How Much Does Therapy Cost? What to Expect From a Perimenopause Therapist
Therapy costs vary significantly depending on the therapist's credentials, specialization, location, and whether they accept insurance. In Michigan, private pay therapy sessions typically range from $120 to $200 per session. Sessions with Nikki Sewell LMSW are $165 per session. I am private pay only — I do not bill insurance directly, but I provide superbills you can submit to your insurance for potential partial reimbursement, and I accept HSA and FSA cards.
How Much Does Therapy Cost in Michigan?
The cost of therapy in Michigan varies depending on several factors — the therapist's credentials and experience, their specialty, and whether they accept insurance or work on a private pay basis.
According to SimplePractice data from 2023-2024, the average therapy session fee in Michigan falls in the range of $140-$180 per session for private pay clients. Therapists with specialized training — in perimenopause, trauma, EMDR, or grief — often charge at the higher end of that range because their expertise is specific and in demand.
For context, therapy platforms like BetterHelp and Talkspace offer lower per-session costs but provide generalist support without specialty focus. For women navigating perimenopause — where the mental health symptoms are hormonally driven and require clinically specific understanding — a specialist typically produces meaningfully better outcomes than a generalist at a lower price point.
How Much Do Sessions With Nikki Sewell LCSW Cost?
Sessions are $165 per session.
I am private pay only — meaning I do not bill insurance companies directly. Here's what that means practically:
Superbills: I provide detailed superbills — itemized receipts with the diagnostic and procedure codes your insurance company needs — that you can submit directly to your insurer for potential partial reimbursement. Depending on your out-of-network benefits, you may receive reimbursement of 40-80% of session costs. Contact your insurance company and ask about your out-of-network mental health benefits before your first session.
HSA and FSA cards: I accept Health Savings Account and Flexible Spending Account cards — which many clients find makes the cost significantly more manageable since these funds are pre-tax dollars already set aside for healthcare expenses.
Session frequency: I recommend starting weekly — research consistently shows clients make faster progress with more frequent sessions. Many clients move to every other week as they find their footing. On average clients attend 12-14 sessions, though this varies depending on what you're working through.
Why Private Pay? And Is It Worth It?
Private pay therapy — sometimes called out-of-network or self-pay therapy — means the therapist sets their own rates and doesn't negotiate fees with insurance companies. This arrangement has meaningful clinical advantages worth understanding:
No diagnosis required for payment. Insurance companies require a mental health diagnosis to reimburse for therapy. Private pay therapy means you can seek support — for perimenopause, life transitions, grief, identity questions — without receiving a formal diagnosis that becomes part of your permanent medical record.
No session limits. Insurance companies frequently limit the number of covered sessions per year. Private pay means your care isn't dictated by an insurer's definition of when you should be done.
Full clinical autonomy. Private pay therapists can focus entirely on what's clinically best for you — not on what an insurance company will reimburse. This matters particularly for perimenopause work, which often doesn't fit neatly into a diagnostic category that insurance recognizes.
Specialist access. The therapists who specialize in specific populations — perimenopause, grief, EMDR — are disproportionately private pay, because building and maintaining deep specialty expertise takes ongoing investment in training, research, and continuing education that insurance reimbursement rates don't support.
How to Check Your Out-of-Network Benefits
Before your first session call your insurance company and ask these specific questions:
Do I have out-of-network mental health benefits?
What is my out-of-network deductible for mental health services?
What percentage of the session fee will be reimbursed after my deductible is met?
What do I need to submit for reimbursement — and how do I submit it?
Many clients are surprised to find their out-of-network benefits are more generous than expected — particularly those with PPO plans, which typically have stronger out-of-network coverage than HMO plans.
I provide detailed superbills after each session that include everything your insurance company needs to process a reimbursement claim.
Is Therapy Worth the Cost?
This is the question underneath the question — and it deserves a direct answer.
For women navigating perimenopause, the cost of not getting support is worth considering alongside the cost of therapy itself. Perimenopause can last four to ten years. Without support — without understanding what's happening hormonally and neurologically, without tools for managing anxiety, rage, sleep disruption, and identity shifts, without a space to process what this transition is asking of you — those years can be significantly harder than they need to be.
The women I work with don't just feel better during our work together. They understand themselves differently. They have tools that work. They stop white-knuckling through a transition they've been handed no roadmap for.
That's not a luxury. That's an investment in the next decade of your life.
Frequently Asked Questions About Therapy Costs
How much does a therapy session cost in Michigan?
Private pay therapy in Michigan typically ranges from $120 to $200 per session depending on the therapist's credentials, specialization, and experience. Sessions with Nikki Sewell LMSW are $165 per session.
Does insurance cover therapy?
Many insurance plans cover therapy with in-network providers. If your preferred therapist is out-of-network — as I am — you may still receive partial reimbursement through your out-of-network mental health benefits. I provide superbills to support reimbursement claims.
Can I use my HSA or FSA for therapy?
Yes — therapy is an eligible expense for both Health Savings Accounts and Flexible Spending Accounts. I accept HSA and FSA cards directly.
Why don't you take insurance?
Private pay allows me to provide specialized, diagnosis-optional care focused entirely on what's clinically best for you — without session limits, required diagnoses, or insurance company oversight of your treatment. It also allows me to maintain the depth of perimenopause specialization that insurance reimbursement rates don't support.
Do you offer a sliding scale?
I do not offer sliding scale fees at this time. If cost is a significant barrier, I'm happy to discuss session frequency options that make our work together more financially manageable.
What is a superbill?
A superbill is an itemized receipt that includes the diagnostic codes, procedure codes, dates of service, and provider information your insurance company needs to process an out-of-network reimbursement claim. I provide these after each session.
You've taken care of everyone else. Here's your permission slip to take care of you.
If you have questions about fees, superbills, or what to expect from working together — reach out. I'm happy to answer any questions before you schedule your consultation.
Schedule your free 20-minute consultation →
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