Why Paying Cash for Therapy May Benefit You
There are several reasons you may want to choose to pay “cash” or “direct pay” for your mental
health sessions. Paying “cash” means that the client pays for sessions out of pocket. “Cash”
clients, despite the terminology, can, in fact, pay by cash, check, credit card, PayPal, Venmo,
health savings accounts, etc… “Cash,” simply put, refers to a non-insurance client. One of the
most valuable reasons is Privacy and Control.
Privacy and Control
When you use your insurance plan to pay for services, your information (including
diagnosis, treatment plan, progress notes, etc.) can become part of your permanent insurance
record. Yes, HIPPA and privacy laws are intended to protect sensitive and private
information, but insurance companies have access to your records for oversight and the necessity
It works like this…..For an insurance company to pay any clinician for services, all clients must
receive a “diagnosis code.” (https://coder.aapc.com/cpt-codes/) Once you are assigned a
diagnosis, this becomes part of your permanent insurance record. Just so you know, there is not a
diagnosis code for “looking to better myself,” “my husband cheated on me, and I am stressed
out,” or for many of life’s little innumerable stumbling blocks for which many seek a trusted
advisor/therapist. Unfortunately, the diagnosis code provided to the insurance company so you
can receive care becomes a permanent part of your insurance medical record. Sometimes
insurance companies request additional information (e.g.) progress notes, treatment plans, etc.) to
confirm treatment progression and clients receive proper care. Just know, this information may
However, when you pay cash, your information is only readily accessible to your therapist
and yourself. All notes, treatment plans, etc. are retained solely by your therapist and are
only used to help you and does not have to be shared without a Writ signed directly by a Judge.
That is assuming you let someone else know you ever went to counseling.
“Cash” or direct payment provides the utmost privacy protection for those who are concerned
about their future careers, current careers or just want privacy.