Fees & Insurance

Self-pay means that we are not in-network with insurance companies and do not bill insurance directly for sessions. Payment is made by you at the time of service.

Some insurance plans offer out-of-network reimbursement, which may allow you to recoup a portion of the cost after paying out of pocket. We can provide documentation to support this when applicable.

Self-pay is sometimes referred to as "cash pay," though we do not accept cash. We accept secure online payments via major credit cards.

Most people are not under any illusions about what insurance companies are. The prior authorizations, the denials, the coverage that disappears when you actually need it—none of that is surprising anymore. The calculation most people make is not "this system is trustworthy." It is "this system is what exists, and staying under the radar is the safest strategy."

We understand that calculation. We just decided we couldn't make it.

In-network participation means operating inside an infrastructure whose financial incentives run directly counter to good clinical care. That was true before January 2026, when CAQH—the platform that has controlled provider credentialing, network enrollment, and the directory listings patients use to find in-network therapists since 1998—was formally converted from a nonprofit into a privately held company with twelve shareholder organizations representing UnitedHealth Group, Cigna, Aetna, Elevance Health, Humana, and a coalition of Blue Cross Blue Shield plans. In June 2026, it rebranded as DataSpring.

Every governance seat in that structure belongs to a major commercial payer. The platform that determines whether independent providers can participate in networks at all is now owned by the industry that benefits when they cannot.

The same dynamic is playing out on the platform side. A significant portion of the therapy market has moved into venture capital. Headway, Alma, and similar platforms have raised hundreds of millions in outside funding. That capital has return expectations, and those expectations shape clinical decisions whether or not anyone in the room says so out loud.

TKG was built as a private-pay, independently owned practice. That was a values decision made before any of this became impossible to ignore. It means no payers, no investors, no outside stakeholders whose financial interests sit alongside yours in the room. The only question we are accountable to is whether the care we provide is good for our patients.

We are not inside a system owned by the people who profit when care is limited. That is what being out-of-network actually means here.

In many cases, yes. Many private and employer-based insurance plans offer out-of-network reimbursement, which may allow you to be reimbursed for a portion of your session fees after paying out of pocket.

Reimbursement rates vary by plan and are determined by factors such as deductibles, coinsurance, and whether your plan includes out-of-network mental health benefits. We can provide documentation to support reimbursement when applicable, though we cannot guarantee coverage or reimbursement amounts.

Because insurance plans differ widely, we encourage clients to contact their insurance provider directly to understand their specific out-of-network benefits. Our administrative team can also help clarify what information to request before you schedule.

You pay for each session at the time of service and then submit a reimbursement request to your insurance company. We provide a detailed receipt, often called a superbill, to support this process.

If you have not yet met your annual deductible, the amount you paid for sessions will typically be applied toward that deductible and you may not receive reimbursement until it has been met.

If your deductible has already been met, your insurance company may reimburse you for a portion of the session fee, based on your plan’s out-of-network benefits. Reimbursement is usually issued by check or direct deposit, though timing and amounts vary by plan.

We cannot guarantee reimbursement, as coverage decisions are made by your insurance provider. Our administrative team is available to answer general questions about documentation and the reimbursement process.

In many cases, yes. Many clients use a health savings account (HSA) or flexible spending account (FSA) to pay for therapy.

You may be able to pay directly using an HSA or FSA debit card, or pay out of pocket and request reimbursement from your account, depending on how your plan is structured. Because these funds are pre-tax, using an HSA or FSA can help reduce the overall cost of therapy.

We recommend confirming eligibility and reimbursement details directly with your plan administrator.