Therapy cost and insurance terminology can be confusing enough to delay people from starting. Here’s a plain-language breakdown of three common terms worth understanding before you start comparing options.
What a Sliding Scale Is
A sliding scale is a reduced-fee option some clinicians offer based on financial need, rather than a single fixed rate for everyone. Availability varies by clinician and practice — it’s worth asking directly rather than assuming it either is or isn’t offered.
What a Superbill Is
A superbill is a detailed receipt a therapist provides after an out-of-pocket session, which you can submit to your insurance company for possible reimbursement, even if that clinician isn’t in-network. It typically includes diagnostic and procedure codes your insurer needs to process a claim.
How Out-of-Network Reimbursement Generally Works
Many insurance plans offer some out-of-network mental health benefits, though the percentage reimbursed and any deductible that applies varies significantly by plan — it’s worth calling your insurer directly to ask about your specific out-of-network mental health coverage.
Reimbursement timelines also vary by insurer, and some plans require you to meet a separate out-of-network deductible before any reimbursement kicks in, which is worth confirming before you budget around it.
Questions to Ask Your Insurance Company
- Do I have out-of-network mental health benefits?
- What percentage of the session fee is typically reimbursed?
- Is there a deductible that needs to be met first?
- What’s the process for submitting a superbill?
Why This Is Worth Understanding Before You Start
Knowing these terms ahead of time can make the financial side of starting therapy feel less confusing, and can open up options beyond only in-network providers — which can meaningfully widen your choice of clinician.
