Specialty therapy that takes your insurance — in Texas, Maine, New Hampshire & Montana
Sagebrush Counseling offers neurodivergent-affirming therapy for OCD, anxiety & phobias, BFRBs, and ADHD & autistic adults — in-network with Aetna, Cigna, Blue Cross Blue Shield, Harvard Pilgrim, Tufts, Carelon, Providence, and more. I can check your benefits before you ever book, and many clients pay only their plan's copay.
Currently accepting new clients
Do you accept my insurance?
Pick your state and plan for an instant answer. Whatever it says, I can check your specific benefits for free and share an estimated cost before you book anything.
Insurance I accept, by state
In-network means your plan pays me directly — you're typically responsible for just your copay or coinsurance rather than the full session fee. Your specific plan sets your specific costs, and I can check yours for free.
| Insurance plan | TX | ME | NH | MT |
|---|---|---|---|---|
| Aetna | ||||
| Cigna billed via Evernorth Behavioral Health | ||||
| Carelon Behavioral Health formerly Beacon Health Options | ||||
| Providence Health Plan | ||||
| Blue Cross Blue Shield of Texas | ||||
| Anthem Blue Cross and Blue Shield | ||||
| Harvard Pilgrim Health Care Point32Health | ||||
| Tufts Health Plan Point32Health | ||||
| Ascension SmartHealth |
What to know about your insurance
Cards are confusing on purpose. Here's the plain-language version — including the alternate names that trip people up.
Aetna
I accept most Aetna commercial and employer-sponsored plans in all four states — Texas, Maine, New Hampshire, and Montana. That includes Aetna's telehealth benefits: online sessions are covered like office visits. I can check your benefits and share an estimated copay before your first session.
Cigna / Evernorth
Cigna's mental health benefits run through Evernorth Behavioral Health. If your card says either name, you're covered — including most employer plans. Many Cigna plans have low or $0 therapy copays.
Blue Cross Blue Shield
BCBS operates regionally: I'm in-network with BCBS of Texas for Texas clients and Anthem Blue Cross and Blue Shield in Maine and New Hampshire.
Have a BCBS plan from another state? Coverage varies by plan — send me a photo of your card and I'll check whether yours is covered.
Harvard Pilgrim & Tufts
I'm in-network with Point32Health, the parent company of both Harvard Pilgrim Health Care and Tufts Health Plan. Either name on your card means in-network coverage in Maine and New Hampshire.
Carelon Behavioral Health
Formerly Beacon Health Options. Carelon rarely appears on the front of a card — it manages mental health benefits behind the scenes for many plans, employers, and EAPs. Check the back of your card near the behavioral health number, or just ask me.
Providence Health Plan
Providence members in all four states — including Montana, where in-network options are thinnest — can see me via telehealth on most commercial plans.
Ascension SmartHealth
If you or a family member work for Ascension and carry the SmartHealth plan, I'm in-network for Texas members — SmartHealth typically has very low out-of-pocket costs for in-network mental health care.
You still have options
1. Your behavioral benefits may secretly route through Carelon or Evernorth — I'll check for free. 2. If your plan includes out-of-network benefits, a superbill may let you claim partial reimbursement — check with your insurance provider. 3. Your employer's EAP may cover free sessions. Ask me.
What therapy actually costs with insurance
The honest answer is "it depends on your plan" — so I can check your benefits for free and share an estimated cost before your first session. Benefit checks are good-faith estimates based on what your insurer reports; your plan determines final costs when claims are processed.
A flat fee per session — commonly $0–$50. Mental health copays are often lower than specialist copays. Insurance covers the rest.
You pay a discounted contracted rate until your deductible is met, then typically 10–30% coinsurance after.
Therapy is a qualified medical expense — HSA and FSA cards work for copays, coinsurance, and private pay.
