Psychiatrist Cost per Session Without Insurance: 2026

4 days ago

9 min read

We read the posted self-pay fee pages of 51 US psychiatry practices in 21 metro areas and 6 national telehealth platforms, logging prices for first psychiatric evaluations and medication follow-up visits, and set them against 2026 Medicare rates. The data shows what a patient without insurance pays to see a psychiatrist as of the fourth quarter of 2026.

Key Findings

The median posted self-pay price for a first psychiatric evaluation at a US private practice was $400 in November 2026.
A medication follow-up visit cost a median $200 at private practices in November 2026, 1.47 times the 2026 Medicare national rate for a moderate-complexity office visit.
Telehealth platforms charged a median $299 for a first psychiatric visit and $152 for a follow-up in November 2026.
At nine practices that post both, a first evaluation with a nurse practitioner or physician assistant cost a median 67% of the psychiatrist price in November 2026.
First-evaluation prices ran from $100 at TRS Health, a nonprofit clinic near Houston, to $2,600 at Menlo Park Psychiatry & Sleep Medicine in November 2026.

A first visit with a psychiatrist is a long appointment, usually 45 to 90 minutes on the fee pages in this study, built around a full history and a diagnosis. After that come shorter follow-ups to check how a medication is working. A patient paying cash has to budget for both, and the prices sit on separate fee pages that differ by city, by clinician, and by whether the visit happens in an office or on a screen.

Our analysts recorded each practice's posted price for an adult first evaluation and its lowest-priced medication follow-up visit. Where a practice listed separate prices for psychiatrists and for nurse practitioners or physician assistants, we used the psychiatrist price for the main comparison and kept both for a same-practice look at clinician type. We also logged per-visit prices from telehealth platforms and monthly fees from medication services, and calculated 2026 Medicare national rates from the CMS relative value file.

In the following sections, we compare self-pay psychiatry prices by metro area, psychiatrist and nonphysician prices at the same practice, telehealth platform prices, and self-pay prices against Medicare rates.

Psychiatrist Cost Without Insurance by Metro Area

Prices at private practices change a lot from one city to the next. We grouped the 51 practices by metro area and took the median price for a first evaluation and for a follow-up visit in each one.

Median Self-Pay Psychiatry Fees by Metro Area (November 2026)

Metro area	Practices	First evaluation	Follow-up visit
San Francisco Bay Area	2	$1,550	$400
Los Angeles	3	$675	$300
Minneapolis-St. Paul	1	$655	$475
Detroit	1	$650	$400
Boston	4	$600	$350
Washington, DC	3	$550	$275
Austin	2	$500	$195
New York	3	$500	$350
Philadelphia	2	$463	$300
Nashville	1	$450	$150
San Diego	1	$450	$350
Portland	1	$400	$250
Miami	3	$375	$175
Denver	5	$350	$199
Atlanta	2	$323	$163
Chicago	3	$320	$235
Dallas-Fort Worth	4	$300	$130
Seattle	1	$300	$150
Phoenix	3	$300	$150
Charlotte	1	$299	$199
Houston	5	$250	$150
All practices	51	$400	$200

Source: Signal Hill Strategies analysis of self-pay fee pages posted by 51 US psychiatry practices, read November 6, 2026

Bar chart of the median self-pay price for a first psychiatric evaluation in 21 US metro areas, from $250 in Houston to $1,550 in the San Francisco Bay Area, with a $400 median across 51 practices

Source: Signal Hill Strategies analysis of self-pay fee pages posted by 51 US psychiatry practices, read November 6, 2026

Key Findings

The San Francisco Bay Area had the highest metro median for a first evaluation, $1,550, across two practices. One of them, in Menlo Park, charges $2,600 to $3,000 for a 90-minute evaluation with a psychiatrist.
Houston had the lowest metro median, $250 across five practices, followed by Dallas-Fort Worth, Phoenix, and Seattle at $300. TRS Health, a nonprofit clinic near Houston, posted a $100 evaluation and an $80 follow-up.
For a patient in Los Angeles, Boston, or Washington, DC, the typical first visit costs roughly two to nearly three times what it does in Houston or Phoenix. Several practices charge the same price for office and video visits, so a patient who shops around within a metro is choosing a practice more than a visit format.

