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8 pages

Getting paid

What a session is worth, and who actually pays it.

California
Last checked6 August 2026All updates →
Figures checked, narrative not re-read

The numbers are current. The argument around them has not been reviewed since it was written.

Three decisions sit under everything here. What to charge. Whether to take insurance at all, and if so whether to hold the contracts yourself or let a network hold them for you. And what paperwork you owe the clients who pay you directly, which in California is most of them.

What this section can settle: the arithmetic, and the difference between a published rate and a rumor. Medicare pays a California LMFT 75% of the physician fee schedule, which is $134.47 for a 60-minute session in Los Angeles, and every commercial rate in the state is quoted against that number. What it cannot settle is your own contracted rate, because those are confidential — and no network publishes a California per-session figure, whatever their marketing implies. Where a number is unknowable, these pages say so rather than guessing.

8 pages, in 3 sections: What the work is worth · Getting on a panel, or not · The paperwork. Every figure below is computed or cited, and links to the page that carries it.

Most askedHeadway, Alma, Grow — or my own contracts?How do I get on insurance panels in California?What does insurance actually pay per session?

Key insights

$1.24 a session

All four routes priced at three caseloads, with the crossover

$1.24a session
What you should know about this figure

This figure comes from Headway, Alma, Grow — or my own contracts?, on the 2026 Medicare and Medi-Cal fee schedules and the platforms' own published terms. Your own number will differ — the page shows the working and, where there is a calculator, runs it on your figures.

$41,234 a year

Medicare and Medi-Cal computed, and the truth about commercial rates

$41,234a year
What you should know about this figure

This figure comes from What does insurance actually pay per session?, on the 2026 Medicare and Medi-Cal fee schedules and the platforms' own published terms. Your own number will differ — the page shows the working and, where there is a calculator, runs it on your figures.

$106–132 insurance against $180–350 Bay Area private pay

Panel rates and private-pay ranges by region, and what moves yours

$106–132 insurance against $180–350 Bay Area private pay
What you should know about this figure

This figure comes from What should I be charging?, on the 2026 Medicare and Medi-Cal fee schedules and the platforms' own published terms. Your own number will differ — the page shows the working and, where there is a calculator, runs it on your figures.

What the work is worth

GuideChecked Aug 2026What should I be charging?Panel rates and private-pay ranges by region, and what moves yours$106–132 insurance against $180–350 Bay Area private payGuideChecked Aug 2026What does insurance actually pay per session?Medicare and Medi-Cal computed, and the truth about commercial rates$41,234 a year

Getting on a panel, or not

GuideChecked Aug 2026How do I get on insurance panels in California?The real sequence, the 60-day rule, and which panels are open11.5 hoursGuideChecked Aug 2026Headway, Alma, Grow — or my own contracts?All four routes priced at three caseloads, with the crossover$1.24 a sessionGuideChecked Aug 2026Is Headway worth joining?What Headway keeps, what it will not publish, and who it refuses$0 a month, share kept not publishedAnswerChecked Aug 2026Is Alma worth it for a California therapist?A flat fee instead of a cut, and what it does not tell you$1,140 a yearAnswerChecked Aug 2026Is Grow Therapy worth it for a California therapist?The widest Medi-Cal reach, and a cut it does not publish14 Medi-Cal plans

The paperwork

GuideChecked Aug 2026What paperwork do I owe a private-pay client?The Good Faith Estimate you must give, and a superbill that works$1,656 back

The other four areas

MoneyWhat the practice pays you, and what you can keep.LicensureThe route to LMFT, and how long it really takes.PracticeFilling the week, and running the admin behind it.TrainingCertificates, and what each one actually permits.

Everything on the site → · Every question →

Cite this pageTherapist Support, “Getting paid”, checked 8 August 2026, therapistsupport.org/getting-paid/

Free to reuse with attribution. If you are a program or a professional association linking to a figure, link to the page that carries it rather than copying the number — it will change.