How Much Do Private-Pay Therapists Charge? 2026 Data

Short answer: three recent sources put the average private-pay therapy session at roughly $140 to $160. Each one measured something different, none reports a median, and the spread between states and specialties is wide. Below is what each source measured, the state figures that exist, and a way to work out your own fee.

Where we stand: we make CoralEHR, an EHR for private-pay practices. None of the figures here come from our own customers.

The national figures

A few things to keep in mind when you read these:

• None is a median. All three are averages, and a handful of very high fees pulls an average up.
• None ties the fee to a session length. They are per-session figures, not 90837 rates.
• Listed rates are asking prices. The Health Affairs study used what therapists post on their profiles, which may differ from what clients pay after sliding-scale discounts. More than a third of providers listed no rate.
• Practices that don't take insurance charged more. In the Health Affairs study, therapists who accepted no insurance listed an average of $155.90, against $141.06 for those who did.

By state

No public source we found gives a median private-pay fee for every state. Here is what does exist.

Listed self-pay rates, late 2023. The Health Affairs Scholar study charts the average listed rate for every state. The text gives these examples, each next to the state's Medicaid rate for a 45-minute session (90834):

Nebraska was the only state where Medicaid paid more than the average cash rate. Across all states, Medicaid paid 42.4% less on average. The full state chart is Figure 2 in the published study.

All session fees, 2023 to 2024. SimplePractice published state averages from more than 104 million sessions on its platform. These combine self-pay and insurance sessions, so they aren't private-pay rates, but they show how far states differ:

SimplePractice says its 2025 report includes tables for all 50 states comparing self-pay and insurance rates. The report is behind a sign-up form, so we haven't reproduced it.

Public reference points

These aren't private-pay fees, but they help when you're deciding where yours sits:

• Medicare. The 2026 national amount for a 60-minute session (90837) is about $167, and $113.90 for 45 minutes (90834), before the adjustment for your area. Clinical social workers, marriage and family therapists and mental health counselors are paid 75% of those amounts. Our reimbursement calculator shows the amount for each state.
• Hospital cash prices. A 2021 study of hospital price lists found a median cash price of $199 for 90837 across 547 hospitals. Hospital clinics price differently from private practices, and the data is from 2021.
• Low-fee networks. Open Path Collective members charge $40 to $70 for individual sessions, and up to $80 for couples and families.
• What therapists earn on salary. Our therapist salary tool has federal wage data by state and license, a useful floor when you weigh private practice against employment.

How to work out your own fee

Averages tell you where the market is. Your fee also has to cover your costs and the number of sessions you can sustain. A simple way to check it:

1. Start from the income you need before tax, plus your yearly practice costs: rent, software, insurance, licensing, continuing education, and card processing (about 3% of what you collect on standard card pricing).
2. Count realistic sessions a year. For example, 22 sessions a week for 46 weeks is 1,012 sessions, and late cancellations and no-shows reduce that.
3. Divide. $110,000 in income plus $15,000 in costs, over 1,012 sessions, is about $124 a session before any sliding scale.

Then compare that with the figures above and with therapists near you who share your license and specialty. If you plan to offer reduced fees to some clients, our sliding scale calculator shows what that does to your average. If you're raising fees for current clients, our guide on how to raise therapy fees has the notice and wording.

Private-pay clients with out-of-network benefits can often claim part of your fee back from their insurer with a superbill, so your fee isn't always their real cost. Our superbill generator makes one in your browser, and our guide to explaining out-of-network benefits covers the conversation.

CoralEHR is built for private-pay practices: card payments, superbills in one click and Good Faith Estimates at booking, from $29 a month. See pricing.

Sources: SimplePractice, State of Private Practice 2025 · SimplePractice, average therapy session fees by state · Heard, 2026 Financial State of Private Practice · Zhu JM, et al. Insurance acceptance and cash pay rates for psychotherapy in the US. Health Affairs Scholar, 2024 · Jiang JX, et al. JAMA Network Open, 2021 · Open Path Collective · CMS Physician Fee Schedule

Read on October 31, 2026. Figures are averages from each source's own data and method. They describe the market and aren't a recommendation for any one practice.