PublishedSep 21st, 2026•14 min read
Cost and Insurance for Perinatal and Postpartum Therapy
Author
Leigh Hall
LMFT
If you're thinking about therapy during pregnancy or after having a baby, cost is likely a big concern, as you're already managing extra expenses. The cost of perinatal therapy, which covers the amount you pay for counseling during pregnancy or after birth, depends on whether you use insurance, your specific plan, and the provider. With insurance, many people pay a modest co-pay per session; without insurance, costs vary more widely. At the same time, perinatal therapy is mental health care, so it falls under mental health coverage protections.
Understanding how much therapy costs with insurance, what affects therapy prices, and how insurance contributes can help ease any uncertainty you have. This guide explains what perinatal therapy typically costs, what insurance covers, and ways to keep care affordable.
At-a-glance: Perinatal therapy cost and insurance
Cost with insurance | Often a modest co-pay per session; at Octave, avg $28/session |
|---|---|
Cost without insurance | Varies by provider and location; some offer sliding scale |
Is it covered? | Usually yes; perinatal therapy is mental health care under parity laws |
Medicaid | Covers therapy; nearly every state extends postpartum coverage to 12 months |
Ways to lower cost | FSA/HSA, in-network care, sliding scale, employer/EAP benefits |
Confirm before you start | Exact cost depends on your plan and is verified before care begins |
At Octave | In-network for 40 million Americans; FSA/HSA accepted; no subscription; transparent pricing |
What perinatal therapy typically costs
If you're wondering how much a therapy session costs, the answer depends largely on whether you use insurance. With insurance, many people pay a modest co-pay per session. Without insurance, session costs vary more widely by provider and location.
Comparison table: Cost with insurance vs. without insurance
| Dimension | With Insurance | Without Insurance |
|---|---|---|
| What you pay | Typically a co-pay per session (often modest) | The full session rate, which varies by provider |
| At Octave | Average $28/session; 95%+ pay under $45/session | Transparent pricing; the Care Navigation team can explain options |
| What affects it | Deductible, co-pay, in-network status | Provider, location, session length, sliding scale |
| Ways to reduce it | Stay in-network, use FSA/HSA, employer benefits | Sliding scale, FSA/HSA, shorter or less frequent sessions |
| How to confirm | Verify benefits (Octave can do this for you) | Ask the provider for the self-pay rate up front |
A 2024 cross-sectional analysis published in Health Affairs Scholar found that the average cash-pay rate for therapy is $143.26 per session (Zhu et al., 2024). The average cost of therapy in the United States varies significantly depending on where you live, though. Services typically cost more in metropolitan areas than in rural areas, with certain types of therapy costing over $200 per hour in some locations.
Under insurance, KFF's 2025 Employer Health Benefits Survey reports that average co-pays for specialist office visits are about $45, and therapy visits often fall into this tier. Your actual co-pay or deductible may vary based on your plan.
If you're wondering how much therapy costs with your insurance, use our Therapy Cost Calculator, which factors in your state and insurance provider to estimate out-of-pocket therapy costs.
Does insurance cover perinatal and postpartum therapy?
Yes, in most cases, insurance covers perinatal and postpartum therapy. Because perinatal therapy is a form of mental health care, most health plans are required to provide coverage comparable to medical care under mental health parity laws.
The Affordable Care Act (ACA) classifies mental health services as an essential health benefit. While your plan may place limits on the number of covered therapy sessions or require co-pays or prior authorization, it generally cannot exclude medically necessary mental health treatment altogether.
You'll typically receive the highest level of coverage when you see an in-network provider, which results in lower out-of-pocket therapy costs. If you choose an out-of-network therapist, you'll usually pay more, though some insurance plans offer partial reimbursement. Check your plan's benefits to understand your coverage and expected costs.
A 2025 study published in Women's Health Issues found that higher out-of-pocket costs were associated with lower psychotherapy use among commercially insured birthing individuals, particularly among higher-income enrollees (Zivin et al., 2025). This underscores why confirming your benefits before starting care can make a meaningful difference, particularly for conditions like postpartum depression or postpartum anxiety.
Perinatal and postpartum therapy on Medicaid
For those on Medicaid, therapy is covered, and nearly every state now extends postpartum Medicaid coverage to 12 months after birth. A 2024 analysis published in Health Affairs Scholar found that Medicaid reimbursement rates for therapy were, on average, 40% lower than cash-pay rates (Zhu et al., 2024), so confirming that your provider accepts Medicaid is an important step.
What affects what you'll pay
Therapy prices depend on your insurance, provider, and format. The main factors include:
- Your plan's deductible and co-pay: If you haven't met your deductible this year, you'll pay the negotiated rate until you do. After that, you'll pay either a co-pay (a flat fee) or coinsurance (a percentage of the session cost). For example, if your plan has a $1,500 deductible and you've used $1,200, you would pay the negotiated rate for your next few sessions until you reach $1,500, then switch to your co-pay for the rest of the year.
- In-network vs. out-of-network: In-network providers have contracts with your insurance provider and have agreed to a lower rate. With out-of-network providers, you often need to pay the full cost upfront and submit for reimbursement. Not all insurance plans offer reimbursement for out-of-network providers, so check directly with your plan.
- Session length and frequency: Most therapy sessions are 45 to 60 minutes. Longer sessions can come at a higher cost, and how frequently you attend also affects your monthly costs.
- Provider credential type: A marriage and family therapist (LMFT), professional counselor (LPC), or clinical social worker (LCSW) generally charges less for a cash-pay rate than a psychologist (PhD/PsyD). When sessions are covered by insurance, co-pays are typically the same across credential types.
- Therapy format: Virtual therapy can be less expensive than in-person therapy because it removes many of the overhead costs associated with a physical office.