$200 per 50–55 min session (individual or couples) · $120 30-min check-in. No diagnosis filed with any insurer, and superbills are available.
| In-network insurance | Private pay | |
|---|---|---|
| Per-session cost | Copay or coinsurance — often $0–$50, set by your plan | $200 per 50–55 min · $120 per 30-min check-in |
| Diagnosis on file with insurer | Yes — required for coverage | No |
| Before you start | I can check your benefits free and share an estimated cost | Flat rate — nothing to verify |
| Often chosen for | Lower per-session cost | Privacy, or plans that aren't in-network |
Not using insurance? Under the federal No Surprises Act, you're entitled to a Good Faith Estimate of expected costs before starting care.
Online therapy, wherever you are
Sessions are held by secure, HIPAA-compliant video — one link to click, no downloads, no waiting room. If you're physically in a state where I'm licensed, we can work together.
TX Online therapy in Texas
Austin · Dallas · Houston · Midland · Katy · The Woodlands · McKinney · anywhere in Texas
Licensed Professional Counselor, TX LPC #92348. Texas plans accepted: Aetna, Cigna/Evernorth, Blue Cross Blue Shield of Texas, Carelon, Providence, and Ascension SmartHealth. Texas requires insurers to cover telehealth mental health care, so online sessions bill like office visits. If your card says Evernorth or Beacon, you're still covered — those are Cigna's and Carelon's other names. And if your BCBS plan is from another state, send me your plan info and I'll check whether it's covered.
ME Online therapy in Maine
Portland · Brunswick · Scarborough · Bangor · Kennebunk · anywhere in Maine
Licensed Clinical Professional Counselor, ME LCPC #8561. Maine plans accepted: Aetna, Cigna/Evernorth, Anthem Blue Cross and Blue Shield, Harvard Pilgrim, Tufts, Carelon, and Providence — without the months-long waitlists common across the state. Worth knowing: Anthem is Maine's Blue Cross plan, and either Harvard Pilgrim or Tufts on your card means in-network coverage through Point32Health.
NH Online therapy in New Hampshire
Manchester · Nashua · Concord · Bedford · Hanover · anywhere in New Hampshire
Licensed Clinical Mental Health Counselor, NH LCMHC #5711. New Hampshire plans accepted: Aetna, Cigna/Evernorth, Anthem Blue Cross and Blue Shield, Harvard Pilgrim, Tufts, Carelon, and Providence. Anthem is New Hampshire's Blue Cross plan, and Cigna plans from Massachusetts-based employers — billed through Evernorth — are covered too, with sessions that fit around a Boston commute.
MT Online therapy in Montana
Billings · Bozeman · Kalispell · Missoula · Butte · anywhere in Montana
Licensed Clinical Professional Counselor, MT LCPC #87815. Montana plans accepted: Aetna, Cigna/Evernorth, Carelon, and Providence — especially valuable where the nearest in-network specialist is an hour's drive or more. Your benefits may route through Carelon (formerly Beacon) behind an employer plan or EAP even when the name isn't on your card — I can check. And if your plan isn't listed, superbills are available for possible out-of-network reimbursement; check your benefits with your insurance provider first.
What I help with
Sagebrush Counseling is a structured specialty practice for adults. Every specialty below is treated with a named, evidence-based protocol — and billed to insurance as standard psychotherapy, so specialized care doesn't cost more than regular therapy.
OCD
Intrusive thoughts, checking, confessing, relationship doubt (ROCD), contamination, perfectionism. Treated with Inference-Based CBT and exposure & response prevention — delivered neurodivergent-affirming. OCD therapy →
Anxiety & phobias
Panic & agoraphobia, social anxiety, emetophobia, driving anxiety, misophonia, and ARFID. When your days are built around avoiding the thing, ERP takes it apart step by step. Anxiety therapy → · ARFID → · Depression →
BFRBs
Hair pulling, skin picking, nail and cheek biting. "Just stop" was never the treatment — the ComB model maps what the behavior does for you and builds strategies that fit your sensory system. BFRB therapy →
Neurodivergent adults
Late-identified autism & ADHD, AuDHD, burnout recovery, executive function. Therapy that works with how you're wired, not against it — self-identified clients welcome, no formal diagnosis needed. Neurodivergent adults →
Neurodiverse couples
Communication breakdowns, intimacy & sensory differences, mixed-neurotype relationships — translation, not blame. Also offering ND premarital counseling. Note: not all plans cover couples therapy; ask your insurer about CPT 90847. Neurodiverse couples →
How sessions feel
Solutions-driven and structured: by session three you'll know your plan, its phases, and roughly how long it takes. Most individual work runs 10–30+ weekly sessions, depending on the person and what you're working through. How therapy works here →
How to verify your benefits
The easy way: send me your insurance name and member ID — I can check your mental health benefits and send you an estimated per-session cost. Free, no commitment, response within one business day.
