Clarity Counseling Seattle

Rates, Payment, and Insurance Questions

Standard Rates

We understand that therapy is an investment, of both your time and your money. An investment into yourself and perhaps also into your relationship, and the therapists in our practice do everything we can to help you to maximize your investment. Rates for the standard 50-minute appointment are $160 for Bill Aloe, Lisa Stewart, and Hanna Kokko; $175 for Mary-lynn Ballew, Corey Thompson, and Sara Whitney; $195 for Justin Pere. We do not charge more for the initial intake session, nor do we charge more for couples or family therapy than we do for individual therapy.

 

Health Savings Accounts and Flexible Spending Accounts

We are happy to run your sessions through your health savings account (HSA) or flexible spending account (FSA), which can be used to pay for medical expenses such as therapy (both individual and couples therapy) and can often significantly decrease the cost of treatment.

 

Health Insurance

For individual clients, we provide invoices for reimbursement of whatever your out-of-network benefits will cover. Many of our individual clients choose to submit to insurance for out-of-network coverage, and what we most often see is 20-60% reimbursement (for example, Premera most often reimburses $94 per session). We encourage you to contact your health insurer to inquire about your out-of-network coverage, as each policy varies.

For couples/relationship clients, while we would love for you to be able to utilize your insurance benefits, the reality is that health insurance rarely covers relationship therapy, regardless of how great your plan is or even what your insurance company may have told you. We know that this is often surprising and unwelcomed news so we ask that you please take a few minutes to read the explanation below so that you can make informed decisions about your care.

Do you take our insurance for couples/relationship therapy? is a common question that takes a moment to answer (believe it or not this is the short version!)...

If your insurance company tells you that they do indeed cover couples counseling, they are referring to the following scenario: one person's mental illness is being treated and the partner is only present to support that person's mental health treatment. When health insurance is utilized for therapy, the insurance company will only cover mental illnesses, such as Major Depressive Disorder or Generalized Anxiety Disorder or ADHD. By definition, illnesses afflict one person at a time. Insurance is known to be somewhat flexible about how a mental illness is treated, meaning that if a spouse needs to be involved and present in the treatment of the mental illness, insurance will allow for that.

Please note that in this scenario, one member of the couple is officially diagnosed with a mental illness (considered the "identified patient" by the insurance company), and the treatment file and treatment progress notes that the therapist has to write and keep reflects ongoing treatment for that patient's mental illness. So again, in this scenario, couples therapy is only covered by health insurance because the treatment is focused solely on one partner's diagnosed mental illness, and the other partner is only present to be part of their spouse's treatment of their mental illness. Please also note that in this scenario, a valid mental illness needs to be assigned by the therapist and sent to the insurance company, where that diagnosis becomes part of the patient's permanent medical record.

If the person who will serve as the “identified patient” is already in individual counseling for that mental health diagnosis, the couples therapist cannot bill insurance, because the person is already receiving individual treatment for that diagnosis. Health insurers are assuming that couples therapy is always focused on the treatment of one spouse's mental illness.

The challenge is this: most couples do not enter couples therapy to work on one person's mental illness. They instead seek relationship counseling for help with communication, conflict, emotional connection, parenting, trust, sex/intimacy, and all sorts of other important reasons to seek help from a relationship counselor. But these focuses of therapy are not "medically necessary" mental illnesses, and thus the scenario described above does not apply, given that health insurance only pays for treatment of diagnosable mental illness. Additionally, the couple as a unit is the focus of therapy, and so billing insurance as if the couple's sessions are treating just one individual is potentially insurance fraud.

This is a frustrating reality for both the public and for therapists. We would love for couples to be able to utilize their insurance benefits for relationship help, but we are forced to adhere to the very strict rules around what is covered and what isn't. And we need to be careful because breaking these rules really can be insurance fraud.

