How much does online therapy cost? What you pay now and after the first month

By CBT Guide USA editorial team · Updated 2026-11-08 · Prices checked November 2026 · Editorial policy

Online therapy subscriptions are usually priced per week and billed monthly, and the first month is often discounted, so the price you see first is not the price you keep paying.

First month vs renewal: the numbers

OT lists prices as weekly equivalents. To turn those into monthly figures we use weekly price x 52 / 12 (about 4.33 weeks per month). If your account is billed every four weeks instead of every calendar month, multiply by 4; we show both so you can see the range. These are our estimates, not OT's published monthly prices.

Prices as listed in November 2026, rounded. The first month includes an automatic 20% discount (code THERAPY20 if it is not applied). Taxes or currency differences may apply. Check the final price at checkout. Plug your own figures into the therapy cost calculator.

Year-one estimate. If you stayed for 12 months on the same plan, our estimate (one discounted month plus 11 regular months, using x52/12) would be about $3,068 on Basic, $4,602 on Standard and $6,136 on Premium. Most people do not need to commit to a year, and you can cancel any time, but it helps to see the total if therapy goes on longer than you expected.

How billing works

• Monthly billing. OT lists weekly equivalents but bills monthly. The checkout screen shows the amount of the first charge and when it is taken.
• Renewal at the regular price. The 20% discount applies to the first month only. Check the renewal terms at checkout so you know when the next, higher charge is due.
• Upgrading or downgrading is allowed at any time. Check how the change is billed (immediately or from the next cycle) on the checkout or account screen.
• Before the renewal date, note the date in your calendar and decide whether to continue, switch plans or cancel.

What is included in each plan

OT does not prescribe medication and is not a crisis service. If you need either, budget for separate care. See the Online-Therapy.com review for the full picture, and how online therapy works for what messaging and sessions involve.

Cost per live session (a rough comparison)

A subscription bundles messaging and worksheets with sessions, so "price per session" is not a perfect measure. Still, if live time is what you value most, it helps to divide:

• Standard: about $90 per week for one 45-minute session = about $90 per session (about $72 in the first month).
• Premium: about $120 per week for two sessions = about $60 per session (about $48 in the first month), but only if you actually use both sessions every week.
• Basic: no live sessions, so no per-session figure. You pay for the program, worksheet feedback and messaging.

Premium is only better value per session if you will use both sessions. If you skip one most weeks, Standard costs less for the same contact. Our plan chooser helps you weigh this.

Insurance, receipts, HSA and FSA

• No direct insurance billing. OT does not bill insurers. You pay the full subscription yourself.
• Receipts for out-of-network claims. You can request itemized receipts to submit to your insurer. Reimbursement is not guaranteed. Before signing up, ask your insurer: Do I have out-of-network mental health benefits? Is there a deductible? Do you reimburse subscription-based or messaging-based therapy, or only live sessions?
• HSA and FSA. IRS Publication 502 lists payments to a psychologist and "therapy received as medical treatment" among medical expenses. Whether an online subscription qualifies for your specific account is for your plan administrator or tax adviser to confirm.

Financial aid

Students, veterans and people on low income can apply for financial aid during OT's checkout. OT decides who qualifies and how much the reduction is, so you will not know the amount until you apply. Our financial aid guide explains the steps, what to ask about renewal pricing and what to do if you are not approved.

How this compares with in-person therapy

We have not found a recent, reliable national survey of US self-pay therapy fees that we are comfortable quoting, so we do not give a single "average session price." What we can say:

• Private-practice fees vary widely by location, the therapist's training and whether they offer a sliding scale.
• Insurance changes the math. If you have in-network mental health coverage, your cost may be a copay or coinsurance per session, which could be less than a subscription. Check your plan.
• Ask for a good faith estimate. Under federal rules, if you are not using insurance, a health care provider usually must give you a good faith estimate of expected charges if you ask or schedule at least 3 business days ahead (CMS).
• Community health centers offer care, including referrals to mental health services, with fees based on income (HealthCare.gov). See affordable online therapy options and the lower-cost care guide.

To compare fairly, multiply a provider's session fee by how many sessions you expect per month, then compare that with the subscription total in the table above.

Check plans at Online-Therapy.com (We earn a commission if you subscribe through this link, at no extra cost to you.)