How to check your perinatal therapy benefits
You can confirm your coverage in three ways: 1. check your plan's member portal, 2. call the number on your insurance card, or 3. let a provider verify your benefits for you.
1. Check your plan's member portal
Navigate to your insurance provider's official website or mobile app. You'll need your policy ID or membership number to register and log in. Once logged in, navigate to the coverage or benefits section to view your plan details.
2. Call the number on your insurance card
Ask specific questions, including:
- Does my plan cover outpatient mental health therapy?
- What is my co-pay before and after meeting my deductible?
- What is my deductible and has it been met?
- Is this provider in-network?
- Do I need a referral or prior approval to receive coverage?
- Is virtual therapy covered? (if desired)
- Are there any limits on the number of sessions per year?
3. Let a provider verify your benefits
A provider can work with your specific insurance plan to understand what is covered. Many therapists and clinics can explain your costs before your first appointment so you can make an informed choice and avoid any unexpected bills.
How to keep perinatal therapy affordable
Several options can help lower your out-of-pocket therapy costs, even if the price feels like a stretch right now.
- Flexible spending account (FSA) and health savings account (HSA) funds: Therapy is an eligible HSA and FSA expense, meaning you can use pre-tax funds to pay for services. Coverage generally applies when therapy is used to diagnose or treat a mental health condition, rather than for general wellness or personal growth.
- In-network care: Choosing in-network providers usually means better coverage and lower out-of-pocket costs.
- Sliding-scale options: Some therapists offer sliding-scale fees, meaning rates are adjusted based on your income.
- Employer or EAP benefits: Some employer benefits cover mental health care, including perinatal therapy. Employee assistance programs (EAPs) usually cover a set number of sessions per year at no cost.
- Affordable therapy alternatives: Community mental health clinics and university training clinics offer more affordable therapy. Group therapy is also typically less expensive than individual sessions.
See your estimated therapy cost with Octave
A note on crisis support
If you are in crisis, call or text 988, and for perinatal support, contact Postpartum Support International at 1-800-944-4773. Cost should never be a barrier to safety.
How Octave supports you
Octave is in-network with insurance covering 40 million Americans, and clients pay an average of $28/session through insurance, with 95%+ paying less than $45/session. FSA and HSA are accepted, there is no subscription, and pricing is transparent with no surprise bills. Octave verifies your benefits and confirms your exact cost before care begins, so there are no unexpected charges.
Every therapist at Octave is fully licensed with an average of 10+ years of experience, including clinicians experienced in perinatal mental health, and Octave does not work with trainees or pre-licensed associates. Octave is therapy only; if your care also involves medication, that is handled by an external prescriber, and our Care Navigation team can help coordinate. Exact costs vary by plan and are always confirmed before care begins.
Frequently asked questions about perinatal therapy cost and insurance
It depends on whether you use insurance and details of your specific plan. With insurance, many people pay a modest co-pay per session; at Octave, clients pay an average of $28/session through insurance and 95%+ pay less than $45/session. Without insurance, session costs vary more widely by provider and location. Exact costs are confirmed before care begins.
In most cases, yes. Perinatal and postpartum therapy is mental health care, and mental health parity laws require most plans to cover mental health care comparably to medical care. Coverage specifics vary by plan, so it is worth confirming your benefits, which Octave can do for you.
Medicaid covers mental health therapy, and nearly every state now extends Medicaid postpartum coverage to 12 months after birth, which can be an important coverage path for new parents. Check your state's Medicaid plan for specifics, including which providers are in-network.
Your cost depends on your insurance and plan (deductible, co-pay, who is in-network vs. out-of-network), the provider's credential type, session length and frequency, and whether you meet with a therapist virtually or in person. If you have not met your deductible, you may pay the negotiated rate until you do, then a co-pay after that.
Yes. Therapy is generally an eligible expense for both flexible spending accounts (FSA) and health savings accounts (HSA), which let you pay with pre-tax funds and reduce your out-of-pocket therapy cost. Octave accepts FSA and HSA.
You can check your plan's member portal, or call the number on your insurance card and ask whether outpatient mental health therapy is covered, what your co-pay is, whether the provider is in-network, and whether you need a referral. Octave can also verify your benefits and confirm your costs before you start.
Without insurance, therapy costs vary by provider and location, and some practices offer sliding-scale rates. Octave's pricing is transparent, and our Care Navigation team can help you understand your options. Cost should not be a barrier to getting support, especially in the perinatal period.
No. Octave is therapy only and does not prescribe or bill for medication or psychiatry. If your care involves medication, that is handled by an external prescriber such as your OB-GYN or a psychiatrist, and Octave can coordinate with them.
Sources
- KFF. (2025). 2025 employer health benefits survey. https://www.kff.org/health-costs/2025-employer-health-benefits-survey/
- Zivin, K., Courant, A., Fendrick, A. M., & Dalton, V. K. (2025). Association between out-of-pocket insurance costs and psychotherapy utilization among commercially insured birthing individuals. Women's Health Issues, 35(3), 143-150. https://doi.org/10.1016/j.whi.2025.02.003
- Zhu, J. M., Huntington, A., Haeder, S., Wolk, C., & McConnell, K. J. (2024). Insurance acceptance and cash pay rates for psychotherapy in the US. Health Affairs Scholar, 2(9), qxae110. https://doi.org/10.1093/haschl/qxae110
About the Author
Leigh Hall
LMFT
In my work, I use mindfulness and cognitive-behavioral approaches, combined with cultural sensitivity and curiosity — as well as a dose of irreverence — to help clients reconnect with themselves and their true values, honor their emotions without being controlled by them, and access their strengths to build resiliency and a sense of purpose.