Psychiatrist vs Nurse Practitioner Cost Without Insurance

Some practices staff psychiatric nurse practitioners or physician assistants alongside psychiatrists and post a separate price for each. Nine practices in the sample list both, which lets us compare the two at the same address.

Same-Practice Self-Pay Fees for Psychiatrists and Nonphysician Prescribers (November 2026)

Practice	Location	Psychiatrist evaluation	Nonphysician evaluation	Psychiatrist follow-up	Nonphysician follow-up
Able Psychiatry	Chicago	$435	$270	$235	$160
Animo Sano Psychiatry	Charlotte	$299	$199	$199	$119
Austin PsychCare	Austin	$500	$400	$190	$175
Delos Psychiatry	Boulder	$599	$299	$199	$89
Denova Collaborative Health	Arizona	$299.99	$224.99	$179.99	$134.99
Denver Wellness Associates	Denver	$350	$300	$250	$175
Menlo Park Psychiatry & Sleep Medicine	Menlo Park, CA	$2,600	$900	$600	$300
Renova Health	Miami	$500	$300	$250	$150
Texas Psychiatry Group	Houston	$250	$250	$150	$125

Source: Signal Hill Strategies analysis of self-pay fee pages posted by 51 US psychiatry practices, read November 6, 2026

Bar chart of nurse practitioner and physician assistant self-pay prices as a share of psychiatrist prices at nine practices, ranging from 35% to 100% for first evaluations

Source: Signal Hill Strategies analysis of self-pay fee pages posted by 51 US psychiatry practices, read November 6, 2026

Key Findings

At the median practice, a first evaluation with a nurse practitioner or physician assistant cost 67% of the psychiatrist price, and a follow-up cost 68%. In dollars, the median gap was $100 for an evaluation and $75 for a follow-up.
Texas Psychiatry Group charges $250 for a first evaluation with either type of clinician. Menlo Park Psychiatry & Sleep Medicine charges $900 for a physician assistant evaluation and $2,600 with its lower-priced psychiatrist.
For a patient paying cash, seeing a nurse practitioner at the same practice cuts about a third off most visits. Follow-up visits repeat over the course of treatment, so the follow-up gap adds up faster over a year than the one-time evaluation gap.

Online Psychiatry Cost Without Insurance by Platform

National telehealth companies sell psychiatric visits at one posted price per visit. A second group of online services sells a monthly plan that bundles the first evaluation, check-ins, and prescription management. We recorded both.

Posted Self-Pay Prices at Online Psychiatry and Medication Services (November 2026)

Service	Pricing model	First visit	Follow-up or monthly fee	Clinicians
Rula	Per visit	$225	$175	Psychiatric clinicians
Teladoc Health	Per visit	$235	$105	Psychiatrists and psychiatric NPs
Talkspace	Per visit	$299	$175	Psychiatrists and NPs
Doctor On Demand	Per visit	$299	$129	Psychiatrists
Thriveworks	Per visit	$300	$210	Psychiatric clinicians
Array Behavioral Care	Per visit	$425	$115	Psychiatric clinicians
Brightside	Monthly plan	Included	$95 per month	Psychiatrists and psychiatric NPs
Cerebral	Monthly plan	Included	$95 per month	Licensed prescribers
Lemonaid	Monthly plan	Included	$95 per month	Doctors and NPs
Hers	Monthly plan	Included	$85 per month	Doctors or NPs

Source: Signal Hill Strategies analysis of self-pay price pages posted by 10 online psychiatry and medication services, read November 6, 2026

Grouped bar chart of self-pay prices for first and follow-up online psychiatry visits at six platforms, with first visits from $225 to $425 and follow-ups from $105 to $210

Source: Signal Hill Strategies analysis of self-pay price pages posted by 10 online psychiatry and medication services, read November 6, 2026

Key Findings

Across the six per-visit platforms, first visits ranged from $225 at Rula to $425 at Array Behavioral Care. Both platform medians sat below the private practice medians for the same visits.
Follow-up prices ranged from $105 for a 15-minute visit at Teladoc Health to $210 at Thriveworks, which charges more in six states and Washington, DC.
Brightside, Cerebral, and Lemonaid each charge $95 per month, and Hers charges $85, with the first evaluation included. Over 12 months, a $95 plan comes to $1,140, which suits a patient who expects regular check-ins more than one who needs a single evaluation.