The DIY way: call the member services number on the back of your card and read this script:
"I'd like to check my outpatient behavioral health benefits for telehealth. Is Sagebrush Counseling, PLLC in-network? What's my copay or coinsurance for outpatient psychotherapy via telehealth? Does a deductible apply, and how much have I met?"
Write down the call's reference number — it protects you if anything they quote turns out wrong. For couples therapy, also ask whether CPT code 90847 is covered.
Frequently asked questions
Do you take Aetna insurance for therapy?
Yes. I'm an in-network Aetna therapist in Texas, Maine, New Hampshire, and Montana, including telehealth sessions on most commercial and employer plans.
Do you take Cigna?
Yes — in all four states. Cigna behavioral health claims run through Evernorth; if your card says either name, you're covered.
Do you take Blue Cross Blue Shield?
Yes: BCBS of Texas for Texas clients, and Anthem Blue Cross and Blue Shield for Maine and New Hampshire. Have a BCBS plan from another state? Send me your plan info and I'll check whether it's covered.
Do you take Harvard Pilgrim or Tufts?
Yes. I'm in-network with Point32Health — parent of both Harvard Pilgrim Health Care and Tufts Health Plan — for Maine and New Hampshire clients.
My card says Beacon Health Options. Can I see you?
Very likely yes. Beacon is now Carelon Behavioral Health, and I'm in-network with Carelon in all four states.
Does insurance cover online therapy?
Yes — every plan I accept covers telehealth therapy, generally at the same cost to you as an in-person visit. Texas, Maine, New Hampshire, and Montana all support insurance coverage of telehealth mental health care.
How much will I pay per session?
Many in-network clients pay a copay, often between $0 and $50, or a discounted contracted rate toward an unmet deductible — your specific plan determines your specific cost. I can check your benefits for free and share an estimated cost before your first session. Private pay is $200 for a standard 50–55 minute session (individual or couples) and $120 for a 30-minute check-in.
How many therapy sessions will I need?
It depends on the person and what you're working through — most individual work runs 10–30+ weekly sessions, and couples work typically runs 6–12 months. By session three you'll know your plan, its phases, and a realistic timeline for your specific situation, then step down to shorter check-ins as the work holds. The how-therapy-works page breaks down timelines by specialty.
Do you provide superbills for out-of-network reimbursement?
Yes — superbills are available. If your plan isn't in-network, you pay the private-pay rate ($200 per session) and receive a superbill: an itemized receipt with the codes your insurer needs. Whether and how much your plan reimburses varies — some PPO plans cover a portion of out-of-network care after a deductible, and some plans don't cover it at all. Check with your insurance provider about your out-of-network mental health benefits before booking, so you know what to expect — and feel free to reach out; I'm happy to walk you through what to ask them.
Does insurance cover I-CBT, ERP, and other specialty treatments?
Does insurance cover couples therapy?
Sometimes — not all plans cover couples work. Before scheduling couples therapy, ask your insurance company whether CPT code 90847 (family psychotherapy with patient present) is covered under your plan. I can help you figure out what to ask.
Do you take Medicare or Medicaid?
No — I'm not in-network with Medicare or Medicaid, including Medicare Advantage and managed-Medicaid plans from the companies listed above. If you have Medicare or Medicaid coverage, reach out and I'd be happy to send referrals to help you find a therapist who accepts your plan.
Do I need a referral from my doctor?
Usually not. Most PPO and open-access plans let you book a therapist directly; a small number of HMO plans require a referral — I'll flag it during verification.
