Question 1

What are your fees?

Accepted Answer

$150 for a 50 minute individual session.
$175 for a 50 minute couples session.

I also offer Superbills for reimbursement from insurance as an Out-of-Network provider (client responsible for checking with insurance company to ascertain whether they would accept Superbills - most do).  See FAQ below for more detailed information about health insurance.

Question 2

Do you accept health insurance?

Accepted Answer

I will no longer accept ANY health insurance effective July 1, 2026.  I am presently a participating provider in the following health insurance plans via my biller, Alma:

Optum/United/UMR
UnitedHealthcare
UnitedHealthcare Shared Services (UHSS)
GEHA - UnitedHealthcare Shared Services (UHSS)
Oscar
Oxford
UHC Student Resources
UMR
All Savers (UHC)
Health Plans Inc
Medica (Eligible if policy is commercial only)
Surest (Formerly Bind)

Aetna 
Aetna
Meritain
Nippon
Allied Benefit Systems
GEHA - United Healthcare Shared Services (UHSS)
Trustmark
Trustmark Small Business Benefits
Health Scope
Christian Brothers Services
If you have a subsidiary insurance related to Aetna, please reach out to insurance_operations@helloalma.com to confirm whether that subsidiary insurance is currently billable through my insurance biller, Alma.

Cigna

I am considered an "out of network" provider with other insurance providers, meaning I can provide you with a Superbill so that you can request reimbursement (full or partial) from your insurance company.

Please note that Superbills and insurance claims are required to list a mental health diagnosis, in addition to information about your treatment.  Your insurance company will keep a record of that diagnosis, in some cases permanently.

Not all insurance companies provide reimbursement, so it is your responsibility to call your insurance company to see: 
if your submitting a Superbill to them is an option
what their rate of reimbursement is for CPT code 90837 (couples session - 50 minutes) or 90834 (individual session - 50 minutes) - the two codes used most frequently in my office
if you have an out-of-network deductible
if your deductible has been met
if you need a preauthorization or precertification, and
if there is an annual dollar amount or session limit associated with your specific health insurance plan.

I am required by Federal Law to provide each of my current and potential clients with a Good Faith Estimate under the No Surprises Act effective 1/1/2022.  If you were to attend one initial free consultation and 51 (fifty-one) one hour sessions with me, Deborah Vail, LPC, NCC, over the course of one year you could expect to spend the following:  $125/hour x 51 = $6,375.  Most of my clients do not attend this frequently, nor this long.  We determine your treatment goals and plan together.  Please see the "how long does therapy take" FAQ.

Question 3

Why does therapy cost this much?

Accepted Answer

Therapy is an investment in your life-long wellbeing.

1.   There is more work and cost than you see.
Many people mistakenly believe their counselors only "work" for them during the session time.  However, I often spend an additional 90 to 120 minutes after EACH session completing documentation, creating treatment plans, taking continuing education, preparing at-home experiments for clients, and many other administrative tasks.  I custom-make treatment plans with a level of detail that results in better and faster positive outcomes, in my experience.  I also prefer to make myself more available to my existing clients between sessions, assisting them occasionally outside of scheduled session time via email, text and phone with their at-home experiments in utilizing new skills.

There also are many costs associated with running a practice that each session fee pays for: property rental, professional insurance, software, licensure fees, continuing education, and much more.  Many clients easily make the mistake that counselors earn their hourly rate multiplied out by 40 hours a week, but in reality, most counselors "billable session time" is just a small fraction of our 40+ hour work week.  I prefer to see a smaller number of clients so I can better focus on the clients under my care.

2.  Weekly attendance is usually only necessary for a short time.
People often see a counselor's rate and visualize the expense of weekly therapy being added to their monthly budget, however, many of my clients attend weekly for only a short time and decrease frequency to bi-weekly and/or monthly within just a month or two.  While some people may choose to attend therapy weekly for a longer time if means allow, my goal is for every client to find the shortest path to improvement and to feeling comfortable functioning without therapy once again.  We discuss session frequency and make decisions about what is necessary together.

3.  Most counselors are providing pro-bono services to qualifying individuals.
I take seriously my responsibility to make therapy as financially accessible for people as possible.  I work pro-bono each week for a national suicide hotline and crisis services provider.  I also provide pro-bono trauma counseling to individuals referred to me by crisis response teams in the aftermath of mass trauma events.

4.  For every person who establishes counseling with me, there are dozens more who make contact requiring a call back, an email, a referral, and more.  
I keep a list of low cost counseling resources and insurance-accepting referrals on hand to help inquiring clients find a therapist offering a rate that fits their budget or a therapist who accepts a specific brand of health insurance.  My sincere interest is in seeing each person seeking mental health support placed with a therapist that feels like an excellent fit - in knowledge, skills, shared-connection, and in cost!  If you have any questions or need a referral, please feel free to give me a call at 636 626 4300.

Fees

What are your fees?

Do you accept health insurance?

Why does therapy cost this much?