Therapy Fees in Plano, TX | Nathaniel Smith, LPC
New clients are seen on a private-pay basis — $225 for a 50-minute session. This practice is transitioning to fee-for-service and is no longer taking new clients through insurance. A monthly superbill is available for out-of-network reimbursement, and HSA and FSA cards are accepted.
Session fees — clear, straightforward, no surprises
One session type. One rate. Your treatment is guided entirely by what serves you — not by what an insurer will authorize.
Individual Cognitive Therapy
- In-person at the Plano office (7150 Preston Road, Suite 100)
- Secure telehealth — available anywhere in Texas (you must be physically located in Texas at the time of the session)
- HSA and FSA cards accepted
- Monthly superbill provided for out-of-network reimbursement
- Rate reflects more than 20 years of clinical practice and advanced training in cognitive behavioral therapy through the Beck Institute and the Feeling Good Institute
Free 15-minute phone consultation before you book.
Sessions cancelled with less than 24 hours' notice are charged the full session fee. Insurance does not reimburse missed appointments.
Using out-of-network benefits
Many insurance plans offer partial reimbursement for sessions with out-of-network providers — even when the therapist doesn't bill insurance directly. If your plan includes out-of-network mental health benefits, you may be able to recover a meaningful portion of the session fee.
Nathaniel provides a detailed monthly superbill — an itemized receipt with all the codes and provider information your insurer needs — that you can submit directly for reimbursement. Note that providing a superbill requires assigning a mental health diagnosis to your record; this is a requirement of the insurance billing process, not a clinical judgment about your care. Reimbursement is determined by your plan, not by this practice, and is not guaranteed.
Before your first session, call the member services number on the back of your insurance card and ask: "What are my out-of-network mental health benefits?" Ask about your deductible, your reimbursement rate, and whether a referral is required.
Questions to ask before your first session
- Do I have out-of-network mental health benefits?
- What is my out-of-network deductible, and how much have I met?
- What percentage of the allowed amount will you reimburse after the deductible?
- Do I need a referral or prior authorization for outpatient therapy?
- How do I submit a superbill for reimbursement?
Sliding scale
A limited number of reduced-fee spots are available in special circumstances. These are reserved for clients for whom the standard fee would be a genuine barrier to care — not a preference.
If you believe you may qualify, please ask during your initial consultation. Availability is limited and not guaranteed, but the conversation is always welcome.
Ask During Your ConsultationCancellation and other fees
Cancellation policy
Please give at least 24 hours' notice to cancel or reschedule a session. Cancellations with less than 24 hours' notice may be charged the full session fee of $225. This policy exists because a late cancellation leaves a time slot that cannot be filled on short notice.
Time outside of therapy sessions
Time requested by you or an authorized agent outside of scheduled sessions is billed separately, in quarter-hour increments:
- Record review and preparation$300 / hour
- Deposition, testimony, and travel$500 / hour
A deposit may be required for anticipated court appearances.
What fee-for-service means for you
The decision to move to private pay is deliberate. Here is what actually changes.
Your records
Submitting a claim to an insurer requires assigning a mental health diagnosis, which then becomes part of your claims record with that plan. In a fee-for-service arrangement, no diagnosis is required in order to bill, so nothing is submitted to a third party unless you choose to submit a superbill yourself.
How treatment decisions get made
Insurers determine what they will cover, and many plans apply medical-necessity criteria or authorize a set number of sessions at a time. Working outside of insurance means the length and direction of treatment are decided between you and Nathaniel, based on your goals and your progress.
A focused practice
This practice works exclusively in cognitive behavioral therapy for anxiety and depression in adults. That focus shapes the training pursued, the measures used, and the way each course of treatment is structured.
Common questions about fees
Not for new clients. This practice is transitioning to fee-for-service, and new clients are seen on a private-pay basis at $225 for 50 minutes. Many clients use their out-of-network benefits and submit a monthly superbill for partial reimbursement. If you are currently covered by a plan this practice still participates in, mention that when you reach out and we will review your options together.
Yes. HSA (Health Savings Account) and FSA (Flexible Spending Account) cards are accepted. Therapy is a qualified medical expense under both account types, so you can use pre-tax dollars to cover session fees.
A limited number of reduced-fee spots are available in special circumstances — for clients for whom the standard fee would be a genuine barrier to care. Availability is limited and not guaranteed. Please ask about it during your initial consultation.
A superbill is an itemized receipt that includes everything your insurance company needs to process an out-of-network reimbursement claim: diagnosis codes, procedure codes, session dates, and provider credentials. Nathaniel provides a monthly superbill you can submit directly to your insurer. Reimbursement rates vary by plan — call your insurer before your first session to understand your out-of-network mental health benefits.
That depends on how long you are in treatment, which varies by person. CBT is designed as a defined course of treatment rather than open-ended therapy, so a total is something you can estimate up front rather than something that stays unknown. A typical course runs roughly 8 to 20 sessions depending on the presentation, which at $225 puts most courses between $1,800 and $4,500 before any out-of-network reimbursement. We will talk about expected length during your consultation, and we revisit it as your progress is measured. Individual course length varies, and no specific outcome or timeline can be guaranteed.
Use of artificial intelligence
Clinical judgment, assessment, diagnosis, and treatment decisions are made by Nathaniel, within the scope of his license. No chatbot, automated agent, or AI system provides counseling, crisis response, or clinical advice in this practice. AI tools may be used in a limited administrative capacity — such as helping draft or organize documentation — always within a HIPAA-compliant environment under a business associate agreement, and always reviewed by Nathaniel. The full disclosure is in the intake packet.
No Surprises Act
Your Right to a Good Faith Estimate
You have the right to receive a Good Faith Estimate explaining how much your care will cost. Under federal law, health care providers must give people who are uninsured, or who are not using insurance, an estimate of the expected charges for services. Because new clients here are seen on a private-pay basis, this right applies to most clients of this practice.
- You have the right to a Good Faith Estimate for the total expected cost of any non-emergency services, including psychotherapy.
- You can ask for one before you schedule, and you may ask questions about any item or service you do not understand.
- You will receive a written Good Faith Estimate before services begin, whether you are seen in person at my Plano office or by telehealth.
- Make sure to save a copy of your estimate.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you may dispute the bill.
To ask questions or request a Good Faith Estimate, call (214) 205-0237 or email [email protected].
For more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-985-3059.
Questions about fees? Let's talk.
Reach out with any questions about pricing, out-of-network benefits, or sliding scale availability. There's no pressure — just a first conversation.
Contact Nathaniel