Scheduling, Fees, and Insurance

Karissa Mueller Counseling Office


Standard sessions are 50 minutes and are generally scheduled for the same day/time each week. Extended sessions may be available. I currently see clients on Tuesdays, Wednesdays, and Thursdays in the mornings and afternoons and offer in-person and online sessions.

I meet with clients once a week, or more if desired. My hope (and this is the only agenda I set for my clients) is for you to eventually trust your ability to take care of all parts of yourself. How long this takes can vary quite a bit and may depend on the types of experiences that brought you to therapy in the first place. For some clients, this takes a few months. For others, it’s a few years. Alternatively, some clients like to stay in therapy even when things are going well as a part of their self-care maintenance.


Appointments are $295 per 50-minute session and can be paid with cash, check, or card (including FSA & HSA). Extended sessions are prorated accordingly. 

I believe in keeping my practice relatively small (like – between 10-12 clients a week as opposed to the 20-30 many therapists will see) so you will get really individualized and intentional work with me each time we meet.

A small caseload and higher fees ensure that I’m taking care of myself so I can be my best and most available self when I’m with you. I do this by prioritizing my own individual therapy (yes, the therapist goes to therapy), ongoing training (4-6 weekends a year), and clinical supervision (2+ times a month).

Karissa Mueller Counseling Office


Doing deep, reflective work in therapy requires you to keep what you’re working on top of mind by investing the time to come weekly. It also requires that the person you’re working with (me) be fully engaged in and present for your sessions – which is hard if I’m working in a way that isn’t sustainable long-term or unable to predict my income. To accomplish all these things, your appointments are designated slots in my schedule reserved for you and only you. Your appointments are YOUR time, and therefore, your financial responsibility, whether or not you attend. It’s like purchasing an airline ticket – you are reserving your spot in advance, and are financially responsible for it whether or not you show up for your flight.

However, unlike most airlines, I am happy to reschedule as needed – even last minute, because we all need a little flexibility! Missed sessions can be rescheduled for another time the week of, the week before, or the week after the original session. If we can’t find a mutually available time to reschedule, you are still responsible for the payment of the missed appointment.

Forrrrr example: you wake up the morning of your in-person appointment to find out your childcare plans have fallen through. NBD. We can either meet virtually instead OR you can reschedule for another day that week, or a day the following week. Another scenario: you let me know you’ll be out of town a month from now for a college roommate reunion. Cool. You can reschedule that week’s session for the week before your trip, a different day/time during your trip (it’s not unusual for me to see clients while they’re on vacation!), or for the week after your trip. If we can’t find a time in those three weeks that works for both of us, then you have a great time with your friends, pay the $295 for therapy the week that you miss, and we pick back up the next week.

I generally plan to take about 7 weeks off a year between vacation, sick days, bad-weather days, holidays, etc. I’ll give you as much notice as possible when I need to cancel a session, and you are never charged sessions I cancel.


I am not in network with any insurance companies – and to be honest, while insurance coverage is great for some things, it’s not the best when it comes to covering our sessions, and here’s why:

1) It requires me to diagnose you, and I prefer not to work that way. I don’t consider my client’s problems evidence of an illness or disease to be treated or cured.

2) It allows insurance companies to control how often and for how long we meet – which I’m not a big fan of because they’re not the ones in the room, doing the work together. How are they supposed to know whether or not you needed that extra session or if you’re really ready to be done with therapy?

3) If they’re paying for our sessions, they’re also entitled to details about the content of our sessions. I prefer not to explain to a third party what we’ve been talking about so they can evaluate whether or not it’s valid or if we’re making “progress” fast enough.

4) The reimbursement rates (what your therapist is actually paid) are typically only a portion of what they actually charge. My practice (which is both my passion and my business) could only function on insurance reimbursement rates if I saw…like…30-40 clients per week. That many clients a week just isn’t sustainable in the long term.

Out of Networking Reimbursement: I generally have philosophical complaints about the diagnostic nature of receiving reimbursement from health insurance companies for therapy – and – if seeking out-of-network reimbursement helps to make this service accessible to you, I am happy to provide you with a superbill to submit to your insurance company, provided you fit the criteria for a diagnosis. (We will talk more about this at length if applicable).

I get that paying out of pocket isn’t a fit for everyone though. It wasn’t always for me either, and you’re not totally out of luck if you can’t do it right now. I know plenty of other therapists who work with insurance companies and I’m glad to provide referrals if insurance is a must.

Got more questions? Ask me here.


Under the law, healthcare providers need to give clients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. This is called a Good Faith Estimate. The Good Faith Estimate shows the cost of items and services that are reasonably expected for your healthcare needs and treatment. This Good Faith Estimate does not include unexpected costs that could arise during treatment.

You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service, or at any time during
treatment. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, or how to dispute a bill, visit

Effective January 1, 2022