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Fees, Insurance and Ethics Codes In Psychotherapy & Counseling


This resource page is part of an Online Course
Fees In Therapy: Clinical, Ethical & Management Considerations


Fees in Therapy

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Medical & Medicare Billing

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Insurance Reimbursement

Insurance Panels

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ObamaCare - Affordable Health Care

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Resources on Insurance Fraud

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Meaning of Money

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To Charge or Not to Charge: The Dilemma of Missed Sessions

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Codes of Ethics on Fees

Additional References

  • Acuff, C., Bennett, B.E., Bricklin, P.M., Canter, M.B., Knapp, S.J., Moldawsky, S., & Phelps, R. (1999). Considerations for ethical practice in managed care. Professional Psychology, 30, 563–575.
  • Alexander, G.C., Casalino, L.P., & Meltzer, D.O. (2003). Patient–physician communication about out-of-pocket costs. Journal of the American Medical Association, 290, 953–958.
  • Alexander, G.C., Casalino, L.P., Tseng, C.-W., McFadden, D., & Meltzer, D.O. (2004). Barriers to patient–physician communication about out-of-pocket costs. Journal of General Internal Medicine, 19, 856–860.
  • Altmann, U., Wittmann, W. W., Steffanowski, A., von Heymann, F., Bruckmayer, E., Pfaffinger, I., & Steyer, R. (2014). Non-completion of insurance-funded outpatient psychotherapy: frequency, risk factors, outcome. Psychiatrische Praxis, 41(6), 305-312. DOI: 10.1055/s-0034-1370172
  • Austad, C.S., Hunter, R.D.A., & Morgan, T.C. (1998). Managed health care, ethics, and psychotherapy. Clinical Psychology: Science and Practice, 5, 67–76.
  • Barnett, J.E., & Walfish, S. (2012). Billing and collecting for mental health practice. Washington, DC: American Psychological Association.
  • Barnett, J.E., Zimmerman, J., & Walfish, S. (2014). The ethics of private practice: A practical guide for mental health clinicians. New York, NY: Oxford University Press.
  • Bishop, D. R. and Eppolito, J. M. (1992). The clinical management of client dynamics and fees for psychotherapy: Implications for research and practice. Psychotherapy: Theory, Research, Practice, Training 29(4), 545-553.
  • Blackmon W. D. (1993). Are psychoanalytic billing practices ethical? American Journal of Psychotherapy. 47(4), 613-620.
  • Brenner, I. (2011). Making extraordinary monetary arrangements. In S. Akhtar (Ed.), Unusual interventions (pp. 3–30). London, England: Karnac Books.
  • Brown, G.D., Hunter, W.G., Hesson, A., Davis, J.K., Kirby, C., Barnett, J.A., … Ubel, P.A. (2017). Discussing out-of-pocket expenses during clinical appointments: An observational study of patient–psychiatrist interactions. Psychiatric Services, 68, 610–617.
  • Buck, S. (2000). The function of the frame and the role of fee in the therapeutic situation. Women & Therapy, 22, 37–50.
  • Chamberlin, J. (2009). Offer a financial break: Six ways psychologists can help patients who can no longer afford therapy. Monitor Staff, 40/1, 40. Retrieved from
  • Clark, P., & Kimberly, C. (2014). Impact of fees among low-income clients in a training clinic. Contemporary Family Therapy, 36(3), 363-368. doi:10.1007/s10591-014-9303-9
  • Clark, P., & Sims, P. L. (2014). The practice of fee setting and collection: Implications for clinical training programs. The American Journal of Family Therapy, 42(5), 386-397.
  • Corbett, A. (2000). Psychotherapy for those who do not pay -understanding money in the therapeutic relationship.
  • Cummings, N. A. (1995). Unconscious fiscal convenience. Psychotherapy in Private Practice 14(2), 23-28.
  • Dear, B. (2016). Getting Paid: a guide to therapy fees. Retrieved from .
  • Erle, J. B.(1993). On the setting of analytic fees. Psychoanalytic Quarterly, 61, 106-10
  • Fay, A. (1995). Ethical implications of charging for missed sessions. Psychological Reports. 77, 1251-1259.
  • Fehr, S.S. (Ed.). (2012). The vicissitudes of power and its relationship to money. 101 interventions in group therapy. New York, NY: Routledge.
  • Fenichel, O. (1954). The drive to amass wealth, in The Collected Papers of Otto Fenichel: Second Series. New York, Norton, pp 89-108.
  • Field, R., & Hemmings, A. (2007). The role of money in the therapeutic exchange. In A. Hemmings & R. Field (Eds.), Counselling and psychotherapy in contemporary private practice (pp. 140–157). New York, NY: Routledge.
