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Two words on your insurance card can completely change how much you pay for therapy and how you get reimbursed for it. “In-network” and “out-of-network” aren’t just insurance jargon – they determine your upfront cost, how billing works, and even how much say your insurance company has in your care. Here’s exactly what each one means, how the costs actually compare, and how to figure out which applies to you.
In this article:
What Does "In-Network" Mean?
When a therapy practice is in-network with your insurance plan, it means the practice has a direct contract with your insurer. That contract sets a negotiated rate for each session — and because your insurer has already agreed to that rate, you typically only pay a copay (a flat fee, like $25) or coinsurance (a percentage of the session cost) at the time of your appointment. The practice bills your insurance directly for the rest.
This is usually the more predictable option: you know your cost before you walk in, and there’s no paperwork on your end.
What Does "Out-of-Network" Mean?
Out-of-network means the opposite — the practice doesn’t have a direct contract with your specific insurer. That doesn’t mean therapy isn’t covered. Many PPO-style plans still include out-of-network mental health benefits; the billing process is just different.
Instead of the practice billing your insurer directly, you typically pay your full session fee upfront and receive a superbill— an itemized receipt with your diagnosis code, procedure code, and provider information. That superbill gets submitted to your insurer (sometimes by you, sometimes by the practice on your behalf), and your insurer reimburses you directly based on your plan’s out-of-network benefit percentage.
Mind in Motion is out-of-network with EmblemHealth, BlueCross BlueShield, 1199SEIU, Beacon Health Options, and ComPsych.
How the Costs Actually Compare
In-Network
Out-of-Network
What you pay upfront
Just your copay/coinsurance, loosely $10-$50/session
Full session fee ($125–$350)
Who bills your insurer
The practice, directly
You, or the practice on your behalf
When you know your cost
We give you the estimate before your session, but final cost is provided by the insurer after reimbursement is processed
We give you the estimate before your session, but final cost is provided by the insurer after reimbursement is processed
Typical out-of-pocket result
After the first reimbursement is processed, copay for each visit is predictable
Often 0–20% of total cost, once reimbursed
The upfront cost looks very different, but the final out-of-pocket cost can end up surprisingly close – it just arrives on a different timeline. In-network gives you certainty upfront; out-of-network usually gives you more of your money back over time, just not immediately.
Not sure which applies to your specific plan? Send us a photo of your insurance card and we'll tell you directly, before you commit to anything.
Why Some Practices Choose to Stay Out-of-Network
It’s worth knowing that staying out-of-network with certain plans is often a deliberate choice. Practices that do this are usually trying to:
- Avoid insurer-imposed session limits – treatment length is based on clinical need, not what a plan will pre-approve.
- Protect client privacy – out-of-network claims generally involve less clinical detail shared with the insurer, since the client controls what gets submitted.
- Keep clinical decisions between the client and therapist – without a plan dictating diagnosis coding, session frequency, or approach.
- While a client’s final out-of-pocket cost can be similar with in-network coverage and out-of-network benefits, the amount the therapy practice ultimately receives from insurance can be very different, and in some cases, out-of-network reimbursement can be more favorable for the practice.
This is why a practice can be an excellent fit for you clinically and still being out-of-network with your specific plan.
So, Which Should You Choose?
In most cases, this isn’t really a choice you make freely, it depends on which insurance you already have and which providers you want to see.
- Check your insurance card or member portal – many list in-network vs. out-of-network benefits explicitly.
- Call the member services number on your card and ask: “Do I have out-of-network mental health benefits, and what’s my in-network status with [practice/provider]?”
- Ask the practice directly – most, including ours, will verify your coverage for you for free before you book anything. Our goal is to help getting started with therapy without the insurance side becoming its own source of stress.