Teletherapy is therapy delivered by video, phone, or messaging instead of in an office, and it typically costs less than in-person sessions

Teletherapy (also called telehealth counseling or online therapy) means you meet with a licensed therapist through your computer, phone, or messaging app instead of sitting in an office. A session usually lasts 45 to 60 minutes and happens on a video call, though some providers offer phone-only or text-based options. The therapist is licensed in your state and bound by the same confidentiality rules as an in-person therapist.

Cost varies widely. Some teletherapy platforms charge $60 to $90 per session when you pay out of pocket. Others charge $200 to $300 per session but accept insurance, which can lower your cost to a copay of $20 to $50. A few nonprofits and community mental health centers offer teletherapy on a sliding scale based on your income, sometimes as low as $0 to $25 per session. The main savings come from no travel time, no missed work, and lower overhead for the provider.

Key Takeaways

  • Teletherapy sessions cost $60 to $300 depending on the provider and whether you use insurance, compared to $100 to $200 for in-person therapy in many areas.
  • Your therapist must be licensed in your state; teletherapy does not bypass licensing requirements, but it does let you see therapists outside your city.
  • Insurance often covers teletherapy at the same rate as in-person therapy, so calling your insurance company first can cut your out-of-pocket cost significantly.
  • Community mental health centers and nonprofits offer teletherapy on sliding scales based on income, and some have no minimum fee.
  • You need a private space, a device with video or phone capability, and a stable internet connection; many public libraries offer free WiFi if you do not have it at home.

How to find a teletherapy provider that accepts your insurance

Start by calling your insurance company's customer service line — the number is on your insurance card. Tell them you want to know which teletherapy providers are in-network. They will give you a list or direct you to their website. In-network means your insurance has already negotiated rates with that provider, so your copay applies instead of you paying the full session fee.

Major insurance companies have their own lists of in-network teletherapy providers, and many also accept providers through platforms like Teladoc, Amwell, or MDLive. Ask your insurance company specifically whether they cover teletherapy at the same copay as in-person therapy — most do, but some charge a slightly higher copay for virtual visits. Write down the copay amount and any limits on how many sessions per year are covered.

If you do not have insurance or your insurance does not cover teletherapy, move to the next section. Do not assume you cannot afford it — sliding-scale and nonprofit options exist.

Low-cost and sliding-scale teletherapy options

Community mental health centers in your area often offer teletherapy on a sliding scale, meaning you pay based on your household income. To find yours, search "[your city or county] community mental health center" or call your local 211 line (dial 2-1-1 from any phone) and ask for teletherapy providers that use sliding scales. When you contact them, have your recent pay stubs or tax return ready so they can calculate your fee.

Nonprofits like Open Path Collective, BetterHelp's nonprofit arm, and Talkspace's low-cost plans offer sessions between $30 and $80 per session. Open Path Collective charges $30 to $80 depending on your income and location. BetterHelp's standard plans start around $60 to $90 per week for unlimited messaging and weekly video sessions, though they run periodic promotions. Talkspace charges similarly. These are not government programs, so you pay directly, but the cost is lower than standard teletherapy rates.

Some employers offer teletherapy through an Employee Assistance Program (EAP), which typically covers three to eight free sessions per year. Check your employee handbook or ask your HR department whether your workplace has an EAP. If you are a student, your school or university likely offers free counseling through student health services, sometimes including teletherapy options.

What you need to have before your first session

You need a private space where you can talk without being overheard — a bedroom, car, or quiet corner of a library works. You need a device: a computer, tablet, or smartphone with a camera and microphone. You need a stable internet connection; if you do not have one at home, use your phone's data plan or go to a public library during hours when you can find a private study room.

Before your first appointment, the provider will send you a link to download their video platform or app, or they will send you a Zoom link. Test your camera and microphone 10 minutes before your session. Have your insurance card or payment method ready. If you are using a sliding scale, have your income documentation (recent pay stub, tax return, or a letter from your employer stating your income) ready to upload or show during your first call.

Some providers ask you to fill out an intake form online before your first session — basic questions about your mental health history, current symptoms, and what you want to work on. This usually takes 15 to 20 minutes. Do it in a quiet moment; you do not have to finish it all at once if the platform saves your progress.