Do I need a formal autism or ADHD diagnosis to start?
No — self-identified and questioning clients are welcome, and a formal evaluation is not required to begin therapy. For insurance billing, sessions are covered under a billable clinical diagnosis (such as anxiety or OCD), which we discuss together in your first sessions.
Can I use my HSA or FSA?
Yes. Therapy is a qualified medical expense, so HSA/FSA cards work for copays, coinsurance, and private-pay sessions.
Is there a limit on how many sessions insurance covers?
Under federal mental health parity law, plans generally can't cap medically necessary outpatient therapy more strictly than medical care. In practice, the plans I accept cover ongoing weekly or biweekly therapy for as long as it's medically necessary.
What if I travel between states?
As long as you're physically in Texas, Maine, New Hampshire, or Montana at session time, we can meet. That includes people with two places of residence, students who spend part of the year in one of these states, and travel-heavy or seasonal schedules — you keep the same therapist year-round.
Will therapy show up on my insurance records?
Using insurance requires a diagnosis and dates of service on file with your insurer. There's also an option for private pay ($200 per session) if you'd prefer not to use insurance.
What happens if my insurance changes?
Tell me before your next session and I'll re-verify. Because I'm in-network with most major national plans, a job change often doesn't interrupt care at all.
How quickly can I get an appointment?
Availability changes month to month, so reaching out is the best first step — I respond to every inquiry within one business day. If I'm at capacity when you contact me, I'm happy to send referrals.
How do I know if we're a good fit?
Book a free 15-minute phone consultation — I'll call you at the time you schedule. You can also read more about me and my training first. We'll talk about what's bringing you in, I'll answer your questions, and you'll get a feel for whether it's right. No pressure either way.
More questions? The full FAQ page covers therapy itself — approaches, timelines, and what a first session looks like.
Insurance terms, translated
- In-network
- I have a contract with your insurer. You pay a copay/coinsurance; they pay me the rest directly.
- Out-of-network
- No contract. You pay upfront, then submit a superbill for partial reimbursement (PPO plans).
- Copay
- A flat fee per session — e.g., $25.
- Deductible
- What you pay each year before insurance starts sharing costs.
- Coinsurance
- Your percentage of the cost after the deductible — e.g., 20%.
- Superbill
- An itemized receipt with the diagnosis and billing codes your plan needs for out-of-network reimbursement.
- EAP
- Employer-funded program offering a set number of free sessions — often 3–8 per year.
- Prior authorization
- Rarely needed for outpatient therapy — and if your plan requires it, I handle the paperwork.
How to find a therapist who takes your insurance
Insurance directories are notoriously outdated — full of therapists who've retired, moved, or stopped taking new clients years ago. Here's the process that actually works, anywhere:
Email therapists directly
Skip the directory phone tag. Most therapists will tell you within one message whether they take your plan and have openings — it's the fastest, most accurate first move.
Know your plan and what it covers
Have your plan name and member ID ready, and check the back of your card: behavioral health benefits often run through a different company — like Evernorth or Carelon — than the brand on the front.
Check the therapist's website
Look for an insurance or fees page that lists your plan. Therapists update their own websites, so they're usually far more current than any directory.
In Texas, Maine, New Hampshire, or Montana? You're already on step three.
My plan list is right on this page — and step one works here too. Send me a message with your plan name, and I'll reply within one business day with whether we're in-network and an estimated cost.
Start with step one — message me Or check your plan in 60 seconds ↑Getting started is simple
Reach out
Fill out the contact form — I respond to every inquiry within one business day.
Free consult + benefit check
A 15-minute phone call (I'll call you at the time you schedule). I can check your insurance and share an estimated per-session cost.
First session
We meet on secure video — one link to click, no downloads, no waiting room. Join from anywhere private in TX, ME, NH, or MT.
Your insurance is the easy part. Start here.
Free 15-minute phone consultation. Free benefit check with an estimated cost. No pressure, no commitment — just a clear sense of whether this is the right fit.
Book your free consultation