  • Friedman, R. (1991). Psychotherapy without fee, in Money and Mind, edited by Klebanow S, Lowenkopf EL. New York, Plenum, pp 207-221.
  • Furnham, A., (2014). The Psychology of Money. London: Routledge,
  • Geistwhite, R. (2000). Inadequacy and Indebtedness: No-Fee Psychotherapy in County Training Programs. Journal of Psychotherapy Practice and Research, 9, 142-148. Retrieved from
  • Gedo, J. (1963). A note on non-payment of psychiatric fees. Int J Psychoanal, 44, 368-371.
  • Griswold, B. (2015). Navigating the Insurance Maze: The Therapist's Complete Guide to Working With Insurance. Retrieved from
  • Groman M. (2016) Lowering Fees in Hard Times: The Meaning Behind the Money, Retrieved from
  • Gutheil, T, Gabbard G. (1993). The concept of boundaries in clinical practice: theoretical and risk-management dimensions. Am J Psychiatry; 150, 188-192.
  • Herrell, J. M. (1993). The therapeutic value of fees: what do practitioners believe? Journal of Mental Health Administration, 20, 270-277.
  • Herron, W. G. (1995). Visible and invisible psychotherapy fees. Psychotherapy in Private Practice. 14(2), 7-17.
  • Herron W.G., Rouslin Welt S. (1992). Money Matters: The Fee in Psychotherapy and Psychoanalysis. New York, Guilford.
  • Herron, W.G., and Sitkowski, S. (1986). Effects of fees on psychotherapy: what is the evidence? Professional Psychology: Research and Practice, 17, 347-351.
  • Hill, M. & Kaschak, E. (Eds.). (1999). For love or money: Fee in feminist therapy. New York, NY: Haworth Press Inc.
  • Hixson, R.R. (2004). The business of therapy. Annals of the American Psychotherapy Association, 7, 16–21.
  • Holmes, J. (1998). Money and psychotherapy: Object, metaphor or dream. International Journal of Psychotherapy, 3, 123–133.
  • Inman, D. J. & Bascue, L. O. (1984) Fee policies of psychologists in private practice. Psychotherapy in Private Practice, 2, 3-12.
  • James, S., Freeman, K. R., Mayo, D., Riggs, M. L., Morgan, J. P., Schaepper, M. A., & Montgomery, S. B. (2015). Does insurance matter? Implementing dialectical behavior therapy with two groups of youth engaged in deliberate self-harm. Administration and Policy in Mental Health and Mental Health Services Research, 42(4), 449-461. doi:10.1007/s10488-014-0588-7
  • Jensen, S. A., & Lowry, L. S. (2012). Payment schedules do not affect attendance/completion of group behavioral parent training. Psychological Services, 9, 101–109. doi:10.1037/a0027101.
  • Koocher, G. P. (2005). Billing issues. In G. P. Koocher, J. C. Norcross, & S. S. Hill, III. (Eds.). Psychologists’ desk reference (2nd ed., pp. 657-661). New York: Oxford University Press.
  • Koocher, G. P. & Soibatian, C. (2017). Understanding Fees in Mental Health Practice. Practice Innovations, 2/3, 123-135.
  • Lecker, C. (2016). Client perceptions of the fee in community mental health centers. Dissertation Abstracts International: B, The Sciences and Engineering, 76, 2016.
  • Lin, M. (2013). Incentivizing Healthy Behaviors with Financial Rewards. TuftScope, 13(1), 28-29. Retrieved from
  • Lorand, S. and Console, W. A. (1958). : Therapeutic results in psycho-analytic treatment without fee: observation on therapeutic results. Int J Psychoanal, 39, 59-64.
  • Lovinger, R.J. (1978). Obstacles in psychotherapy: Setting a fee in the initial contact. Professional Psychology, 9, 350–352.
  • Manos, N, (1982). Free psychotherapy: the therapist's and the patient's view. Psychother Psychosom; 37, 137-143.
  • Marteau, T. M., Ashcroft, R. E., & Oliver, A. (2009). Using financial incentives to achieve healthy behaviour. BMJ: British Medical Journal, 338. doi:10.1136/bmj.b1415.
  • Mellan, O. (1994) Money Harmony: Resolving Money Conflicts In your Life and Relationships, Walker and Co.: New York.
  • Mellan, O. (1995) Overcoming Overspending: A Winning Plan for Spenders and their Partners, Walker and Co.: New York
  • Monger, J. (1998). The gap between theory and practice: A consideration of the fee. Psychodynamic Counselling, 4, 93–106.
  • Motherwell, L. (2010). The vicissitudes of power and its relationship to money. In S. S. Fehr (Ed.), 101 interventions in group therapy (pp. 53–57). New York, NY: Routledge/Taylor & Francis.
  • Myers, K. (2011). Show me the money: The problem of the therapist’s desire, subjectivity and relationship to the fee. In B. Berger & S. Newman (Eds.), Money talks: In therapy, society, and life (pp. 143–165). New York: Routledge.
  • Nash, J.L. and Cavenar, J. O. (1976). Free psychotherapy: an inquiry into resistance. Am J Psychiatry, 133, 1066-1069.
