Choose for fit
Consider therapists based on their experience, approach, and the relationship you want—not only on who appears in a directory.
Why direct pay
Why many of the best therapists don’t take insurance.
Direct pay can feel like one more insurance workaround. For many therapists, it is simply a different way to practice—one that puts their time and clinical judgment back at the center.
You choose the therapist. Your plan may still help with the cost.
38%
of psychologists reported accepting no form of health insurance in 2025.
That was up from 34% the year before. More than a third of psychologists are now practicing outside insurance panels.
Source: American Psychological Association, 2025 Practitioner Pulse Survey. This figure covers psychologists—not every kind of therapist—and accepting no insurance is not identical to being direct-pay only.
The care model
Why therapists make the move.
The decision is not about caring more or less. It is often about whether a practice can remain sustainable without letting insurer administration dictate its shape.
Insufficient reimbursement
75%Administrative burden
57%Concerns about payment reliability
43%Among psychologists who left or never joined insurance panels. Source: APA Practitioner Pulse Survey, 2025.
What it means for you
More choice. More clarity. A different kind of paperwork.
Know the fee up front
Your therapist sets and collects their fee directly. Marlo does not set or discount their rates.
Keep insurance in the picture
If you have out-of-network benefits, you may submit a superbill and receive partial reimbursement. The amount depends on your plan.
A superbill includes diagnosis and procedure codes, so seeking reimbursement still involves sharing those details with your insurer.
The honest downsides
Direct pay still asks something of you.
You pay up front
You pay your therapist directly, then pursue any available reimbursement yourself.
Reimbursement varies
Allowed amounts, deductibles, and coinsurance differ by plan. Some plans reimburse little or nothing.
Claims need follow-through
Superbills can be forgotten, denied, or left unresolved without a clear way to track them.
Marlo’s answer
One place for every superbill.
We help you stay organized and guide you through the reimbursement process, so you don’t leave money on the table.
- See what is unsubmitted, pending, paid, or denied
- Get reminders for claims and appeal deadlines
- Follow guidance for resubmission or appeals
- Compare what you have paid with what you have received
You submit your own claims. Marlo cannot guarantee reimbursement.
A few clear answers
Before you decide.
Does direct pay mean my insurance is useless?
Not necessarily. If your plan includes out-of-network benefits, you may be reimbursed for part of your sessions after you submit a claim. PPO and POS plans often include these benefits; HMO and EPO plans usually do not.
Will I get the full session fee back?
Usually not. Insurers reimburse a percentage of their own allowed amount, not necessarily your therapist’s fee, and an out-of-network deductible may apply first. Your plan determines the actual amount.
Does direct-pay care guarantee a better therapist?
No—but many of the top therapists are direct-pay only. To help you find the best, we’ve built a curated network of only the best therapists, each nominated by their peers.
Your care, your choice