Self-Pay Psychiatry Prices Compared With Medicare Rates

Medicare sets a national payment rate for every psychiatric billing code, which gives a fixed point for judging cash prices. We calculated the 2026 national non-facility rate for the codes that match a first evaluation and a follow-up visit.

Medicare National Payment Rates for Psychiatric Visit Codes (2026)

CPT code	Service	Medicare national rate
90792	Psychiatric diagnostic evaluation with medical services	$202.08
90791	Psychiatric diagnostic evaluation without medical services	$173.35
99215	Office visit, established patient, high complexity	$192.39
99214	Office visit, established patient, moderate complexity	$135.61
99213	Office visit, established patient, low complexity	$95.19
90833	Psychotherapy add-on, 30 minutes, with an office visit	$81.50

Source: Signal Hill Strategies analysis of the CMS 2026 Physician Fee Schedule relative value file (RVU26D), conducted November 6, 2026

Grouped bar chart comparing Medicare 2026 rates with median self-pay psychiatry prices: first evaluation $202 Medicare, $299 telehealth, $400 practices; follow-up $136 Medicare, $152 telehealth, $200 practices

Source: Signal Hill Strategies analysis of the CMS 2026 Physician Fee Schedule relative value file (RVU26D) and posted self-pay prices, November 6, 2026

Key Findings

The median private practice price for a first evaluation was 1.98 times the 2026 Medicare rate for CPT 90792, $202.08. Telehealth platforms came closer, at 1.48 times the rate.
Only 2 of 51 practices posted a first-evaluation price below the Medicare rate, and 5 of 50 posted a follow-up price below the $135.61 rate for CPT 99214.
Medicare rates are what the program pays, not what a cash patient owes, but they are a useful check on a quote. CMS resets these rates every year, so the comparison will shift when the 2027 fee schedule takes effect.

For people paying out of pocket, the cost of psychiatric care depends as much on the follow-up price as on the first evaluation. The evaluation is paid once, while follow-ups repeat for as long as a medication needs checking.

The broader trend is toward posted, flat prices. Telehealth platforms list one price across most states, monthly services fold visits into a subscription, and private practices publish full fee schedules, some with separate psychiatrist and nurse practitioner rates.

So if you are paying cash to see a psychiatrist, compare the posted follow-up price as well as the first evaluation, and ask whether a nurse practitioner at the same practice can manage your medication.

Sources

Methodology

We read the self-pay fee pages of 51 US psychiatry practices in 21 metro areas, 6 per-visit telehealth platforms, and 4 monthly medication services on November 6, 2026.
The first evaluation is the posted price for an adult initial psychiatric evaluation. The follow-up is the lowest-priced posted medication-management follow-up visit. Where a page posted a range, we used the low end.
Where a practice posts separate prices for psychiatrists and nonphysician prescribers, the metro comparison uses the lowest posted psychiatrist price. The same-practice comparison uses both. Denver Wellness Associates lists its nonphysician clinicians as psychiatry providers; Animo Sano lists them as advanced practice providers.
Metro medians include every practice in the metro. Metros with one practice show that practice's price. Boulder practices are grouped with Denver, and Denova Collaborative Health's statewide Arizona prices with Phoenix. One practice, Renewing Mindsets, posts no follow-up price, so follow-up medians use 50 practices.
Thriveworks prices are for most states; it posts higher prices in Georgia, North Carolina, Pennsylvania, Washington, DC, Maryland, Virginia, and Massachusetts. Array Behavioral Care's follow-up is its low-complexity medication visit (CPT 99213).
Medicare rates are 2026 national non-facility amounts: total non-facility relative value units multiplied by the $33.4009 conversion factor in the CMS RVU26D file.
We excluded pages dated before 2024, practices with no stated location, pages that gave one price range for all visit types, and services with no posted price, including Talkiatry, Mindpath Health, SonderMind, and Sesame. Amwell's prices appeared only on a third-party review, so Amwell is not included.
Medians, ratios, percentages, and dollar gaps were calculated from these data. Prices posted with cents appear as posted in tables; medians are rounded to the nearest dollar.