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More therapists than ever are choosing to leave insurance networks in 2025.
And when you see why, it’s hard to blame them.
From financial instability to overwhelming administrative burdens, the traditional insurance model is pushing providers away.
According to our annual Mental Health Insurance and Marketing Report (co-created with Beacon Media + Marketing), therapists are prioritizing:
‍…none of which insurance companies make easy.
For therapy seekers, we’ll also cover a few ways to get the care you need, because that’s what’s most important.
Our annual report gathered survey data on why therapists are opting out of insurance networks. While many assume finances are the driving factor, the reality is more complex.
Therapists face a web of often overlapping challenges. Many find the insurance system unsustainable, leading them to shift toward private pay.
Key findings:
These issues don’t exist in isolation—most therapists experience multiple challenges at once. This, of course, makes the decision to go private pay an enticing one.
While every therapist’s experience is different, most who leave insurance do so for four primary reasons: financial security, administrative relief, clinical freedom, and burnout prevention.
Low reimbursement rates mean in-network therapists often see more clients for less pay.
Private pay offers higher rates, financial predictability, and reduced overhead.
There’s also the benefit of not paying a 3rd party or in-house biller (which can cost six-figures for larger practices).
Therapists spend hours navigating insurance paperwork, claims, and audits.
Delayed payments create financial stress, while denied claims and clawbacks add unpredictability.
Many find private pay simpler and more sustainable.
There’s also something to be said about basic peace of mind.
When we overwork and overstress about superbills and jumping through insurance’s many hoops, it’s harder to keep our zen.
Insurance companies dictate treatment plans, limiting session length, covered treatments, and client eligibility.
Private pay allows therapists to make clinical decisions based on client needs—not insurance policies.
For therapists, who lead with their hearts in the majority of instances, insurance interference is a dealbreaker.
Providing the highest quality of care their capable of is reason enough to leave insurance panels behind.
The insurance model forces many therapists into high caseloads to stay financially afloat.
This leads to exhaustion, lower-quality care, and provider burnout.
Private pay enables therapists to work fewer hours while maintaining financial stability -- simple as that.
For many (read: most), leaving insurance isn’t just about income.
It’s about building a sustainable, fulfilling practice that serves both them and their clients better.
With so many therapists opting out of insurance, the mental health industry is at a turning point.
Insurance companies may need to adapt their policies to retain providers, or the trend toward private pay will continue.
Some therapists are exploring hybrid models, staying in-network for some services while offering private pay options for others. This allows them to maintain financial stability while still providing access to insured clients.
Others are relying on out-of-network reimbursement solutions to bridge the gap between affordability and sustainability.
If insurance companies don’t improve reimbursement rates, streamline administrative processes, and reduce the risk of audits and clawbacks, the exodus of therapists from networks will likely accelerate.
Yet as we already know, humans follow their incentives, and one major incentive for insurers, who are often beholden to shareholders, is to keep more money for themselves.
That means denying more and more claims.
Overall, this could push more clients toward out-of-network providers, further increasing demand for reimbursement services and alternative payment models.
For now, therapists are prioritizing their ability to provide quality care in a sustainable way. I.e. leaving insurance panels for private pay.
The insurance industry’s response will determine whether this shift is temporary or becomes the new norm.
If your ideal therapist is out of network, you may still have options.
Many therapists provide superbills to help with reimbursement, and services like Thrizer make the process easier. If you have out-of-network benefits (many do), you’ll want to ask your therapist for help and use Thrizer to streamline your claim.
If affordability is a concern, ask your therapist about their sliding scale rates or flexible payment plans. Consider getting your therapy from community clinics, university training programs, or nonprofit mental health organizations as well.