How teletherapy differs from in-person therapy

The main difference is practical: you do not travel, so you save time and money on transportation. You can do it from home, which some people find less intimidating. You can also see therapists who are not in your city, which matters if you live in a rural area or need a therapist who specializes in something specific and is not available locally.

The clinical work is the same. Your therapist still listens, asks questions, and helps you work through what is troubling you. Some people find video therapy just as effective as in-person; others prefer being in the same room. A few types of therapy — like certain trauma therapies that involve physical grounding techniques — may work better in person, but most talk therapy translates well to video.

One real limitation: if you are in crisis or having thoughts of harming yourself, teletherapy is not the right tool. Call 988 (the Suicide and Crisis Lifeline) or go to your nearest emergency room. Teletherapy is for ongoing counseling, not emergency mental health care.

What happens if you cannot afford any of these options

Call your local 211 line (dial 2-1-1) and ask for free or very low-cost mental health services in your area. Many communities have crisis counseling lines that offer free phone support, and some offer text-based crisis support. Crisis Text Line (text HOME to 741741) is free and available 24/7. These are not replacements for ongoing therapy, but they can help in the moment and can connect you to longer-term resources.

If you are uninsured and have low income, ask whether you may have access to for Medicaid in your state. Medicaid covers mental health services, including teletherapy, at no cost or very low cost. You can check your state's Medicaid rules at your state health department website or by calling 211. Some states expanded Medicaid; others have not. The rules vary, but it is worth checking.

Some therapists offer a small number of pro-bono (free) slots each year. When you contact a provider, ask directly whether they have any pro-bono availability. It does not hurt to ask, and some do.

Questions to ask a teletherapy provider before you book

Ask whether the therapist is licensed in your state — this is non-negotiable. Ask what happens if your internet cuts out during a session (most providers will reschedule at no charge). Ask about their cancellation policy: do you have to cancel 24 hours in advance, or can you cancel with less notice? Ask whether they offer flexibility if you need to reschedule — life happens, and you want to know the rules upfront.

Ask how they handle privacy and data security. Reputable providers use encrypted video platforms and do not record sessions without your written permission. Ask what their policy is if you are in crisis or having thoughts of self-harm — they should have a clear protocol, usually involving a call to 988 or directing you to an emergency room.

Ask about the cost and what is included. If you are paying out of pocket, ask whether they offer a discount for paying upfront for multiple sessions. If you are using insurance, confirm the copay and whether there are any session limits. If you are on a sliding scale, ask what income documentation they need and how quickly they can process it.

Frequently Asked Questions

Is teletherapy as effective as in-person therapy?

Research shows teletherapy is effective for depression, anxiety, and many other conditions. Some people do just as well or better with video therapy because they feel more comfortable at home. Others prefer in-person. The best therapy is the one you will actually show up for, so if teletherapy removes a barrier (cost, travel, time), it may work better for you.

Can I use teletherapy if I do not have a smartphone or computer?

Most teletherapy requires a device with video or phone capability. If you do not have one at home, use a public library computer during their open hours, or ask the provider whether they offer phone-only sessions. Some do, though video is more common.

What if my therapist and I do not click?

You can switch providers. Most teletherapy platforms and private therapists allow you to end the relationship without penalty. If you are using insurance or a sliding scale through a community center, ask how to request a different therapist. Do not stay with someone you do not trust or feel comfortable with.

Will my employer or insurance company know what I talk about in teletherapy?

No. Your therapist is bound by confidentiality laws (usually called HIPAA). Your employer will not see your session notes or what you discuss. Your insurance company will see that you had a session and may see a diagnosis code, but not the details of what you talked about. If you use an EAP (Employee Assistance Program), the same confidentiality rules apply.

Can I get a prescription from a teletherapy provider?

Some teletherapy platforms include psychiatrists or nurse practitioners who can prescribe medication, but many are counselors or therapists who cannot. Ask the provider upfront whether they offer psychiatric services. If you need medication, you may need to see a psychiatrist or your primary care doctor in addition to a therapist.