What this costs, plainly.
No packages, and no consultation call you have to sit through before anyone will tell you a number. Here are the fees, here’s exactly why I don’t bill insurance, and here’s what you get for the money.
If your schedule and budget allow it, start here. Fifty minutes has a way of ending exactly as something important is opening up. Eighty gives us room to get into a pattern, work it, and land somewhere — rather than stopping mid-sentence and waiting a week.
A perfectly good option, and the right one if the longer session doesn’t fit your week or your budget. Plenty of couples do their whole course of work this way.
Both fees are per session, not per person. You’re a couple, you come together, it’s one appointment. Payment is due at the time of the session, and I’ll set you up with a card on file through my secure practice system so there’s nothing to remember.
I don’t bill insurance, and I’ll tell you exactly why.
Not paperwork. Not preference. Because doing it the way insurance requires would mean putting something false in one of your medical records.
Insurance pays for the treatment of diagnosed mental illness. To bill your plan for our work, I would have to name one of you as the patient, give that person a psychiatric diagnosis, and record that the therapy is treating their disorder.
That isn’t what’s happening. Neither of you is ill. You have a relationship problem — and a relationship problem doesn’t meet the medical necessity standard insurance requires. Recording otherwise would be insurance fraud, and it would put a psychiatric diagnosis in one of your permanent records for no clinical reason at all.
Plenty of therapists do it anyway. I’m telling you this partly so you understand my answer, and partly so you understand what it means when someone else’s answer is yes.
What I will give you
A receipt or superbill you can submit yourself, on request. It uses Z63.0 — relational distress, and it lists both of you as the clients, because that is what is actually true.
Be prepared for your plan to decline it. Z63.0 isn’t a mental illness code, so most insurers won’t reimburse against it — which is precisely the point. The only way to make that claim pay would be to swap it for a psychiatric diagnosis one of you doesn’t have, and I’m not willing to do that. An honest receipt is what I can offer, and I’d rather you know its limits up front than be surprised later.
This is real money. Here’s what it’s for.
Fifteen years of couples only
I don’t see individuals. I don’t treat anxiety or depression or grief. Every hour of my professional life has gone into two people in a room, which is why I can usually name your pattern in the first session.
Certification that means something
AASECT certification took over 160 hours of specialised coursework, 50 hours of supervision, and hundreds of clinical hours. Washington requires none of it — anyone here may call themselves a sex therapist.
Work that ends
Most couples are with me three to six months. I’m not building a decade-long relationship with your calendar. The point is that you finish.
The rest of the details.
What’s your cancellation policy?
I need 48 hours’ notice. Inside that window the full fee is charged, because your time is held for you and can’t usually be filled at short notice.
That said — if I can offer you a makeup slot within two business days, I will. I’m flexible where my calendar lets me be. Life genuinely does happen, and I’d far rather move a session than have you sit through one on a day when it won’t be useful.
Can I get a good faith estimate of what this will cost?
Yes — ask and I’ll write you one. It sets out in advance what your course of work is likely to come to, and you’re entitled to it as a self-pay client.
It is a genuine estimate, though, and I’d rather say so than hand you a number that looks more certain than it is. I don’t require a set number of sessions, so what you finally spend depends on how long the two of you choose to keep coming.
Can I use my HSA or FSA?
Often yes — many health savings and flexible spending accounts cover therapy, and a good number of my clients use theirs. Check with your plan administrator, since the rules vary and I can’t promise on their behalf.
Will you give me a superbill?
Yes, on request. It uses Z63.0 for relational distress and lists both of you as the clients. It’s an honest document, and honest documents in this area are rarely reimbursed — most plans won’t pay against a relational code. Please don’t plan your budget around getting that money back.
Do you offer a sliding scale?
Not currently — I don’t have reduced-fee slots available. If the fee is genuinely out of reach, the online course covers a good deal of the same ground at a fraction of the cost, and the book costs about as much as a sandwich.
How many sessions will we need?
Most couples work with me for three to six months. Some come with one specific question and finish in a handful of sessions. Some want a deeper overhaul and stay a year. We’ll talk honestly about where you are as we go, and you can stop whenever you’re ready.
Should we book 50 or 80 minutes?
Eighty, if your schedule and budget allow. Much of what I do is experiential rather than conversational, and fifty minutes has a habit of ending right as something starts to move. Fifty works perfectly well and plenty of couples use it throughout — but if you can manage the longer session, you’ll get more out of each one.
If the number works, let’s talk.
Tell me a little about what’s going on between the two of you and we’ll find out whether I’m the right fit. If I’m not, I’ll say so and try to point you somewhere better.
Not in Washington? Private coaching is available anywhere. Not ready to book? The Better Sex Podcast is free.