*Please note: Very rarely, we do see some insurance carriers cover couples therapy. The way to clarify this with your insurance is to ask if your plan covers what is called a “Z Code” diagnosis, specifically the code Z63.0. As mentioned above, all insurance billing must include a mental health diagnosis (they want to know what they are paying for), and there is a group of relationship-related codes that start with Z (such as the Z63.0 example above, which is for “Relationship Distress with Spouse or Intimate Partner”), that most insurance plans exclude. Again, most insurance plans do not cover Z codes so it is unlikely that your insurance will allow for this to be the diagnosed reason for couples therapy, however it may be worth checking with your specific plan. The exact question to ask your insurer is this: "Does my policy cover diagnosis code Z63.0 for procedure code 90847 in an outpatient office setting?"

If a "Z code" is indeed covered by your specific insurance policy, we are happy to give you an invoice to submit to your insurer for whatever out-of-network benefits you have, so that you may receive some reimbursement.

We know that relationship therapy is not inexpensive - that it's an investment. And we do everything we can to help you to get the most out of your investment. Therapy sessions with us range from $160 - $195 for the standard 50-minute appointment, which is about average for this area and for the advanced training our therapists have.

So thank you for your patience in reading through all of that, and we know that understanding health insurance can be quite confusing so please always feel free to follow up with any questions you have.

Frequently Asked Questions

Given that telehealth is a great option, absolutely! So many of the people we've helped since Covid hit have been in locations that are often hours away from our Seattle office, allowing a great number of clients to receive needed services. Our therapy license does not extend outside of Washington State but it does allow us to help anyone within the state if they are open to using the telehealth approach, which has worked wonderfully for hundreds of couples and individuals over the past few years.

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes  related costs like medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your health care provider, and any other provider you choose     for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises

We can't wait to be sitting across from our couples and individuals again, absolutely! But for now we must. Above anything else is maintaining the safety of anyone who enters our offices so we are taking a cautious approach to reintegrate in-person sessions as vaccinations increase and guidelines change.

Why We Prefer Online Therapy At This Time

Please also consider the following. Outpatient mental health clinics are considered healthcare settings, and the Washington State Secretary’s current health order requires mask-wearing in healthcare settings, regardless of vaccination status. So any in-person appointments right now would need to be masked, for both therapist and client. Wearing a mask during a therapy session hampers communication between therapist and client, and if couples therapy then the masks impede on the couple's communication as well. Doing telehealth allows us all to be able to see each other, communicate fully, and not be distracted by the wearing of masks.

Contact Our Seattle Office For More Information

We will be sure to inform current and new clients of our ability to see clients in-person without masks just as soon as we're able. For now teletherapy has worked wonderfully for the people seeking our help.

We are often asked about how/if health insurance can be part of paying for individual or couples therapy. It's an important and surprisingly not-so-simple answer, so we have devoted a page to providing a detailed explanation of how insurance works as well as what our rates are, so that clients are making informed decisions about their care.

That depends on a few factors, such as what you are seeking help for and how motivated you are to progress. Perhaps the most important part of this answer is to say that how long you stay in therapy is entirely up to you. You aren't signing a contract or being put on a 12-week program  - instead, you and your therapist are working together to reach the goals you set for therapy with us. Some people get what they need in just a few sessions, and others stay for many months or even years, but that duration is entirely up to you.

On the one hand, we want you to get what you need from therapy as quickly as possible so that you are empowered to go off and essentially be your own therapist. Our job should absolutely be to help get you to where you don't feel you need us any longer. And on the other hand, having a long-standing relationship with a therapist you come to know, trust, and greatly benefit from is one of the neatest relationships you'll ever have. Personally, I (Justin Pere) have always sought out therapists with whom I hope to be in relationship with for many years, and have had a number of therapeutic relationships that were invaluable to me. I have also had a few that lasted just a few months, as I either did not gel with the therapist or I simply got what I needed from a short stay.

So the short answer to this question is that it really varies, but that for however long you are working with our therapists, we are using everything we know to help you to make the most of your "x" number of sessions with us.

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