Private pay (AKA "self-pay" or out of pocket) means clients pay the full session fee directly to the therapist without involving insurance. This option offers the most privacy and flexibility, since no diagnosis is required and treatment is not limited by insurance rules. Private pay clients have the right to receive a Good Faith Estimate (GFE). 

• Pros:

  • Full privacy — No diagnosis or treatment details shared with insurance.

  • Greater flexibility — More freedom in session length, frequency, and treatment methods.

  • No insurance limitations — No eligibility criteria, session caps, or medical necessity requirements.

  • Easier access — No need for insurance approvals or referrals.

• Cons: 

  • Higher out-of-pocket cost — Investing themselves in this way can be financially challenging for some clients.

  • No automatic reimbursement — Clients bear the full cost unless using HSAs/FSAs.

​​

Good Faith Estimate (GFE)

Your Right to a Clear Estimate of Counseling Costs

Under the No Surprises Act, you have the right to receive a Good Faith Estimate (GFE) explaining the expected cost of your counseling services. This requirement helps ensure transparency so you can make informed decisions about your mental health care.

What Is a Good Faith Estimate?

A Good Faith Estimate outlines the estimated total cost of the services you may receive. It includes things like:

• The type of service (e.g., intake session, individual therapy)

• The session fee

• The expected number of sessions

• Any other potential costs related to treatment

A GFE is not a bill — it is simply an estimate to help you understand and plan for your care.

Who Receives a Good Faith Estimate?

A Good Faith Estimate is provided to:

• Clients who are uninsured, or

• Clients who choose not to use insurance (private pay/self-pay)

If this applies to you, you will receive a written estimate before your first scheduled service and can request one at any time.

What to Expect in Your Estimate

Your Good Faith Estimate will include:

• Your provider’s name and contact information

• A description of the services recommended

• The cost of each service

• A total estimated cost for your course of care over a set period

• Instructions on what to do if your actual charges differ significantly from your estimate

Estimates are based on the information known at the time and may be updated if your treatment plan changes.

What If the Actual Cost Is Higher?

If your bill is $400 or more above the Good Faith Estimate, you have the right to:

• Dispute the charge, and

• Request a review through the U.S. Department of Health and Human Services (HHS)

Your estimate will include instructions on how to file a dispute if needed.

How to Request a Good Faith Estimate

You can request a GFA at any time by contacting your provider directly. You will receive it in writing—either by email or in a paper format—depending on your preference.

Our Commitment

I am committed to transparency, clarity, and supporting you in making informed choices about your mental health care. If you have questions about your estimate or billing, I’m here to help guide you.

Using insurance allows clients to pay only a copay or deductible for counseling sessions. However, insurance requires a mental health diagnosis and may limit session frequency, length, or treatment type. Some personal information must be shared with the insurance company for coverage.

• Pros:

  • Lower cost per session — Clients pay only copays or deductibles once met.

  • Accessible — Makes counseling more accessible for many individuals.

  • Consistency — May encourage consistent attendance due to reduced cost barrier.

• Cons:

  • Diagnosis — Requires a mental health diagnosis to justify medical necessity. Some clients are uncomfortable with having a mental health diagnosis as a part of their medical record.

    • Please note: Though I provide a diagnosis based on your symptoms and the DSM-5-TR for insurance purposes, I do not pathologize or treat you as "defective"/"need cured." 

  • Less privacy — Treatment details become part of the insurance record.

  • Reduced flexibility — Restrictions on session frequency, provider choice, or treatment types.

  • Administrative complexity — Billing issues, denials, and delays are possible.

​​​​

Using insurance at Metamorphic Counseling:

We currently use Headway to help you understand your benefits, check coverage for mental health services, estimate your out of pocket costs, and for paying your co-pay/co-insurance with ease.

​

​​Accepted in-network insurances:

• ​Aetna

• Anthem Blue Cross and Blue Shield Ohio

• Carelon Behavioral Health

• Cigna

• Horizon Blue Cross and Blue Shield of New Jersey

• Independence Blue Cross Pennsylvania

• Quest Behavioral Health​​

​​

​

​

​

A superbill is a detailed receipt that a therapist provides after private-pay sessions. Clients can submit this document to their insurance company to request partial reimbursement for out-of-network services. This means if you have a different insurance from those listed above, you may be able to get reimbursed from your insurance for the cost of our sessions. A diagnosis is required, and reimbursement is not guaranteed, but clients still benefit from the flexibility of private pay.

• Pros:

  • Potential cost savings — Clients may get partial reimbursement from insurance.

  • More provider choice — Clients can see out-of-network therapists.

  • Flexibility — Greater flexibility compared to fully using insurance, since the therapist is still private pay.

• Cons:

  • Diagnosis still required — Insurance requires a billable diagnosis to be listed on the superbill.

  • Reimbursement not guaranteed — Depends on the client's plan’s out-of-network benefits. Please check with your insurance provider to learn more about your out-of-network benefits.

  • Client must submit paperwork — Clients have added administrative steps and waiting periods for the potential reimbursement.

  • Less privacy than pure private pay — Some treatment information is still shared with insurance so that you may get reimbursed.