, in some cases, their family members. It pays only after other sources, such as health insurance.

Free or low-cost help through work, school or your doctor

• Employee assistance programs. An EAP is a free, confidential service paid for by an employer. It typically offers assessments, short-term counseling and referrals. Ask how many sessions you get, and whether the EAP can refer you to someone in your health plan's network if you need longer care.
• School. Students may be able to get counseling through their school's health center.
• Primary care. A primary care clinician can screen for depression and anxiety, discuss treatment and refer you to counseling. Mental Health and Primary Care explains what to expect. If you need a clinician, see How to find a primary care doctor who is accepting new patients.

Telehealth can lower the cost of getting there

Video or phone sessions can save travel and time off work, and they can widen your choices. Two cautions:

• Rules on practicing across state lines vary by state. Ask, "Are you licensed, or otherwise allowed to practice, in the state where I will be during our sessions?"
• Confirm network status and your cost for telehealth visits, just as you would for office visits.

Questions to ask a therapist before you book

• Are you in network with my exact plan? (Give the full plan name on your card.)
• What is your fee per session? Do you offer a sliding scale, and what proof do you need?
• Is the first visit priced differently from later visits?
• How long is a session, and how often would we meet at first?
• What is your fee for a missed or late-canceled session, and how much notice do you need?
• Do you offer video or phone sessions?
• If you are out of network, will you give me a superbill?
• If I pay for myself, may I have a Good Faith Estimate?
• Are you licensed, or an associate or trainee? Who supervises you? Are fees lower with an associate or trainee?
• If I want couples or family sessions, how are those billed?

Write down the date, the name of the person you spoke with and what they said.

Check the license

In California, use the Department of Consumer Affairs License Search at search.dca.ca.gov. You can search by name or license number, and the result shows whether a license is current or expired and whether there has been disciplinary action. It covers:

• the Board of Behavioral Sciences, which licenses marriage and family therapists (LMFT), clinical social workers (LCSW), professional clinical counselors (LPCC) and educational psychologists (LEP), and registers associates;
• the Board of Psychology, for psychologists; and
• the Medical Board of California, for physicians, including psychiatrists.

Associates are not yet licensed. They see clients under supervision while they complete the supervised hours a license requires. California law requires an associate marriage and family therapist to tell each client, before providing services, that they are an unlicensed registered associate, to give their registration number and employer's name, and to say whether a licensed professional supervises them. Both boards also take complaints.

Outside California, check the licensing board for the profession in your state.

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