  • Needleman, J. (1994) Money and the Meaning of Life, New York Doubleday Books, 1994.
  • Newlin, C.M., Adolph, J.L., & Kreber, L.A. (2004). Factors that influence fee setting by male and female psychologists. Professional Psychology, Research and Practice, 35, 548–552.
  • Newman, S.S. (2005). Considering fees in psychodynamic psychotherapy: Opportunities for residents. Academic Psychiatry, 29, 21–28.
  • Pasternack, S. A. and Treiger, P. (1976). The psychotherapy fee: an issue in residency training. Diseases of the Nervous System, 38, 913-916.
  • Pepper, R. (2004). Raising fees in group therapy: Some ethical and clinical implications. Journal of Contemporary Psychotherapy, 34, 141–152. doi:10.1023/B:JOCP.0000022313.41195.97.
  • Pope, K.S., Geller, J. D., and Wilkinson, L. (1975) Fee Assessment and Outpatient Psychotherapy, Journal of Consulting and Clinical Psychology, 43, 835-841.
  • Power, L. C. & Pilgrim, D. (1990) The fee in psychotherapy: Practitioners' accounts. Counseling Psychology Quarterly, 3, 157-170.
  • Psychotherapy Finance 2000 Survey:
  • Putnam, S.H., & Deluca, J.W. (1991). The TCN professional practice survey: Part II: An analysis of the fees of neuropsychologists by practice demographics. Clinical Neuropsychologist, 5, 103–124.
  • Rauch, J. (2015). How Much Does Therapy Cost? (And Why Is It So Expensive?). Retrieved from
  • Rogoff, J. (2006). Money and outpatient psychiatry: Practice guidelines from accounting to ethics. Psychiatric Services, 57, 1051.
  • Shanok, A.F. (2012). Money and gender: Financial facts and fantasies for female and male therapists. In B. Berger & S. Newman (Eds.), Money talks in therapy, society, and life (pp. 165–183). New York, NY: Routledge.
  • Shapiro, E.L., & Ginzberg, R. (2006). Buried treasure: Money, ethics, and countertransference in group therapy. International Journal of Group Psychotherapy, 56, 477–494.
  • Soderlund, J. A century of fees. New Therapy, Retrieved from
  • Sommers, E. (2000). Payment for missed sessions: Policy, countertransference and other challenges. Women & Therapy, 22, 51–68.
  • Stanley, I. H., Chu, C., Brown, T. A., Sawyer, K. A., & Joiner, T. E. (2016). Improved Clinical Functioning for Patients Receiving Fee Discounts That Reward Treatment Engagement. Journal of Clinical Psychology, 72(1), 15-21.
  • Tinter, J. (2009). Down low and dirty: Talking about how money matters, especially on a sliding scale. In A. Carrington (Ed.), Taboo or not taboo? Forbidden thoughts, forbidden acts in psychoanalysis and psychotherapy (pp. 242–259). London, England: Karnac Books.
  • Trautt GM, Bloom L. J. (1982). Therapeugenic factors in psychotherapy: the effects of fee and title on credibility and attraction. J Clin Psychol, 38:274-279.
  • Treloar, H. R. (2010). Financial and ethical considerations for professionals in psychology. Ethics and Behavior, 20, 454–465. doi:10.1080/10508422.2010.521447.
  • Tudor, K. (1998). Value for money? Issues of fees in counseling and psychotherapy. British Journal of Guidance & Counselling, 26, 477–493.
  • Valentine, M. (1999). The cash nexus: Or how the therapeutic fee is a form of communication. British Journal of Psychotherapy, 15, 346–354.
  • Whitson, G. (1989). Money matters in psychoanalysis: The analyst's co-participation in the matter of money (working copy). Retrieved from
  • Wood, W. D. (1982). Do fees help heal? J Clin Psychol; 38, 669-673.
  • Woody, R.H. (1988). Protecting your mental health practice: How to minimize legal and financial risk. San Francisco, CA: Jossey–Bass.
  • Woody, R. H. (2011). The financial conundrum for mental health practice. American Journal of Family Therapy, 39(1), 1-10.
  • Woody, R. H., & Zand, M. J. (1989). Independent contractors in psychological practice: Part I. Factors used for determinations. Florida Psychologist, 39(3), 4-6.
  • Wortman, R. J. (1984) The relationship of psycho-analytically oriented psychologists' fee policies to personality, training and experience. Psychotherapy in Private Practice, 2, 25-38.
  • Yoken, C. and Berman J. S. (1984). Does paying a fee for psychotherapy alter the effectiveness of treatment? J Consult Clin Psychol, 52, 254-260.
  • Zur, O. (2009). Therapy in times of financial crisis and global despair: Taking care of our clients and ourselves. The Central Valley Therapist, January-March, 2-6.
  • Zur, O. (2017a). The Complete Fee-for-Service Private Practice Handbook (7th Ed.) Sonoma, CA: Zur Institute.
  • Zur, O. (2017b). Ethics codes on fees in psychotherapy and counseling. Retrieved from

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