Why Your Therapist May Soon Be Out-of-Network

If you've noticed your therapist suddenly doesn't take your insurance anymore — or you're hearing this from friends — you're not imagining it. It's happening across New York.

Here's the short version: insurance companies have been steadily cutting what they pay therapists per session. Some networks now reimburse $70–$85 for an hour that costs the therapist's practice $115+ to deliver, once overhead, taxes, and supervision are factored in. This isn't about greed. It's about whether independent practices can survive at all. Major insurers like UnitedHealth/Optum now own both the insurance side AND large therapy networks. They can afford to underpay because they collect premiums on one end and pay themselves on the other. Independent practices can't compete with that math. The result: more and more excellent therapists are leaving insurance panels and going out-of-network so they can stay in business and keep offering 50-minute sessions — not 15-minute ones. If your therapist makes this change, it's not personal, and it doesn't have to mean the end of your care. Most PPO plans reimburse 50–80% of out-of-network costs.

(We'll cover how to actually use those benefits in our next post.)