Out-of-Network vs. Self-Pay Therapy: What’s the Difference & What’s Right for You?
Navigating the world of therapy can already feel overwhelming - especially when you’re dealing with burnout, stress, or trauma. If you’re a woman or BIPOC professional in Washington State looking for EMDR therapy, you may find yourself wondering about your options for paying for care.
Maybe you’ve come across terms like “self-pay therapy” or “out-of-network therapy” while searching for support in Kirkland, WA. But what do those terms actually mean? And how do they impact your healing journey? In this post, I will walk you through the differences of self-pay and out of network therapy, how to use your insurance benefits, and questions to consider on which option is best for you.
What’s the Difference Between Self-Pay and Out-of-Network Therapy?
Self-pay therapy means you pay your therapist directly for sessions without involving your insurance provider. There’s no paperwork, claims process, or need for a mental health diagnosis. You and your therapist handle everything privately.
Out-of-network therapy, on the other hand, means the therapist you’re working with isn’t in-network with your insurance company. You may still be able to receive partial reimbursement if your insurance plan includes out-of-network mental health benefits.
So while both models involve direct payment to your therapist, the key difference is that out-of-network therapy may allow you to still utilize your insurance benefits and get reimbursed for some of the cost.
Why Choose Self-Pay or Out-of-Network Therapy?
There are many reasons clients choose either option - especially when navigating sensitive, layered experiences such as racial trauma, career burnout, or past emotional wounds.
Here are some of the unique benefits of each model:
✨ Benefits of Self-Pay Therapy
Greater privacy and confidentiality: Your insurance company doesn’t receive information about your diagnosis or treatment.
Full freedom and flexibility: You and your therapist design your care - whether that’s weekly sessions, EMDR intensives, or a more fluid approach.
No external limitations: Your healing isn’t restricted by what's deemed “medically necessary” by insurance companies.
Deeper emotional safety: Especially for marginalized communities, self-pay can create a more liberated space to do meaningful, identity-affirming work.
Self-pay therapy in Washington State empowers you to prioritize your mental wellness without compromise.
🌿 Benefits of Out-of-Network Therapy
You still use your insurance: If your plan includes out-of-network benefits, you may get reimbursed for a portion of your session cost.
More choice in who you work with: You can choose a therapist based on alignment and specialization - not just who’s in-network.
Access to specialized care: For modalities like EMDR or intensive trauma therapy, out-of-network may be the only way to work with certain providers.
Sustained support: You're not limited by the short-term models often required by insurance companies.
Choosing out-of-network therapy in Washington State gives you access to personalized care - while still making use of your insurance plan.
Step-by-Step: How Out-of-Network Therapy Works
If you’re considering using your out-of-network benefits, here’s how the process typically works:
Pay your therapist directly at the time of service.
Your therapist provides a superbill - a detailed receipt with diagnosis codes, session dates, and other required info.
You submit the superbill to your insurance company through their claims portal or by mail.
If your plan covers it, you receive partial reimbursement, often 40%–80% of the session fee, depending on your plan and deductible.
Many of my clients find this process manageable. For those who struggle to remember to submit their superbills, platforms like Mentaya are a helpful tool to make sure that their get reimbursed quickly by their insurance company.
Questions to Ask Your Insurance Provider About Out-of-Network Benefits
Before starting therapy, it’s helpful to call your insurance company and clarify your coverage. Here are some questions to ask:
Do I have out-of-network mental health benefits?
What is my out-of-network deductible, and how much of it have I met?
What percentage of the session fee will be reimbursed after I meet my deductible?
Do I need prior authorization for out-of-network therapy?
Are CPT codes 90834 (45 minutes) and 90837 (60 minutes) covered?
Is there a limit on the number of therapy sessions allowed per year?
How do I submit a superbill, and how long does reimbursement take?
Tip: Take notes during the call and ask for confirmation in writing if needed. Insurance reps can vary in their responses, so written documentation is always helpful.
Why You Should Choose This Model of Care?
Many of my clients (especially BIPOC professionals, women, and high-achieving individuals) choose self-pay or out-of-network therapy because they’re looking for something deeper than symptom management.
They’re seeking safe, culturally attuned spaces where they don’t have to explain their identities or filter their pain.
They want therapy that’s not just trauma-informed but trauma-healing.
They want the freedom to do an EMDR intensives that offer focused, transformative sessions instead of months of slow progress.
They want flexibility to explore therapy in a way that respects their schedules, their values, and their stories.
They want to invest in long-term emotional freedom, not just in short-term symptom relief.
If that resonates with you, you’re not alone. Choosing self-pay or out-of-network therapy is a powerful step in reclaiming your healing on your own terms.
Final Thoughts
There’s no one-size-fits-all approach to therapy. What matters is that you feel safe, supported, and empowered to do the work in a way that feels right for you.
Here’s what I want you to remember:
Self-pay therapy gives you maximum freedom, privacy, and flexibility.
Out-of-network therapy allows you to work with a therapist of your choice and still make use of your insurance.
Understanding your out-of-network benefits is key to making informed, empowered decisions.
You’re allowed to prioritize your mental health—even if that means investing out-of-pocket.
You deserve a therapy space that honors your lived experience, culture, and healing needs.
Ready to Take the Next Step?
If you’re curious about how EMDR therapy or an EMDR intensive could support your healing journey, I’d love to connect.
I support women and BIPOC professionals in Washington State who are ready to move through burnout, trauma, and stress - and into peace, clarity, and joy.
📅 Click the "Schedule Now" button on my website to book your free consultation. Let’s explore together if an EMDR intensive is right for you.
